{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:48:16Z","timestamp":1784544496009,"version":"3.55.0"},"reference-count":25,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: To evaluate hepatic artery Doppler parameters in fetuses with fetal growth restriction (FGR) and to investigate their relationship with composite adverse neonatal outcomes (CANO). Methods: This prospective cohort study included 108 pregnancies (54 FGR; 54 appropriate-for-gestational-age controls) between 34 and 37 weeks\u2019 gestation. Hepatic artery (HA), umbilical artery (UA), middle cerebral artery (MCA), and uterine artery Doppler indices were recorded. Logistic regression and ROC analyses were used to determine predictors of FGR and CANO. Results: HA pulsatility index (PI), systolic\/diastolic ratio, and peak systolic velocity (PSV) were significantly higher in FGR fetuses (p &lt; 0.05). In multivariate regression, HA-PI remained independently associated with FGR (aOR 1.74, 95% CI 1.07\u20132.87, p = 0.025). For predicting CANO, HA-PSV was the only independent predictor (aOR 1.05, 95% CI 1.00\u20131.10, p = 0.020). ROC analysis demonstrated moderate discriminative ability for HA-PI (AUC 0.681) and HA-PSV (AUC 0.703). Conclusions: Increased HA-PSV in FGR reflects activation of the hepatic arterial buffer response as an adaptive mechanism to maintain hepatic perfusion under hypoxic stress, whereas elevated HA-PI may represent evolving microvascular resistance. Hepatic artery Doppler evaluation may serve as a complementary tool for assessing fetal well-being and identifying fetuses at risk for adverse neonatal outcomes, particularly in late-onset FGR.<\/jats:p>","DOI":"10.3390\/jcm14238403","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T11:19:51Z","timestamp":1764328791000},"page":"8403","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Insights into the Hepatic Arterial Buffer Response in Late-Onset FGR"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8024-204X","authenticated-orcid":false,"given":"Aziz","family":"K\u0131ndan","sequence":"first","affiliation":[{"name":"Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can Ozan","family":"Ulusoy","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0962-1036","authenticated-orcid":false,"given":"Aykut","family":"K\u0131ndan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nurda\u011f\u0131 State Hospital, Gaziantep 27480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6416-7529","authenticated-orcid":false,"given":"Tu\u011f\u00e7e","family":"S\u0131rma","sequence":"additional","affiliation":[{"name":"Department of Gynecological Oncology Surgery, \u0130skenderun State Hospital, Hatay 31200, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A\u015fk\u0131n Evren","family":"G\u00fcler","sequence":"additional","affiliation":[{"name":"Private Clinic of Obstetrics and Gynecology, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3455-1719","authenticated-orcid":false,"given":"\u0130smail Burak","family":"G\u00fcltekin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehra","family":"Vural Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1002\/uog.13190","article-title":"Perinatal Morbidity and Mortality in Early-Onset Fetal Growth Restriction: Cohort Outcomes of the Trial of Randomized Umbilical and Fetal Flow in Europe (TRUFFLE)","volume":"42","author":"Lees","year":"2013","journal-title":"Ultrasound Obstet. 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