To investigate hemodynamic parameters in 2 anatomical segments (S1 and S2) of anterior cerebral artery (ACA) in normal pregnancy during the second and third trimester of gestation.
 Methods: The peak systolic velocity (PSV), end diastolic velocity (EDV), time-average maximum velocity (TAMAXV), peak systolic velocity/end diastolic velocity (S/D), resistance index (RI), and pulsation index (PI) in S1 and S2 of fetal anterior cerebral artery (ACA) in 288 normal pregnant women were detected by power Doppler and pulsed Doppler. Multiple regression models were fitted to estimate the relation between Doppler variables and gestational age. The differences of hemodynamic parameters between ACAS1 and ACAS2 were compared.
 Results: The PSV, EDV, and TAMAXV of ACAS1 and ACAS2 were positively correlated with the weeks of pregnancy (P<0.001), all fitted with the cubic curve. The S/D, PI, and RI values of ACAS1 and ACAS2 were not correlated with gestational ages (P>0.05). The PSV, TAMAXV, S/D, PI, and RI of ACAS1 were significantly higher than those of ACAS2, while EDV in ACAS1 was lower than that in ACAS2 (P<0.05).
 Conclusion: The velocity parameters (PSV, EDV, TAMAXV) of the 2 anatomical segments (ACAS1 and ACAS2) are increased with the increase of gestational age in normal pregnant fetus during the second and third trimester of gestation, and the resistance parameters (S/D, PI, RI) are not significantly correlated with gestational age. Distribution of blood flow is different in the blood supply territory between ACAS1 and ACAS2.
Anterior Cerebral Artery ; physiology ; Blood Flow Velocity ; Female ; Fetus ; blood supply ; Hemodynamics ; Humans ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography, Prenatal

BACKGROUNDThe prevalence reported of maternal depression from the first to the third trimester was 7.4%, 12.8%, 12.0% respectively, which implies that around one-tenth of pregnant women suffer from psychological disorder during the whole pregnancy. It is assumed that during pregnancy the maternal-fetal circulation unit is also affected by maternal psychological status. The aim of this study is to explore the association between maternal psychological status and fetal dynamic blood flow circulation during pregnancy.

METHODSWe recruited 102 singleton low risk pregnant women between 30 to 33 gestational weeks. The Symptom Checklist-90 (SCL-90) was used to assess maternal psychological status. Ultrasound Doppler was used to measure blood flow changes in maternal-fetal circulation. Pulsatility index (PI) value was measured in umbilical artery (UA), fetal middle cerebral artery (MCA) and maternal uterine arteries (UTA). Peak systolic velocity (PSV) was measured in MCA and velocity was measured in umbilical vein (UV). Statistical analysis was performed with standard nonparametric Mann-Whitney U tests. Two-tailed P values <0.05 were considered statistical significance.

RESULTSOf the 102 pregnant women, 12 patients show high levels of poor mental health. Women with poor mental health have higher umbilical artery PI values than good mental health patients (P = 0.020). A higher MCA PI value is found in poor mental health patients but this does not reach statistical significance (P = 0.053). Women with hostility show lower placental scores (P = 0.030). Women with somatization demonstrate higher values in UA PI, MCA PI and MCA PSV (P = 0.049, 0.030 and 0.035 respectively). A higher MCA PSV value is also found in phobic anxiety patients (P = 0.046).

CONCLUSIONSPoor mental health during pregnancy is found to have an adverse effect on maternal-fetal circulation. Umbilical artery and fetal cerebral circulation are more sensitive and affected by maternal psychological disorder.

Adult ; Blood Flow Velocity ; physiology ; Female ; Fetus ; blood supply ; physiology ; Gestational Age ; Hemodynamics ; physiology ; Humans ; Pregnancy ; Pregnancy Trimester, Third ; Stress, Psychological ; physiopathology

The fetus is an unstable subject for an isolated physiological and biochemical study. To study the fetus in a controlled and stable environment, a trial was done using 12 goat fetuses. Extrauterine incubation system was devised using an extracorporeal membrane oxygenation system. The system consisted of a venous reservoir with a servo-controlled roller pump and a membrane oxygenator. The extra-corporeal circuit and membrane oxygenator were primed with the maternal whole blood of 200 mL. Fetal umbilical cords was exposed by Cesarean section. Fetal umbilical arterial blood was drained via the drainage cannula. The drained blood was perfused to the oxygenator by the roller pump. The highly oxygenated and decarboxylated blood was returned to an umbilical vein via the perfusion catheter. The blood flow rate was controlled manually using a roller pump. Fetal heart rate, blood pressure, and electrocardiogram were continuously recorded. Gas analysis of drained and perfused bood was performed hourly. With this system, the fetuses were able to survive under fairly stable physiological condition for periods of up to 34 hr. The extrauterine incubation system used in this study could therefore be a encouraging future experimental model in researching the artificial placenta for premature fetuses.
Animals ; Extracorporeal Membrane Oxygenation/adverse effects/*methods ; Female ; Fetal Blood/metabolism ; Fetus/*blood supply/*physiology ; Goats ; Humans ; Infant, Newborn ; Infant, Premature ; Models, Animal ; Pregnancy ; Time Factors ; Umbilical Arteries ; Umbilical Veins