Maternal hyperoxygenation in congenital heart disease

Published on Aug 1, 2021in Translational pediatrics2.488
· DOI :10.21037/TP-20-226
Fu-Tsuen Lee1
Estimated H-index: 1
Davide Marini9
Estimated H-index: 9
+ 1 AuthorsLiqun Sun7
Estimated H-index: 7
#1Davide Marini (U of T: University of Toronto)H-Index: 9
#2Joshua F.P. van Amerom (U of T: University of Toronto)H-Index: 11
Last. Mike Seed (U of T: University of Toronto)H-Index: 25
view all 5 authors...
: In the last decade, technological advances have enabled the acquisition of high spatial and temporal resolution cardiac magnetic resonance imaging (MRI) in the fetus. Fetal cardiac MRI has emerged as an alternative to ultrasound, which may be helpful to confirm a diagnosis of congenital heart disease when ultrasound assessment is hampered, for example in late gestation or in the setting of oligohydramnios. MRI also provides unique physiologic information, including vessel blood flow, oxygen sa...
#1Abraham M. Rudolph (UCSF: University of California, San Francisco)H-Index: 80
Congenital hypoplasia of left heart structures in fetuses frequently progresses with gestational development. Interference with cerebral development is common in these fetuses. Chronic maternal hyperoxygenation (MHO) has been recommended to increase left ventricular size and to limit cerebral damage. The effects of MHO on cerebral blood flow and metabolism have been studied in normal fetuses and fetuses with left heart hypoplasia. Maternal hyperoxygenation increases fetal pulmonary blood flow. T...
#1Liqun SunH-Index: 7
#2Davide MariniH-Index: 9
Last. Mike SeedH-Index: 25
view all 6 authors...
Human fetal circulatory physiology has been investigated extensively using grey-scale ultrasound, which provides excellent visualization of cardiac anatomy and function, while velocity profiles in the heart and vessels can be interrogated using Doppler. Measures of cerebral and placental vascular resistance, as well as indirect measures of intracardiac pressure obtained from the velocity waveform in the ductus venosus are routinely used to guide the management of fetal cardiovascular and placent...
#1Wonsang YouH-Index: 7
#2Nickie AndescavageH-Index: 14
Last. Catherine LimperopoulosH-Index: 35
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Short-term maternal hyperoxia increased placental oxygenation at blood oxygen level−dependent MRI in both normal pregnancies and those complicated by congenital heart disease and increased fetal ce...
#1Rabia JavedH-Index: 1
#2Frank CettaH-Index: 46
Last. Muhammad Yasir QureshiH-Index: 12
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Hypoplastic left heart syndrome is one of the most complex congenital heart diseases and requires several cardiac surgeries for survival. The diagnosis is usually established prenatally or shortly after birth. Each stage of surgery poses a unique hemodynamic situation that requires deeper understanding to manage common pediatric problems such as dehydration and respiratory infections. Careful multidisciplinary involvement in the care of these complex patients is improving their outcome; however,...
#2Nadieh Khalili (UU: Utrecht University)H-Index: 5
Last. M J N L BendersH-Index: 15
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BACKGROUND AND PURPOSE: Fetuses and neonates with critical congenital heart disease are at risk of delayed brain development and neurodevelopmental impairments. Our aim was to investigate the association between fetal and neonatal brain volumes and neonatal brain injury in a longitudinally scanned cohort with an antenatal diagnosis of critical congenital heart disease and to relate fetal and neonatal brain volumes to postmenstrual age and type of congenital heart disease. MATERIALS AND METHODS: ...
#1Eric M. SchraubenH-Index: 11
#2Brahmdeep S. Saini (U of T: University of Toronto)H-Index: 7
Last. Christopher K. Macgowan (U of T: University of Toronto)H-Index: 25
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Background To date it has not been possible to obtain a comprehensive 3D assessment of fetal hemodynamics because of the technical challenges inherent in imaging small cardiac structures, movement of the fetus during data acquisition, and the difficulty of fusing data from multiple cardiac cycles when a cardiac gating signal is absent. Here we propose the combination of volumetric velocity-sensitive cardiovascular magnetic resonance imaging (“4D flow” CMR) and a specialized animal preparation (c...
#1Lindsay A. EdwardsH-Index: 2
#2Diego A. LaraH-Index: 5
Last. Shaine A. MorrisH-Index: 21
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INTRODUCTION: In a pilot study of chronic maternal hyperoxygenation (CMH) in left heart hypoplasia (LHH), we sought to determine effect estimates of CMH on head size, vascular resistance indices, and neurodevelopment compared to controls. MATERIAL AND METHODS: Nine gravidae meeting the inclusion criteria (fetal LHH, ≥25.9 weeks' gestation, and ≥10% increase in percent aortic flow after acute hyperoxygenation) were prospectively enrolled. Controls were 9 contemporary gravidae with fetal LHH witho...
Aim: To assess the impact of perioperative neonatal brain injury and brain volumes on neurodevelopment throughout school-age children with critical congenital heart disease (CHD). Method: Thirty-four survivors of neonatal cardiac surgery (seven females, 27 males) were included. Neonatal preoperative and postoperative cerebral magnetic resonance imaging was performed and neurodevelopment was assessed at 24 months (SD 0.7, n=32, using Bayley Score of Infant and Toddler Development, Child Behavior ...
#1Anita Szwast (Children's Hospital of Philadelphia)H-Index: 20
#2Mary E. Putt (UPenn: University of Pennsylvania)H-Index: 51
Last. Jack Rychik (Children's Hospital of Philadelphia)H-Index: 73
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Objectives Compared to normal fetuses, HLHS fetuses have smaller brain volumes and more brain injury, possibly due to diminished cerebral blood flow and oxygen content. By increasing cerebral oxygen delivery, maternal hyperoxygenation (MH) might improve brain development and reduce brain injury in these fetuses. This study investigates whether gestational age (GA) and baseline cerebrovascular resistance impact response to MH in HLHS fetuses. Methods The middle cerebral artery (MCA) pulsatility i...
Cited By2
#1Antonio F. CornoH-Index: 8
#2Damien J. LaPar (University of Texas at Austin)
Last. Jorge D. Salazar (University of Texas at Austin)
view all 4 authors...
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