Transient fetal blood redistribution associated with maternal supine position

Karina P. Silva; Tatiana Emy N.K. Hamamoto; Roseli M.Y. Nomura

doi:10.1515/jpm-2016-0288

Article

Transient fetal blood redistribution associated with maternal supine position

Karina P. Silva , Tatiana Emy N.K. Hamamoto and Roseli M.Y. Nomura

Published/Copyright: November 10, 2016

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From the journal Journal of Perinatal Medicine Volume 45 Issue 3

Abstract

Objective:

To investigate whether fetal blood circulation is influenced by the maternal supine position.

Methods:

The inclusion criteria were good health, a singleton pregnancy, maternal age between 18 and 40 years, gestational age between 36 and 40 weeks, and an agreement to participate in the study. Each participant (n=20) was initially asked to adopt the left lateral position for 5 min, while fetal Doppler measurements were taken of the fetal middle cerebral artery (MCA), umbilical artery (UA), and umbilical vein (UV). Subsequently, they were asked to change to the supine position for Doppler measurements at 5 and at 10 min.

Results:

When a woman remained in the supine position for 5 min, there was a significant reduction in fetal MCA-pulsatility index (PI) (median 1.70 vs. 1.42, P=0.003). This reduction did not persist after 10 min (median 1.70 vs. 1.65 P=1.0). There was no significant difference between the left lateral and the supine position at 5 and at 10 min in terms of UA-PI (0.853 vs. 0.870 vs. 0.858, P=0.850), UV flow (217 vs. 242 vs. 236 mL/min, P=0.263), and normalized UV flow (72.2 vs. 80.8 vs. 78.8 mL/min/kg, P=0.271).

Conclusions:

Changing maternal position from the left lateral to the supine position caused a reduction in resistance in fetal MCA and no changes in UA or UV indices. However, despite the changes in cerebral circulation which occurred at 5 min by shifting position, they did not remain for 10 min. The changes may be related to reduction in maternal oxygen saturation as there was no decrease in UV blood flow.

Keywords: Doppler velocimetry; fetal circulation; middle cerebral artery; supine position; umbilical artery; umbilical vein

Acknowledgments

The São Paulo Research Foundation (FAPESP, Fundação de Amparo à Pesquisa do Estado de São Paulo) funded this study with a research scholarship awarded to undergraduate student Karina Peres Silva (Case No. 2014/17216-9).

Competing interests: The authors declare they have no competing interests.

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2016-5-3

Accepted: 2016-10-6

Published Online: 2016-11-10

Published in Print: 2017-4-1

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Articles in the same Issue

https://doi.org/10.1515/jpm-2016-0288

Keywords for this article

Doppler velocimetry; fetal circulation; middle cerebral artery; supine position; umbilical artery; umbilical vein