Adaptive changes in the splenic artery and left portal vein in fetal growth restriction.
OBJECTIVE
The purpose of this study was to determine whether a low splenic artery pulsatility index (PI) and reduced flow through the left portal vein are involved in redistribution of fetal growth restriction.


METHODS
Forty-two women with prenatally diagnosed intrauterine growth restriction of singleton fetuses were included. The next pregnant woman with an appropriately growing fetus, matched for gestational age, was selected as a control. Blood flow velocities were measured in the splenic artery and left portal vein. Obstetric and perinatal information was obtained from standardized medical records.


RESULTS
The blood flow through the left portal vein was significantly reduced compared with the controls (P < .0001). Placental impairment in fetal growth restriction was clearly linked to a decreased splenic artery PI (P = .0004). In growth-restricted fetuses with reduced left portal vein flow and a splenic artery PI below the 5th percentile, perinatal mortality, a low 5-minute Apgar score, and neonatal metabolic acidosis were observed significantly more often (P = .04, .01, and .004; P = .03, .03, and .006, respectively).


CONCLUSIONS
Reduced blood flow through the left portal vein and low resistance in the splenic artery can be found in growth-restricted fetuses with adverse neonatal outcomes.
Department of Obstetrics and Gynecology, Riga Stradins University, 16 Dzirciema St, LV1013 Riga, Latvia. natalyved@apollo.lv
Natalija
N
Vedmedovska
Dace
D
Rezeberga
Uldis
U
Teibe
Jana
J
Zodzika
Gilbert G G
GG
Donders
D000328:Adult; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011673:Pulsatile Flow; D013157:Splenic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016216:Ultrasonography, Prenatal / Q000379:methods*