Relative uteroplacental insufficiency of labor
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Wiley
2024
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| author | Tullio Ghi Stefania Fieni Ruben Ramirez Zegarra Susana Pereira Andrea Dall'Asta Edwin Chandraharan |
| author_facet | Tullio Ghi Stefania Fieni Ruben Ramirez Zegarra Susana Pereira Andrea Dall'Asta Edwin Chandraharan Tullio Ghi Stefania Fieni Ruben Ramirez Zegarra Susana Pereira Andrea Dall'Asta Edwin Chandraharan |
| collection | Wiley Open Access |
| contents | Relative uteroplacental insufficiency of labor Tullio Ghi Stefania Fieni Ruben Ramirez Zegarra Susana Pereira Andrea Dall'Asta Edwin Chandraharan Acta Obstetricia et Gynecologica Scandinavica AbstractRelative uteroplacental insufficiency of labor (RUPI‐L) is a clinical condition that refers to alterations in the fetal oxygen “demand–supply” equation caused by the onset of regular uterine activity. The term RUPI‐L indicates a condition of “relative” uteroplacental insufficiency which is relative to a specific stressful circumstance, such as the onset of regular uterine activity. RUPI‐L may be more prevalent in fetuses in which the ratio between the fetal oxygen supply and demand is already slightly reduced, such as in cases of subclinical placental insufficiency, post‐term pregnancies, gestational diabetes, and other similar conditions. Prior to the onset of regular uterine activity, fetuses with a RUPI‐L may present with normal features on the cardiotocography. However, with the onset of uterine contractions, these fetuses start to manifest abnormal fetal heart rate patterns which reflect the attempt to maintain adequate perfusion to essential central organs during episodes of transient reduction in oxygenation. If labor is allowed to continue without an appropriate intervention, progressively more frequent, and stronger uterine contractions may result in a rapid deterioration of the fetal oxygenation leading to hypoxia and acidosis. In this Commentary, we introduce the term relative uteroplacental insufficiency of labor and highlight the pathophysiology, as well as the common features observed in the fetal heart rate tracing and clinical implications. 10.1111/aogs.14937 http://creativecommons.org/licenses/by-nc/4.0/ |
| doi_str_mv | 10.1111/aogs.14937 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_aogs_14937 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by-nc/4.0/ |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Relative uteroplacental insufficiency of labor Tullio Ghi Stefania Fieni Ruben Ramirez Zegarra Susana Pereira Andrea Dall'Asta Edwin Chandraharan Acta Obstetricia et Gynecologica Scandinavica Relative uteroplacental insufficiency of labor Tullio Ghi Stefania Fieni Ruben Ramirez Zegarra Susana Pereira Andrea Dall'Asta Edwin Chandraharan Acta Obstetricia et Gynecologica Scandinavica AbstractRelative uteroplacental insufficiency of labor (RUPI‐L) is a clinical condition that refers to alterations in the fetal oxygen “demand–supply” equation caused by the onset of regular uterine activity. The term RUPI‐L indicates a condition of “relative” uteroplacental insufficiency which is relative to a specific stressful circumstance, such as the onset of regular uterine activity. RUPI‐L may be more prevalent in fetuses in which the ratio between the fetal oxygen supply and demand is already slightly reduced, such as in cases of subclinical placental insufficiency, post‐term pregnancies, gestational diabetes, and other similar conditions. Prior to the onset of regular uterine activity, fetuses with a RUPI‐L may present with normal features on the cardiotocography. However, with the onset of uterine contractions, these fetuses start to manifest abnormal fetal heart rate patterns which reflect the attempt to maintain adequate perfusion to essential central organs during episodes of transient reduction in oxygenation. If labor is allowed to continue without an appropriate intervention, progressively more frequent, and stronger uterine contractions may result in a rapid deterioration of the fetal oxygenation leading to hypoxia and acidosis. In this Commentary, we introduce the term relative uteroplacental insufficiency of labor and highlight the pathophysiology, as well as the common features observed in the fetal heart rate tracing and clinical implications. 10.1111/aogs.14937 http://creativecommons.org/licenses/by-nc/4.0/ |
| title | Relative uteroplacental insufficiency of labor |
| topic | Acta Obstetricia et Gynecologica Scandinavica |
| url | https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.14937 |