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Placental MRI Predicts Fetal Oxygenation and Growth Rates in Sheep and Human Pregnancy

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Dimitra Flouri, Jack R.T. Darby, Stacey L. Holman, Steven K.S. Cho, Catherine G. Dimasi, Sunthara R. Perumal, Sebastien Ourselin, Rosalind Aughwane, Nada Mufti, Christopher K. Macgowan, Mike Seed, Anna L. David, Andrew Melbourne, Janna L. Morrison

Original languageEnglish
Article number2203738
Pages (from-to)e2203738
JournalAdvanced Science
Volume9
Issue number30
Early online date28 Aug 2022
DOIs
Accepted/In press2022
E-pub ahead of print28 Aug 2022
Published25 Oct 2022

Bibliographical note

Funding Information: D.F. and J.R.T.D contributed equally to the methodology and analysis of the data in this work. A.M. and J.L.M contributed equally to the conceptualization and supervision of this work. The authors gratefully acknowledge Dr. Tamara Varcoe, Emma Bradshaw, and Megan Quinn for their expert assistance in surgical procedures and the post-surgical care of the ewe and her fetus. The authors acknowledge the technical assistance of the National Imaging Facility, an NCRIS capability, at PIRL, SAHMRI. This research was supported by the Wellcome Trust (210182/Z/18/Z, 101957/Z/13/Z, 203148/Z/16/Z), the EPSRC (NS/A000027/1), and an ARC Future Fellowship (Level 3; FT170100431) to JLM. The authors would also like to thank Oliver Melbourne for his artistic contribution to the manuscript. Funding Information: D.F. and J.R.T.D contributed equally to the methodology and analysis of the data in this work. A.M. and J.L.M contributed equally to the conceptualization and supervision of this work. The authors gratefully acknowledge Dr. Tamara Varcoe, Emma Bradshaw, and Megan Quinn for their expert assistance in surgical procedures and the post‐surgical care of the ewe and her fetus. The authors acknowledge the technical assistance of the National Imaging Facility, an NCRIS capability, at PIRL, SAHMRI. This research was supported by the Wellcome Trust (210182/Z/18/Z, 101957/Z/13/Z, 203148/Z/16/Z), the EPSRC (NS/A000027/1), and an ARC Future Fellowship (Level 3; FT170100431) to JLM. The authors would also like to thank Oliver Melbourne for his artistic contribution to the manuscript. Publisher Copyright: © 2022 The Authors. Advanced Science published by Wiley-VCH GmbH.

King's Authors

Abstract

Magnetic resonance imaging (MRI) assessment of fetal blood oxygen saturation (SO2 ) can transform the clinical management of high-risk pregnancies affected by fetal growth restriction (FGR). Here, a novel MRI method assesses the feasibility of identifying normally grown and FGR fetuses in sheep and is then applied to humans. MRI scans are performed in pregnant ewes at 110 and 140 days (term = 150d) gestation and in pregnant women at 28+3 ± 2+5 weeks to measure feto-placental SO2 . Birth weight is collected and, in sheep, fetal blood SO2 is measured with a blood gas analyzer (BGA). Fetal arterial SO2 measured by BGA predicts fetal birth weight in sheep and distinguishes between fetuses that are normally grown, small for gestational age, and FGR. MRI feto-placental SO2 in late gestation is related to fetal blood SO2 measured by BGA and body weight. In sheep, MRI feto-placental SO2 in mid-gestation is related to fetal SO2 later in gestation. MRI feto-placental SO2 distinguishes between normally grown and FGR fetuses, as well as distinguishing FGR fetuses with and without normal Doppler in humans. Thus, a multi-compartment placental MRI model detects low placental SO2 and distinguishes between small hypoxemic fetuses and normally grown fetuses.

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