TY - JOUR
T1 - Vascular changes in fetal growth restriction
T2 - clinical relevance and future therapeutics
AU - Sehgal, Arvind
AU - Murthi, Padma
AU - Dahlstrom, Jane E.
N1 - Publisher Copyright:
© 2018, Springer Nature America, Inc.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Fetal growth restriction (FGR) affects about 5–10% pregnancies and is associated with poorer outcomes in the perinatal period. Additionally, long standing epidemiological data support its association with chronic diseases such as hypertension and diabetes. Cardiac and vascular adaptations in response to chronic hypoxemia due to utero-placental insufficiency are hallmarks of fetal adaptations. Investigators have attempted to identify these changes in the placenta at the microscopic and molecular level. The ex vivo dual perfusion model of the placenta enables the study of placental haemodynamics in growth-restricted pregnancies. Persistent arterial abnormalities (thickness and stiffness) noted on vascular ultrasound during fetal life through to the young-adult age group for those affected by FGR, seem to be a plausible link between in utero events and chronic circulatory diseases. Using these, this review reflects current thought on vascular maladaptive changes in the FGR cohorts and the role in investigating current and future therapeutics.
AB - Fetal growth restriction (FGR) affects about 5–10% pregnancies and is associated with poorer outcomes in the perinatal period. Additionally, long standing epidemiological data support its association with chronic diseases such as hypertension and diabetes. Cardiac and vascular adaptations in response to chronic hypoxemia due to utero-placental insufficiency are hallmarks of fetal adaptations. Investigators have attempted to identify these changes in the placenta at the microscopic and molecular level. The ex vivo dual perfusion model of the placenta enables the study of placental haemodynamics in growth-restricted pregnancies. Persistent arterial abnormalities (thickness and stiffness) noted on vascular ultrasound during fetal life through to the young-adult age group for those affected by FGR, seem to be a plausible link between in utero events and chronic circulatory diseases. Using these, this review reflects current thought on vascular maladaptive changes in the FGR cohorts and the role in investigating current and future therapeutics.
UR - http://www.scopus.com/inward/record.url?scp=85058005506&partnerID=8YFLogxK
U2 - 10.1038/s41372-018-0287-4
DO - 10.1038/s41372-018-0287-4
M3 - Review article
SN - 0743-8346
VL - 39
SP - 366
EP - 374
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 3
ER -