The Cardiac-Fetal-Placental Unit: links between umbilical venous flow and maternal hemodynamics in fetal growth restriction

IF 5.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2026-07-01 Epub Date: 2026-06-27 DOI:10.1016/j.bpobgyn.2026.102745

Daniele Farsetti, Francesca Pometti, Gian Paolo Novelli, Barbara Vasapollo, Herbert Valensise

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引用次数: 0

Abstract

Fetal growth restriction (FGR) is associated with significant perinatal morbidity and mortality, yet its identification remains challenging due to the limited sensitivity of conventional biometric assessment and the lack of a reliable tool for assessing placental function. Placental function depends on uteroplacental perfusion which, in turn reflects maternal cardiovascular adaptation to pregnancy. In this context, umbilical venous flow (UVF) has emerged as a quantitative parameter reflecting fetal blood supply and a potential surrogate marker of placental function.

This narrative review aims to provide an overview of UVF and maternal hemodynamics, and to explore their interaction within the framework of the cardiac–fetal–placental unit.

The current literature indicates that UVF is reduced in pregnancies complicated by FGR, and it correlates significantly with maternal cardiac output (CO) and systemic vascular resistance (SVR). A hypodynamic maternal profile (high SVR, low CO) is consistently associated with reduced UVF and impaired placental perfusion, regardless of fetal biometry.

The integration of maternal cardiovascular assessment and UVF evaluation provides a functional perspective on placental insufficiency and may improve the identification of pregnancies at risk. Furthermore, this approach offers a potential framework for understanding the effects of maternal hemodynamic interventions on fetal growth.

查看原文本刊更多论文

心-胎-胎盘单元：胎儿生长受限时脐静脉流量和母体血流动力学之间的联系。

胎儿生长受限（FGR）与显著的围产期发病率和死亡率相关，但由于传统生物识别评估的灵敏度有限以及缺乏评估胎盘功能的可靠工具，其识别仍然具有挑战性。胎盘功能取决于子宫胎盘灌注，这反过来反映了母体心血管对妊娠的适应。在这种情况下，脐静脉流量（UVF）已成为反映胎儿血液供应的定量参数和胎盘功能的潜在替代标志物。这篇叙述性综述旨在提供UVF和母体血流动力学的概述，并探讨它们在心脏-胎儿-胎盘单位框架内的相互作用。目前的文献表明，妊娠合并FGR时UVF降低，并与母体心输出量（CO）和全身血管阻力（SVR）显著相关。低动力的母体特征（高SVR，低CO）始终与UVF减少和胎盘灌注受损相关，与胎儿生物计量无关。母体心血管评估和紫外线辐射评估的整合为胎盘功能不全提供了一个功能视角，并可能提高对高危妊娠的识别。此外，这种方法为理解母体血流动力学干预对胎儿生长的影响提供了一个潜在的框架。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research Clinical Obstetrics & Gynaecology 医学-妇产科学

CiteScore

9.40

自引率

1.80%

发文量

113

审稿时长

54 days

期刊介绍： In practical paperback format, each 200 page topic-based issue of Best Practice & Research Clinical Obstetrics & Gynaecology will provide a comprehensive review of current clinical practice and thinking within the specialties of obstetrics and gynaecology. All chapters take the form of practical, evidence-based reviews that seek to address key clinical issues of diagnosis, treatment and patient management. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. Management will be described in practical terms so that it can be applied to the individual patient.