Review Article | Published:

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

Journal of Perinatologyvolume 39pages366374 (2019) | Download Citation

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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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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The authors declare that they have no conflict of interest.

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Correspondence to Arvind Sehgal.

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https://doi.org/10.1038/s41372-018-0287-4