Adaptive changes in the splenic artery and left portal vein in fetal growth restriction

Natalija Vedmedovska, Dace Rezeberga, Uldis Teibe, Jana Zodzika, Gilbert G.G. Donders

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The purpose of this study was to determine whether a low splenic artery pulsatility index (PI) and reduced flow through the left portal vein are involved in redistribution of fetal growth restriction. Methods: Forty-two women with prenatally diagnosed intrauterine growth restriction of singleton fetuses were included. The next pregnant woman with an appropriately growing fetus, matched for gestational age, was selected as a control. Blood flow velocities were measured in the splenic artery and left portal vein. Obstetric and perinatal information was obtained from standardized medical records. Results: The blood flow through the left portal vein was significantly reduced compared with the controls (P <.0001). Placental impairment in fetal growth restriction was clearly linked to a decreased splenic artery PI (P =.0004). In growth-restricted fetuses with reduced left portal vein flow and a splenic artery PI below the 5th percentile, perinatal mortality, a low 5-minute Apgar score, and neonatal metabolic acidosis were observed significantly more often (P =.04,.01, and.004; P =.03,.03, and.006, respectively). Conclusions: Reduced blood flow through the left portal vein and low resistance in the splenic artery can be found in growth-restricted fetuses with adverse neonatal outcomes.

Original languageEnglish
Pages (from-to)223-229
Number of pages7
JournalJournal of Ultrasound in Medicine
Volume31
Issue number2
DOIs
Publication statusPublished - 1 Feb 2012

Keywords

  • Doppler velocity
  • Intrauterine growth restriction
  • Left portal vein
  • Splenic artery

Field of Science

  • 3.2 Clinical medicine
  • 3.3 Health sciences

Publication Type

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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