Distribution of Umbilical Glucose Supply to Fetal Liver and Systemic Organs. The Role of Umbilical Vein Glucose Concentration Versus Umbilical Vein Flow, 2015

This research project is based on a cross-sectional study including 124 healthy pregnant women who were delivered by elective cesarean section. Immediately before surgery blood flow in the umbilical vein and ductus venosus were measured by ultrasound technique. Thereafter blood samples from the maternal and umbilical circulations were collected during surgery. These measurements gave us a unique opportunity to investigate how glucose concentration and/or blood flow in the umbilical vein influenced the distribution of flow to the fetal liver versus ductus venosus to the fetal systemic circulation. In addition we investigated how maternal prepregnant body mass index (ppBMI) and markers of fetal wellbeing, i.e. cerebral and umbilical blood flow resistance and fetal proportions in a normal population affected the distribution fetal flow to the liver versus systemic circulation. We found blood flow and not glucose concentration in the umbilical vein to correlate with distribution of flow to the liver versus systemic circulation. After dicitomicing in two maternal ppBMI groups (one normal weight and one overweight) we found maternal ppBMI group to affect this flow distribution. We therefore speculate that to assure both a sufficient glucose supply to brain and heart and stabile blood glucose levels, the amount of blood shunted through DV versus liver, UV blood flow seems to play a central role.