Macklon, Nicholas S., Laudy, Jacqueline A. M., Mulder, Paul G. H. and Wladimiroff, Juriy W.
Behavior-state-dependent changes in human fetal pulmonary blood flow velocity waveforms
Obstetrics and Gynecology, 93, (2), . (PMID:9932552).
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Objective: To establish the influence of fetal behavior states
on venous and arterial pulmonary blood flow velocity waveforms
in the normally developing term fetus.
Methods: The relation between venous and arterial pulmonary
blood flow velocity waveforms and fetal behavior
states was investigated in 18 normal term fetuses. Recordings
of the venous pulmonary blood flow velocity waveforms
were obtained just proximal to the entrance in the left
atrium, and the arterial pulmonary blood flow velocity
waveforms were taken from the most proximal branch of the
pulmonary artery in the same lung using color Doppler
imaging. Time-averaged peak systolic, peak diastolic, and
end-diastolic flow velocity; peak systolic to peak diastolic
ratio; pulsatility index; and fetal heart rate were calculated
from both venous and arterial Doppler recordings obtained
during behavior states 1F (quiet sleep) and 2F (active sleep).
Fetal behavior states were determined from combined recordings
of fetal eye and body movements.
Results: Recordings of sufficient quality for analysis were
obtained from ten fetuses. Venous pulmonary blood flow
velocity waveforms demonstrated a statistically significant
increase in time-averaged peak diastolic and end-diastolic
velocity during fetal behavior state 2F. No behavior-staterelated
changes were observed for the arterial pulmonary
blood flow velocity waveform.
Conclusion: The data suggest an increased pressure gradient
between the pulmonary venous system and the left
atrium during behavior state 2F. Flow velocity waveforms
from the proximal arterial pulmonary branch are independent
of behavioral state.
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