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Maternal Low Volume Circulation Relates to Normotensive and Preeclamptic Fetal Growth Restriction

This narrative review summarizes current evidence on the association between maternal low volume circulation and poor fetal growth. Though much work has been devoted to the study of cardiac output and peripheral vascular resistance, a low intravascular volume may explain why high vascular resistance...

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Autores principales: Gyselaers, Wilfried, Lees, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9218216/
https://www.ncbi.nlm.nih.gov/pubmed/35755049
http://dx.doi.org/10.3389/fmed.2022.902634
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author Gyselaers, Wilfried
Lees, Christoph
author_facet Gyselaers, Wilfried
Lees, Christoph
author_sort Gyselaers, Wilfried
collection PubMed
description This narrative review summarizes current evidence on the association between maternal low volume circulation and poor fetal growth. Though much work has been devoted to the study of cardiac output and peripheral vascular resistance, a low intravascular volume may explain why high vascular resistance causes hypertension in women with preeclampsia (PE) that is associated with fetal growth restriction (FGR) and, at the same time, presents with normotension in FGR itself. Normotensive women with small for gestational age babies show normal gestational blood volume expansion superimposed upon a constitutionally low intravascular volume. Early onset preeclampsia (EPE; occurring before 32 weeks) is commonly associated with FGR, and poor plasma volume expandability may already be present before conception, thus preceding gestational volume expansion. Experimentally induced low plasma volume in rodents predisposes to poor fetal growth and interventions that enhance plasma volume expansion in FGR have shown beneficial effects on intrauterine fetal condition, prolongation of gestation and birth weight. This review makes the case for elevating the maternal intravascular volume with physical exercise with or without Nitric Oxide Donors in FGR and EPE, and evaluating its role as a potential target for prevention and/or management of these conditions.
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spelling pubmed-92182162022-06-24 Maternal Low Volume Circulation Relates to Normotensive and Preeclamptic Fetal Growth Restriction Gyselaers, Wilfried Lees, Christoph Front Med (Lausanne) Medicine This narrative review summarizes current evidence on the association between maternal low volume circulation and poor fetal growth. Though much work has been devoted to the study of cardiac output and peripheral vascular resistance, a low intravascular volume may explain why high vascular resistance causes hypertension in women with preeclampsia (PE) that is associated with fetal growth restriction (FGR) and, at the same time, presents with normotension in FGR itself. Normotensive women with small for gestational age babies show normal gestational blood volume expansion superimposed upon a constitutionally low intravascular volume. Early onset preeclampsia (EPE; occurring before 32 weeks) is commonly associated with FGR, and poor plasma volume expandability may already be present before conception, thus preceding gestational volume expansion. Experimentally induced low plasma volume in rodents predisposes to poor fetal growth and interventions that enhance plasma volume expansion in FGR have shown beneficial effects on intrauterine fetal condition, prolongation of gestation and birth weight. This review makes the case for elevating the maternal intravascular volume with physical exercise with or without Nitric Oxide Donors in FGR and EPE, and evaluating its role as a potential target for prevention and/or management of these conditions. Frontiers Media S.A. 2022-06-09 /pmc/articles/PMC9218216/ /pubmed/35755049 http://dx.doi.org/10.3389/fmed.2022.902634 Text en Copyright © 2022 Gyselaers and Lees. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Gyselaers, Wilfried
Lees, Christoph
Maternal Low Volume Circulation Relates to Normotensive and Preeclamptic Fetal Growth Restriction
title Maternal Low Volume Circulation Relates to Normotensive and Preeclamptic Fetal Growth Restriction
title_full Maternal Low Volume Circulation Relates to Normotensive and Preeclamptic Fetal Growth Restriction
title_fullStr Maternal Low Volume Circulation Relates to Normotensive and Preeclamptic Fetal Growth Restriction
title_full_unstemmed Maternal Low Volume Circulation Relates to Normotensive and Preeclamptic Fetal Growth Restriction
title_short Maternal Low Volume Circulation Relates to Normotensive and Preeclamptic Fetal Growth Restriction
title_sort maternal low volume circulation relates to normotensive and preeclamptic fetal growth restriction
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9218216/
https://www.ncbi.nlm.nih.gov/pubmed/35755049
http://dx.doi.org/10.3389/fmed.2022.902634
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