Kessler, Jörg, Rasmussen, Svein, Godfrey, Keith M., Hanson, Mark A. and Kiserud, Torvid
Venous liver blood flow and regulation of human fetal growth: evidence from macrosomic fetuses
American Journal of Obstetrics and Gynecology, 204, (5), . (doi:10.1016/j.ajog.2010.12.038). (PMID:21354546).
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OBJECTIVE: Experimental studies show that fetal liver venous perfusion
is a determinant for growth in utero. Here we explore the relationship
between fetal venous blood flow to the liver and macrosomia.
STUDY DESIGN: From diameter and blood flow velocity measurements,
we derived liver venous blood flow in a longitudinal ultrasound
study of 25 macrosomic fetuses of nondiabetic mothers during the second
half of pregnancy.
RESULTS: Compared with appropriately growing fetuses, macrosomic
fetuses directed more umbilical blood to the liver tissue, with correspondingly
less contribution from the portal circulation when normalized
for fetal weight. Whereas total venous liver blood flow showed no
late gestation rise in the reference population, it continued to increase in
macrosomic fetuses and was accompanied by greater fetal weight.
CONCLUSION: The direct relationship between venous liver blood flow
and macrosomia in the fetus supports the concept that intrauterine
growth is linked to the amount and distributional pattern of venous liver
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