TY - GEN
T1 - Inverse solution of the fetal-circulation model based on ultrasound Doppler measurements
AU - Luria, O.
AU - Bar, J.
AU - Kovo, M.
AU - Shalev, J.
AU - Barnea, O.
PY - 2012
Y1 - 2012
N2 - Fetal growth restriction (FGR) is one of the major contributors to adverse perinatal outcome. However, the diagnostic tools currently used for estimating the fetal hemo-dynamic status are still limited. In this study we developed a methodology for estimating fetal hemodynamic parameters. The method is based on a mathematical model of the fetal circulation, an optimization algorithm and measurements of power-Doppler ultrasound. The model estimates parameters of the fetal circulation that are not possible for direct measurement. The method was tested on a cohort of 20 normal and 22 growth-restricted fetuses. In each fetus, power-Doppler velocity waveforms were measured in large number of sites of the fetal circulation. Three-dimensional volume-flow measurements were performed in the placenta to evaluate its resistance to blood flow. Model predictions indicated significant changes in the circulation of FGR fetuses compared to normal fetuses. In the FGR group, the model predicted significant reduction in fetal cardiac output and decreased cardiac output distribution towards the placenta. In FGR fetuses that showed adverse outcome, the model indicated significant increase in cardiac output distribution towards the brain and in the degree of blood shunted by the ductus venosus, indicating severe brain-sparing state in these fetuses. We conclude that patient-specific modeling may be useful in personalizing and optimizing the treatment options in pregnancies complicated by fetal growth-restriction.
AB - Fetal growth restriction (FGR) is one of the major contributors to adverse perinatal outcome. However, the diagnostic tools currently used for estimating the fetal hemo-dynamic status are still limited. In this study we developed a methodology for estimating fetal hemodynamic parameters. The method is based on a mathematical model of the fetal circulation, an optimization algorithm and measurements of power-Doppler ultrasound. The model estimates parameters of the fetal circulation that are not possible for direct measurement. The method was tested on a cohort of 20 normal and 22 growth-restricted fetuses. In each fetus, power-Doppler velocity waveforms were measured in large number of sites of the fetal circulation. Three-dimensional volume-flow measurements were performed in the placenta to evaluate its resistance to blood flow. Model predictions indicated significant changes in the circulation of FGR fetuses compared to normal fetuses. In the FGR group, the model predicted significant reduction in fetal cardiac output and decreased cardiac output distribution towards the placenta. In FGR fetuses that showed adverse outcome, the model indicated significant increase in cardiac output distribution towards the brain and in the degree of blood shunted by the ductus venosus, indicating severe brain-sparing state in these fetuses. We conclude that patient-specific modeling may be useful in personalizing and optimizing the treatment options in pregnancies complicated by fetal growth-restriction.
KW - Brain-sparing effect
KW - Fetal growth restriction
KW - Mathematical model
KW - Patient-specific modeling
KW - Placental resistance to blood flow
KW - Power Doppler ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=84871982144&partnerID=8YFLogxK
U2 - 10.1109/EEEI.2012.6376962
DO - 10.1109/EEEI.2012.6376962
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AN - SCOPUS:84871982144
SN - 9781467346801
T3 - 2012 IEEE 27th Convention of Electrical and Electronics Engineers in Israel, IEEEI 2012
BT - 2012 IEEE 27th Convention of Electrical and Electronics Engineers in Israel, IEEEI 2012
Y2 - 14 November 2012 through 17 November 2012
ER -