The fetal blood flow state in pregnant women undergoin psychoemotional stress

Abstract

The fetal blood flow state studies of pregnant women undergoing psycho-emotional stress, with the help of self-report scale of Spielberger and Doppler examination found an increase in state and trait anxiety, increase in resistance of the umbilical artery and descending aorta, as well as raised heart rate and blood pressure values. At the same time there is a decrease in the pulsatility index of the middle cerebral artery and increase in umbilical-cerebral ratios, indicating the compensatory centralization of fetal blood flow and improving blood supply to the brain. Possible mechanisms of the detected changes have been discussed.

Keywords

psycho-emotional stress during pregnancy / anxiety / fetal blood flow / vascular resistance

References

[1] Особенности психоэмоционального статуса у беременных с фетоплацентарной недостаточностью / Чехонацкая М. Л. [и др.] // Саратовский научно-медицинский журнал. — 2012. — T.8, N2. — C. 541–547.

[2] Павлова Н. Г. Универсальные гемодинамические реакции развития плацентарной недостаточности // Пренатальная диагностика. — 2005. — N1. — C. 7–8.

[3] Состояние кровотока в маточных артериях беременных, переносящих стресс / Худавердян А. Д. [и др.] // Акушерство, гинекология и неонатология. — 2011. — Т. 5, N1–2. — С. 45–48.

[4] Татарчук Т. Ф. Стресс и репродуктивная функция женщины // Эндокринная гинекология. — 2006. — Т. 3, N5. — С. 13–17.

[5] Arduini D., Rizzo G. Normal values of pulsatility index from fetal vessels: a cross — sectional study on 1556 healthy fetuses // J. Perinat. Med. — 1990. — Vol. 18. — P. 165–172.

[6] Blood flow velocity waveforms of the umbilical artery in a normal population: reference values from 18 weeks to 42 weeks of gestation / Bahlmann F., Fittschen M., Reinhard I. [et al.] // Ultraschall Med. — 2012. — Vol. 33, N 7. — P. 80–87.

[7] Blood flow velocity waveforms of the middle cerebral artery in a normal population: reference values from 18 weeks to 42 weeks of gestation / Bahlmann F. [et al.] // Perinat. Med. — 2002. — Vol. 30. — P. 490–501.

[8] Cortisol and anxiety response to a relaxing intervention on pregnant women awaiting amniocentesis / Venturaa T. [el al.] // Psychoneuroendocrinology. — 2012. — Vol. 37. — P. 148–156.

[9] Harris A., Seckl J. Glucocorticoids, prenatal stress and the programming of disease // Horm. Behav. — 2011. — Vol. 59, N 3. — P. 279–289.

[10] Impact of maternal psychological distress on fetal weight, prematurity and intrauterine growth retardation / Maina G., [et al.] // J. Affect Disord. — 2008. — Vol. 111. — P. 214–220.

[11] Maternal anxiety in late pregnancy and fetal hemodynamics /Sjostrom K. [et al.] // Eur. J. Obstet. gynecol. — 1997. — Vol. 74. — P. 149–155.

[12] Maternal stressful life events and risks of birth defects / Suzan L. [et al.] // Epidemiology. — 2007. — Vol. 18, N 3. — P. 356–361.

[13] Prenatal stress increases the hypothalamo-pituitary-adrenal axis response in young and adult rats / Henry G. [et al.] // J. Neuroendocrinal. — 1994, N 6. — P. 341–345.

[14] Prenatal pshychosocial factors and the neuroendocrine axis in human pregnancy / Wadwa P. D. [et al.] // Psychosom. Med. — 1996. — Vol. 58. — P. 432–446.

[15] Prenatal stress and cerebral palsy: a nation wide cohort study in Denmark / Vestergaard L. J. [et al.] // Phychosom Med. — 2009. — Vol. 71, N 6. — P. 615–618.

[16] Prenatal stress and brain development / Charil A. [et al.] // Brain Res. Rev. — 2010. — Vol. 65, N1. — P. 56–79.

[17] Ramsay M. M., Broughton P. F., Rubin P. C. Pressor, heart rate and plasma catecholamine responses to noradrenaline in pregnant and nonpregnant women // British J. Obstet. Gynecol. — 1993. — Vol. 100, N 2. — P. 170–176.

[18] Reference resistance indices of the umbilical, fetal middle cerebral and uterine arteries at 24–42 weeks of gestation / Kurmanavicius J. [et al.] // Ultrasound Obstet. Gynecol. — 1997. — Vol. 10. — P. 112–120.

[19] Reference values of fetal aortic flow velocity waveforms and associated intraobserver reliability in normal pregnancies / Bahlmann F. [et al.] // Ultrasound Obstet. Gynecol. — 2000. — Vol. 17. — P. 42–49.

[20] Rosenfield C. R., West J. Circulatory response to systemic infusion of norepinephrine in the pregnant ewe // Am. J. Obstet. Gynecol. — 1976. — Vol. 127. — P. 376–383.

[21] Spielberger C. D., Gorusch R. L., Lushene R. E. STAI manual for the state trait anxiety inventory. — N. Y.: Consulting Psycologists Press, 1970.

[22] Teixeira J. M. A., Fisk N. M., Glover V. Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study // BMJ. — 1999. — Vol. 318 — P. 153–157.

[23] Villas-Boas J. M., Maesta I., Consonni M. Brain sparing effect: from placental insufficiency to fetal circulatory adaptation // Rev. Bras. Ginecol. Obstet. — 2008. — Vol.30, N 7. — P. 366–367.

RIGHTS & PERMISSIONS

Khudaverdyan A.D.