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2018-01-04

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cc-by-nc-nd (c) International Federation of Placenta Associations , 2018
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/123435

Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis.

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https://doi.org/10.1016/j.placenta.2017.12.020

Abstract

AIMS: Myocardial structural and functional abnormalities are known to occur in fetuses of mothers with diabetes mellitus (FMDM). The main aim of this investigation was to explore the cardiovascular circulatory patterns in FMDM using a validated lumped computational model of the cardiovascular system. METHODS: This was a multi-institutional study involving FMDM compared to fetuses of maternal controls (FC). Fetal echocardiographic Doppler data from left and right ventricular outflow tracts, aortic isthmus, middle cerebral and umbilical arteries were fitted into a validated fetal circulation computational model to estimate patient-specific placental and vascular properties. Non-parametric comparisons were made between resistances, compliances and flows in the brain and placenta in FMDM and FC. RESULTS: Data from 23 FMDM and 31 FC were fitted into the model. In FMDM, compared to FC, placental relative resistance was lower (0.59 ± 0.50 versus 0.91 ± 0.41; p < .05) with higher brain relative resistance (2.36 ± 1.65 versus 1.60 ± 0.85; p < .05). Middle cerebral artery flow was lower in FMDM than FC (0.12 ± 0.14 vs. 0.27 ± 0.21 ml/min; p 0.04) with a lower cerebral-placental flow ratio. Combined stroke volume was lower in FMDM (3.65 ± 2.05 ml) than FC (4.97 ± 2.45 ml) (p 0.04). CONCLUSIONS: Blood flow is redistributed in FMDM to the placenta, away from the brain. This alteration may play a role in the postnatal health of these fetuses.

Subject

Sistema cardiovascular, Ecografia Doppler, Diabetis en l'embaràs, Complicacions en l'embaràs, Neonatologia

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Cardiovascular system, Doppler ultrasonography, Diabetes in pregnancy, Complications of pregnancy, Neonatology

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Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
Articles publicats en revistes (BCNatal Fetal Medicine Research Center)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Publicacions de projectes de recerca finançats per la UE

Citation

KULKARNI, Aparna, et al. Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis. Placenta. 2018. Vol. 63, num. 1-6. ISSN 0143-4004. [consulted: 18 of August of 2026]. Available at: https://hdl.handle.net/2445/123435

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