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Fetal Cardiovascular Physiology

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Doppler Ultrasound in Obstetrics and Gynecology

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Abstract

Our understanding of fetal cardiovascular physiology has markedly increased in the last 50 years, with the introduction of suitable animal models. When studying the cardiovascular system before birth, the temporal profile of cardiovascular development between species is a highly important consideration for translation to the human clinical situation. Rats and mice are altricial species, in which cardiovascular maturation continues past birth, becoming completed by the second week of postnatal life. In addition, rodents give birth to litters, so differences in the maternal metabolic adaptations to pregnancy in highly polytocous species also require clear thought. In contrast, sheep and humans share similar prenatal tempos of precocial cardiovascular development and some breeds of sheep give birth to singleton lambs of similar weight to term human babies. Most importantly, the sheep is the only animal model that permits surgical instrumentation of the fetus for long-term in vivo cardiovascular recording. Comparable fundamental insight has not been developed in another species. Therefore, this chapter summarizes our current understanding of fetal cardiovascular physiology derived primarily from studies in fetal sheep during basal and stressful conditions and thereby of direct human obstetric relevance. The effects on fetal cardiovascular function of advancing gestational age, antenatal glucocorticoid therapy, and exposure to adverse intrauterine conditions are also reviewed.

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Acknowledgments

Professor Dino Giussani’s current programs of research are funded by the British Heart Foundation and the Medical Research Council, UK.

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Authors and Affiliations

  1. Department of Physiology Development & Neuroscience, University of Cambridge, Cambridge, UK

    Dino A. Giussani, Kimberley J. Botting, Youguo Niu & Sage G. Ford

  2. BHF Centre for Research Excellence, Cambridge, UK

    Dino A. Giussani, Kimberley J. Botting & Youguo Niu

  3. Cambridge Strategic Research Initiative in Reproduction, Cambridge, UK

    Dino A. Giussani & Youguo Niu

  4. Institute of Reproductive and Developmental Biology, Imperial College London, London, UK

    Caroline J. Shaw

  5. Interventional Regenerative Medicine and Imaging Laboratory, Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA

    Avnesh S. Thakor

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  1. Dino A. Giussani
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  2. Kimberley J. Botting
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  3. Youguo Niu
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  4. Caroline J. Shaw
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  5. Sage G. Ford
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  6. Avnesh S. Thakor
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Correspondence to Dino A. Giussani .

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Editors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Missouri–Kansas City, Kansas City, MO, USA

    Dev Maulik

  2. Department of Metabolism, Digestion and Reproduction, Imperial College Healthcare NHS Trust, London, UK

    Christoph C. Lees

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Giussani, D.A., Botting, K.J., Niu, Y., Shaw, C.J., Ford, S.G., Thakor, A.S. (2023). Fetal Cardiovascular Physiology. In: Maulik, D., Lees, C.C. (eds) Doppler Ultrasound in Obstetrics and Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-031-06189-9_8

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