{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T22:31:13Z","timestamp":1787351473121,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003653","name":"Korea National Institute of Health","doi-asserted-by":"publisher","award":["K23 NS099422"],"award-info":[{"award-number":["K23 NS099422"]}],"id":[{"id":"10.13039\/501100003653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Fetal cerebrovascular resistance is influenced by several factors in the setting of intact autoregulation to allow for normal cerebral blood flow and oxygenation. Maternal hyperoxygenation (MH) allows for acute alterations in fetal physiology and can be a tool to test cerebrovascular reactivity in late\u2010gestation fetuses. In this study, we utilized MH to evaluate cerebrovascular reactivity in fetuses with specific congenital heart disease (CHD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cross\u2010sectional study of fetuses with complex CHD compared to controls without CHD. CHD cases were grouped according to physiology into: left\u2010sided obstructive lesion (LSOL), right\u2010sided obstructive lesion (RSOL) or dextro\u2010transposition of the great arteries (d\u2010TGA). Subjects underwent MH testing during the third\u2010trimester fetal echocardiogram. The pulsatility index (PI) was calculated for the fetal middle cerebral artery (MCA), umbilical artery (UA) and branch pulmonary artery (PA). The change in PI from baseline to during MH was compared between each CHD group and controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty pregnant women were enrolled (CHD, <jats:italic>n<\/jats:italic>\u2009=\u200943; control, <jats:italic>n<\/jats:italic>\u2009=\u200917). In the CHD group, there were 27 fetuses with LSOL, seven with RSOL and nine with d\u2010TGA. Mean gestational age was 33.9 (95%\u2009CI, 33.6\u201334.2) weeks. At baseline, MCA\u2010PI <jats:italic>Z<\/jats:italic>\u2010score was lowest in the LSOL group (\u22121.8 (95%\u2009CI, \u22122.4 to \u22121.2)) compared with the control group (\u22120.8 (95%\u2009CI, \u22121.3 to \u22120.3)) (<jats:italic>P<\/jats:italic>\u2009=\u20090.01). In response to MH, MCA\u2010PI <jats:italic>Z<\/jats:italic>\u2010score increased significantly in the control and d\u2010TGA groups but did not change significantly in the LSOL and RSOL groups. The change in MCA\u2010PI <jats:italic>Z<\/jats:italic>\u2010score was significantly higher in the control group than in the LSOL group (0.9 (95%\u2009CI, 0.42\u20131.4) <jats:italic>vs<\/jats:italic> 0.12 (95%\u2009CI, \u22120.21 to 0.45); <jats:italic>P<\/jats:italic>\u2009=\u20090.03). This difference was more pronounced in the LSOL subgroup with retrograde aortic arch flow. Branch PA\u2010PI decreased significantly in response to MH in all groups, with no difference in the change from baseline to MH between the groups, while UA\u2010PI was unchanged during MH compared with at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The fetal cerebrovascular response to MH varies based on the underlying CHD diagnosis, suggesting that cardiovascular physiology may influence the autoregulatory capacity of the fetal brain. Further studies are needed to determine the clinical implications of these findings on long\u2010term neurodevelopment in these at\u2010risk children. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.22024","type":"journal-article","created":{"date-parts":[[2020,3,23]],"date-time":"2020-03-23T15:38:19Z","timestamp":1584977899000},"page":"769-775","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Fetal\u2009cerebrovascular response to maternal hyperoxygenation in congenital heart disease: effect of cardiac physiology"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1765-0213","authenticated-orcid":false,"given":"W. 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M.","family":"Cresalia","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics The University of California San Francisco  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Nawaytou","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics The University of California San Francisco  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Quezada","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics The University of California San Francisco  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Brook","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics The University of California San Francisco  San Francisco CA 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