Cerebral hemodynamic response to short-term maternal hyperoxygenation in fetuses with borderline small left hearts
Abstract Background Hypoxia delays brain maturation and contributes to neurodevelopmental morbidity in fetuses with congenital heart defects (CHDs). Maternal hyperoxygenation (MH) can, in theory, promote oxygen/nutrient delivery to the fetal brain, owing to an improved heart structure/function and i...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-07-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-020-03103-7 |
| _version_ | 1828274187903434752 |
|---|---|
| author | Shi Zeng Jiawei Zhou Qinghai Peng Wen Deng Qichang Zhou |
| author_facet | Shi Zeng Jiawei Zhou Qinghai Peng Wen Deng Qichang Zhou |
| author_sort | Shi Zeng |
| collection | DOAJ |
| description | Abstract Background Hypoxia delays brain maturation and contributes to neurodevelopmental morbidity in fetuses with congenital heart defects (CHDs). Maternal hyperoxygenation (MH) can, in theory, promote oxygen/nutrient delivery to the fetal brain, owing to an improved heart structure/function and increased fetal oxygen content. We aimed to determine whether MH alters fetal cerebral hemodynamics in fetuses with CHD. Methods Twenty-eight fetuses with borderline small left hearts and 28 age-matched normal fetuses were enrolled and subdivided by gestational age (GA): 23+ 0 ~ 27+ 6 weeks and 28+ 0 ~ 36+ 6 weeks. The middle cerebral artery pulsatility index (MCA-PI), vascular index (VI), flow index (FI) and vascular/flow index (VFI) were measured with baseline room air, after 10 min of MH and after 10 min of recovery for all subjects. Results MCA-PI, VI, FI and VFI did not differ with MH in the normal fetuses. In fetuses with borderline small left hearts, MCA-PI increased and VI, FI and VFI significantly decreased during the 3rd trimester (from 1.44 ± 0.27, 3.19 ± 0.87, 56.91 ± 9.19, and 1.30 ± 0.33 at baseline to 1.62 ± 0.15, 2.37 ± 0.37, 45.73 ± 4.59, and 0.94 ± 0.15 during MH, respectively, P < 0.05), but this response was not apparent during mid-gestation (p > 0.05). These parameters returned to the baseline levels during the recovery phase. The change in cerebral perfusion depended on the baseline MCA-PI and increased the combined cardiac index (CCOi). Conclusions MH alters the cerebral hemodynamics of fetuses with borderline small left hearts during the third trimester. Further investigation is needed to determine whether MH may benefit brain growth and neurodevelopment in this high-risk population. |
| first_indexed | 2024-04-13T06:31:59Z |
| format | Article |
| id | doaj.art-7a46947de971465d90efff24e31d76e0 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-13T06:31:59Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-7a46947de971465d90efff24e31d76e02022-12-22T02:58:07ZengBMCBMC Pregnancy and Childbirth1471-23932020-07-012011910.1186/s12884-020-03103-7Cerebral hemodynamic response to short-term maternal hyperoxygenation in fetuses with borderline small left heartsShi Zeng0Jiawei Zhou1Qinghai Peng2Wen Deng3Qichang Zhou4Department of Ultrasonography, The Second Xiangya Hospital, Central South UniversityDepartment of Ultrasonography, The Second Xiangya Hospital, Central South UniversityDepartment of Ultrasonography, The Second Xiangya Hospital, Central South UniversityDepartment of Genecology & Obstetrics, The Second Xiangya Hospital, Central South UniversityDepartment of Ultrasonography, The Second Xiangya Hospital, Central South UniversityAbstract Background Hypoxia delays brain maturation and contributes to neurodevelopmental morbidity in fetuses with congenital heart defects (CHDs). Maternal hyperoxygenation (MH) can, in theory, promote oxygen/nutrient delivery to the fetal brain, owing to an improved heart structure/function and increased fetal oxygen content. We aimed to determine whether MH alters fetal cerebral hemodynamics in fetuses with CHD. Methods Twenty-eight fetuses with borderline small left hearts and 28 age-matched normal fetuses were enrolled and subdivided by gestational age (GA): 23+ 0 ~ 27+ 6 weeks and 28+ 0 ~ 36+ 6 weeks. The middle cerebral artery pulsatility index (MCA-PI), vascular index (VI), flow index (FI) and vascular/flow index (VFI) were measured with baseline room air, after 10 min of MH and after 10 min of recovery for all subjects. Results MCA-PI, VI, FI and VFI did not differ with MH in the normal fetuses. In fetuses with borderline small left hearts, MCA-PI increased and VI, FI and VFI significantly decreased during the 3rd trimester (from 1.44 ± 0.27, 3.19 ± 0.87, 56.91 ± 9.19, and 1.30 ± 0.33 at baseline to 1.62 ± 0.15, 2.37 ± 0.37, 45.73 ± 4.59, and 0.94 ± 0.15 during MH, respectively, P < 0.05), but this response was not apparent during mid-gestation (p > 0.05). These parameters returned to the baseline levels during the recovery phase. The change in cerebral perfusion depended on the baseline MCA-PI and increased the combined cardiac index (CCOi). Conclusions MH alters the cerebral hemodynamics of fetuses with borderline small left hearts during the third trimester. Further investigation is needed to determine whether MH may benefit brain growth and neurodevelopment in this high-risk population.http://link.springer.com/article/10.1186/s12884-020-03103-7CerebralPerfusionHemodynamicMaternal hyperoxygenationCongenital heart defects |
| spellingShingle | Shi Zeng Jiawei Zhou Qinghai Peng Wen Deng Qichang Zhou Cerebral hemodynamic response to short-term maternal hyperoxygenation in fetuses with borderline small left hearts BMC Pregnancy and Childbirth Cerebral Perfusion Hemodynamic Maternal hyperoxygenation Congenital heart defects |
| title | Cerebral hemodynamic response to short-term maternal hyperoxygenation in fetuses with borderline small left hearts |
| title_full | Cerebral hemodynamic response to short-term maternal hyperoxygenation in fetuses with borderline small left hearts |
| title_fullStr | Cerebral hemodynamic response to short-term maternal hyperoxygenation in fetuses with borderline small left hearts |
| title_full_unstemmed | Cerebral hemodynamic response to short-term maternal hyperoxygenation in fetuses with borderline small left hearts |
| title_short | Cerebral hemodynamic response to short-term maternal hyperoxygenation in fetuses with borderline small left hearts |
| title_sort | cerebral hemodynamic response to short term maternal hyperoxygenation in fetuses with borderline small left hearts |
| topic | Cerebral Perfusion Hemodynamic Maternal hyperoxygenation Congenital heart defects |
| url | http://link.springer.com/article/10.1186/s12884-020-03103-7 |
| work_keys_str_mv | AT shizeng cerebralhemodynamicresponsetoshorttermmaternalhyperoxygenationinfetuseswithborderlinesmalllefthearts AT jiaweizhou cerebralhemodynamicresponsetoshorttermmaternalhyperoxygenationinfetuseswithborderlinesmalllefthearts AT qinghaipeng cerebralhemodynamicresponsetoshorttermmaternalhyperoxygenationinfetuseswithborderlinesmalllefthearts AT wendeng cerebralhemodynamicresponsetoshorttermmaternalhyperoxygenationinfetuseswithborderlinesmalllefthearts AT qichangzhou cerebralhemodynamicresponsetoshorttermmaternalhyperoxygenationinfetuseswithborderlinesmalllefthearts |