Fetal arterial mechanics in health and disease: Intrauterine Growth Restriction (IUGR) and Preeclampsia (PE) biomechanical changes in vascular development

Dodson, Reuben Blair

Graduate Thesis Or Dissertation

Fetal arterial mechanics in health and disease: Intrauterine Growth Restriction (IUGR) and Preeclampsia (PE) biomechanical changes in vascular development Public Deposited

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Citeable URL: https://scholar.colorado.edu/concern/graduate_thesis_or_dissertations/xg94hp67g

Abstract

Preeclampsia (PE) is a maternal disease of pregnancy, which affects up to 5-10% of all pregnancies. Intrauterine growth restriction (IUGR) is commonly seen by itself or with preeclampsia and affects up to 8% of pregnancies. These common complications of pregnancy are associated with both acute and chronic complications for the fetus and newborn. Studies have consistently shown that children whose mothers experience maternal complications during gestation are developmentally programmed for cardiovascular disease later in life. The work in this dissertation aims to better understand the impacts of maternal disease-induced fetal programming on vascular compliance, blood flow and blood pressure within the fetal circulation at term. Specifically, the overarching aim of this dissertation is to assess potentially detrimental fetal arterial tissue alterations in IUGR and PE. To our knowledge, this is the first examination of the systemic effects of both IUGR and PE on fetal vascular compliance and its contribution to hemodynamics-- an area which until recently was neglected. Compliance changes in the human umbilical artery are associated with adult hypertension; however, no study has established if this effect is due to systemic vascular compliance changes in association with maternal disease. Therefore, this work provides an important step towards understanding the systemic vessel formation in both control fetus and the PE and IUGR fetus. We aim to elucidate the imprinting role that PE and IUGR plays on cardiovascular development and provide a model that can translate to a clinical setting for predicting the severity of maternal disease-induced vascular changes in the human fetus.

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