Physiological adaptation of the growth-restricted fetus.
Best Pract Res Clin Obstet Gynaecol
; 49: 37-52, 2018 May.
Article
em En
| MEDLINE
| ID: mdl-29753694
ABSTRACT
The growth-restricted fetus in utero is exposed to a hostile environment and suffers undernutrition and hypoxia. To cope with the stress, the fetus changes its physiological functions. These adaptive changes aid intrauterine survival; however, they can lead to permanent functional and structural changes that can contribute to the development of serious chronic diseases later in life. Epigenetic mechanisms are an important part of the pathophysiological processes behind this "developmental origin of adult diseases." The dominant cardiovascular adaptive change is the redistribution of blood flow in hypoxic fetuses, with preferential supply of blood to the fetal brain, myocardium, and adrenal glands. The proportion of blood from the umbilical vein to the ductus venosus and foramen ovale increases, which increases the cardiac output of the left heart ventricle. The increased perfusion of fetal brain can be followed with Doppler ultrasound as increased diastolic velocities and decreased pulsatility index in the middle cerebral artery.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artérias Umbilicais
/
Adaptação Fisiológica
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Hipóxia Fetal
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Retardo do Crescimento Fetal
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Coração Fetal
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Feto
Tipo de estudo:
Diagnostic_studies
Limite:
Animals
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Female
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Humans
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Pregnancy
Idioma:
En
Revista:
Best Pract Res Clin Obstet Gynaecol
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2018
Tipo de documento:
Article