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Vascular changes in fetal growth restriction: clinical relevance and future therapeutics

Journal of Perinatology volume 39, pages 366–374 (2019)Cite this article

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Abstract

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.

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Authors and Affiliations

  1. Monash Newborn, Monash Children’s Hospital, Monash University, Melbourne, Australia

    Arvind Sehgal

  2. Department of Pediatrics, Monash University, Melbourne, Australia

    Arvind Sehgal

  3. Department of Maternal Fetal Medicine, Pregnancy Research Centre, Royal Women’s Hospital and Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC, Australia

    Padma Murthi

  4. Department of Physiology, Monash University and The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia

    Padma Murthi

  5. Anatomical Pathology, ACT Pathology, The Canberra Hospital and the Australian National University Medical School, College of Health and Medicine, Canberra, ACT, Australia

    Jane E. Dahlstrom

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Sehgal, A., Murthi, P. & Dahlstrom, J.E. Vascular changes in fetal growth restriction: clinical relevance and future therapeutics. J Perinatol 39, 366–374 (2019). https://doi.org/10.1038/s41372-018-0287-4

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