Discordant blood flow velocity waveforms in left and right brachial arteries in growth-retarded fetuses

Sepulveda, Waldo, Bower, Sarah, Nicolaidis, Peter, Deswiet, Michael and Fisk, Nicholas M. (1995) Discordant blood flow velocity waveforms in left and right brachial arteries in growth-retarded fetuses. Obstetrics and Gynecology, 86 5: 734-738. doi:10.1016/0029-7844(95)00253-N


Author Sepulveda, Waldo
Bower, Sarah
Nicolaidis, Peter
Deswiet, Michael
Fisk, Nicholas M.
Title Discordant blood flow velocity waveforms in left and right brachial arteries in growth-retarded fetuses
Journal name Obstetrics and Gynecology   Check publisher's open access policy
ISSN 0029-7844
1873-233X
Publication date 1995-11
Sub-type Article (original research)
DOI 10.1016/0029-7844(95)00253-N
Volume 86
Issue 5
Start page 734
End page 738
Total pages 5
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
Objective:
To determine if the increase in cerebral blood flow ('brain- sparing' effect) with fetal hypoxemia is associated with discordant hemodynamics in the upper extremities.

Methods:

We studied 12 fetuses with severe growth retardation, absent or reverse end-diastolic blood flow in the umbilical artery, and low pulsatility index (PI) in the middle cerebral artery, and 12 appropriately grown control fetuses with normal fetoplacental Doppler studies. The right and left brachial arteries were identified by high-resolution color Doppler ultrasonography, and the PI was measured in each brachial artery.

Results:
All growth-retarded fetuses had lower impedance indices in the right than in the left brachial artery (mean ΔPI 1.0, 95% confidence interval [CI] 0.7-1.3, P < .001). No differences in the brachial artery impedance indices were found in control fetuses matched for gestational age (mean ΔPI 0.0, 95% CI -0.2 to 0.2).

Conclusions:
Left and right brachial artery blood flow velocity waveforms are discordant in fetuses with growth retardation and cerebral vasodilation. Because the right arm receives its blood supply from the same source as the brain (brachiocephalic artery) and given the proximity of the left subclavian artery to the ductus arteriosus, we speculate that this might be the result of increased blood flow into the brachiocephalic circulation and/or functional differences in the distribution of left and right ventricular output within the aortic arch in response to fetal hypoxemia.
Keyword Wave-forms
Doppler ultrasound
Fetal weight
Circulation
Circumference
Retardation
Hypoxemia
Index
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Faculty of Health and Behavioural Sciences -- Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 9 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 11 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Mon, 24 Oct 2011, 17:54:08 EST by System User on behalf of Faculty Of Health Sciences