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Characterizing the Relationship between Uterine Activity and Placental Function Across Pregnancy with MRI

用 MRI 表征妊娠期子宫活动与胎盘功能之间的关系

基本信息

批准号：
10535116
负责人：
Esra Abaci Turk
金额：
$ 22.76万
依托单位：
BOSTON CHILDREN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-01 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10535116
关键词：
Acute Affect Animal Model Animals Blood Flow Velocity Blood Pressure Blood Vessels Blood flow Brain Cesarean section Characteristics Chronic Data Deceleration Development Doppler Ultrasound Electric Capacitance Emergency Situation Event Fetal Growth Retardation Fetal Heart Rate Fetal Monitoring Fetal Movement Fetus Functional Magnetic Resonance Imaging Functional disorder Future Gases Goals Health Heart Rate Human Hypoxia Individual Lead Liver Magnetic Resonance Imaging Maps Mediating Methods Minor Monitor Motion Organ Outcome Oxygen Oxygen Consumption Partial Pressure Pathology Perfusion Personal Satisfaction Pharmacology Placenta Pregnancy Resistance Risk Signal Transduction Stress Stress Tests Testing Time Tissues Uterine Contraction Uteroplacental Circulation Uterus Variant adverse outcome antenatal blood oxygen level dependent falls fetal fetal blood fetus at risk heart rate monitor improved in utero intrapartum novel therapeutics oxygen transport predictive test pressure regional difference respiratory response spatiotemporal stillbirth tool wasting

项目摘要

PROJECT SUMMARY / ABSTRACT The placenta is a vital fetal organ that serves to oxygenate, nourish, and remove waste from fetal blood in utero. Robust maternal perfusion is essential for this function and requires high capacitance, slow blood flow to the placenta. Maternal-placental perfusion can be temporarily compromised by uterine contractions, which occur throughout pregnancy, also known as Braxton Hicks contractions. Healthy fetuses with normally developed placentas have enough placental reserve capacity that Braxton Hicks contractions and minor vascular pathology do not significantly affect necessary placental oxygen transport. However, in dysfunctional placentas with poor reserve (as in some placentas associated with intrauterine growth restriction-IUGR) these events may lead to hypoxic stress. There is a lack of information and quantitative data regarding the effect of antepartum uterine activity (Braxton Hicks contractions) in human pregnancies and whether these findings may help to characterize placental reserve and function and inform development of future tests to identify fetuses at risk for adverse outcomes during delivery mediated by placental dysfunction. New methods to assess uteroplacental function in humans and the impact of contractions on fetal respiratory exchange across pregnancy in pregnancies with normally growing and IUGR fetuses are needed. Here, we will characterize Braxton Hicks contractions across gestation, analyze spatiotemporal changes in placental oxygenation during these contractions and monitor the effect of these placental oxygenation changes on fetal movement and organ oxygenation via MRI. Our hypothesis is that the change in placental flow during Braxton Hicks contractions may have a larger impact on placental oxygen transport for IUGR fetuses compared to normally growing ones. If successful we will have identified placental and fetal MR signal changes during contractions as a possible method to understand individual placental reserve. Such understanding may enable the development of novel therapies and the ability to monitor changes in these dynamics is critical to the assessment of the impact of novel therapies. Towards this end, we propose the following specific aims: Aim 1: Characterize Braxton Hicks contractions and the associated change in placental oxygenation across gestation in pregnancies with normally growing and IUGR fetuses. We will characterize placental oxygenation using T2* mapping approach and analyze regional differences in placental T2*. Then we will compare and correlate differences in pregnancies with normally growing and IUGR fetuses. Aim 2: Determine the impact of placental oxygenation change during Braxton Hicks contractions on fetal motion and brain and liver oxygenation in pregnancies with normally growing and IUGR fetuses. We will track fetal motion and characterize fetal brain and liver oxygenation using T2* mapping. Then we will compare and correlate differences in pregnancies with normally growing and IUGR fetuses.

项目摘要/摘要