{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T20:27:26Z","timestamp":1768595246188,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,3,4]],"date-time":"2014-03-04T00:00:00Z","timestamp":1393891200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p><jats:italic>Fetuses with pulmonary outflow tract obstruction (<jats:styled-content style=\"fixed-case\">POTO<\/jats:styled-content>) have altered blood flow to the pulmonary vasculature. We sought to determine whether pulmonary vascular impedance, as assessed by the pulsatility index (<jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>), is different in fetuses with <jats:styled-content style=\"fixed-case\">POTO<\/jats:styled-content> compared with normal controls<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:italic>Branch pulmonary artery <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> was evaluated in age\u2010matched normal control fetuses (<\/jats:italic>n\u2009=\u2009<jats:italic>22) and 20 <jats:styled-content style=\"fixed-case\">POTO<\/jats:styled-content> fetuses (pulmonary stenosis<\/jats:italic> n\u2009=\u2009<jats:italic>15, pulmonary atresia<\/jats:italic> n\u2009=\u2009<jats:italic>5). Pulsed\u2010wave Doppler was performed in the proximal (<jats:styled-content style=\"fixed-case\">PA1<\/jats:styled-content>), mid (<jats:styled-content style=\"fixed-case\">PA2<\/jats:styled-content>) and distal (<jats:styled-content style=\"fixed-case\">PA3<\/jats:styled-content>) branch pulmonary artery. The direction of flow in the ductus arteriosus was noted. The study and control groups were compared with Student's<\/jats:italic> t\u2010<jats:italic>test and <jats:styled-content style=\"fixed-case\">ANOVA<\/jats:styled-content>. A linear mixed model evaluated the relationship between <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> and ductus arteriosus flow patterns<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>There was no difference in <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> between control, pulmonary stenosis and pulmonary atresia subjects at <jats:styled-content style=\"fixed-case\">PA1<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">PA2<\/jats:styled-content>; however, there was a significant difference at <jats:styled-content style=\"fixed-case\">PA3<\/jats:styled-content>. Subjects with pulmonary atresia had a lower <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> at <jats:styled-content style=\"fixed-case\">PA3<\/jats:styled-content> than did controls (<\/jats:italic>P\u2009=\u2009<jats:italic>0.003) and pulmonary stenosis subjects (<\/jats:italic>P\u2009=\u2009<jats:italic>0.003). Subjects with retrograde flow in the ductus arteriosus had lower <jats:styled-content style=\"fixed-case\">PIs<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">PA2<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">PA3<\/jats:styled-content> than did those with antegrade flow (<\/jats:italic>P\u2009=\u2009<jats:italic>0.01 and 0.005, respectively). The <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">PA3<\/jats:styled-content> was lower in fetuses that required prostaglandin postnatally than in those that did not (<\/jats:italic>P\u2009=\u2009<jats:italic>0.008)<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>Fetuses with pulmonary atresia or severe pulmonary stenosis with retrograde flow in the ductus arteriosus have decreased <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> in the distal pulmonary vasculature. Our findings indicate the capacity of the fetal pulmonary vasculature to vasodilate in response to anatomical obstruction of flow. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons Ltd<\/jats:italic><\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12472","type":"journal-article","created":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T16:37:49Z","timestamp":1364834269000},"page":"297-302","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Pulmonary artery blood flow patterns in fetuses with pulmonary outflow tract obstruction"],"prefix":"10.1002","volume":"43","author":[{"given":"S.","family":"Peyvandi","sequence":"first","affiliation":[{"name":"Fetal Heart Program, Cardiac Center, The Children's Hospital of Philadelphia Philadelphia PA USA"},{"name":"Division of Cardiology, Department of Pediatrics Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Rychik","sequence":"additional","affiliation":[{"name":"Fetal Heart Program, Cardiac Center, The Children's Hospital of Philadelphia Philadelphia PA USA"},{"name":"Division of Cardiology, Department of Pediatrics Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"McCann","sequence":"additional","affiliation":[{"name":"Fetal Heart Program, Cardiac Center, The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Soffer","sequence":"additional","affiliation":[{"name":"Fetal Heart Program, Cardiac Center, The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z.","family":"Tian","sequence":"additional","affiliation":[{"name":"Fetal Heart Program, Cardiac Center, The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Szwast","sequence":"additional","affiliation":[{"name":"Fetal Heart Program, Cardiac Center, The Children's Hospital of Philadelphia Philadelphia PA USA"},{"name":"Division of Cardiology, Department of Pediatrics Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,3,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a113979"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781444311822"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(01)00368-2"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1998.11030173.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70586-0"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2000.00134.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2000.00268.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(98)00327-3"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70229-2"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.127130"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.109.848432"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2004.04.011"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.59.1.179"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2844"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0828-282X(10)70330-5"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)00422-M"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951103000477"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11196"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/039139880602900309"}],"container-title":["Ultrasound in Obstetrics &amp; 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