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dc.contributor.authorShaw, CJ
dc.contributor.authorRivens, I
dc.contributor.authorCivale, J
dc.contributor.authorBotting, KJ
dc.contributor.authorAllison, BJ
dc.contributor.authorBrain, KL
dc.contributor.authorNiu, Y
dc.contributor.authorTer Haar, G
dc.contributor.authorGiussani, DA
dc.contributor.authorLees, CC
dc.date.accessioned2020-06-08T14:58:32Z
dc.date.issued2019-05-31
dc.identifier.citationJournal of the Royal Society, Interface, 2019, 16 (154), pp. 20190013 - ?
dc.identifier.issn1742-5689
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3705
dc.identifier.eissn1742-5662
dc.identifier.doi10.1098/rsif.2019.0013
dc.description.abstractHigh-intensity focused ultrasound (HIFU) is a non-invasive method of selective placental vascular occlusion, providing a potential therapy for conditions such as twin-twin transfusion syndrome. In order to translate this technique into human studies, evidence of prolonged fetal recovery and maintenance of a healthy fetal physiology following exposure to HIFU is essential. At 116 ± 2 days gestation, 12 pregnant ewes were assigned to control ( n = 6) or HIFU vascular occlusion ( n = 6) groups and anaesthetized. Placental blood vessels were identified using colour Doppler ultrasound; HIFU-mediated vascular occlusion was performed through intact maternal skin (1.66 MHz, 5 s duration, in situ ISPTA 1.8-3.9 kW cm-2). Unidentifiable colour Doppler signals in targeted vessels following HIFU exposure denoted successful occlusion. Ewes and fetuses were then surgically instrumented with vascular catheters and transonic flow probes and recovered from anaesthesia. A custom-made wireless data acquisition system, which records continuous maternal and fetal cardiovascular data, and daily blood sampling were used to assess wellbeing for 20 days, followed by post-mortem examination. Based on a comparison of pre- and post-treatment colour Doppler imaging, 100% (36/36) of placental vessels were occluded following HIFU, and occlusion persisted for 20 days. All fetuses survived. No differences in maternal or fetal blood pressure, heart rate, heart rate variability, metabolic status or oxygenation were observed between treatment groups. There was evidence of normal fetal maturation and no evidence of chronic fetal stress. There were no maternal injuries and no placental vascular haemorrhage. There was both a uterine and fetal burn, which did not result in any obstetric or fetal complications. This study demonstrates normal long-term recovery of fetal sheep from exposure to HIFU-mediated placental vascular occlusion and underlines the potential of HIFU as a potential non-invasive therapy in human pregnancy.
dc.formatPrint
dc.format.extent20190013 - ?
dc.languageeng
dc.language.isoeng
dc.publisherROYAL SOC
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectFetus
dc.subjectPlacenta
dc.subjectAnimals
dc.subjectSheep
dc.subjectHumans
dc.subjectVascular Diseases
dc.subjectFetofetal Transfusion
dc.subjectUltrasonography, Doppler
dc.subjectPregnancy
dc.subjectFemale
dc.subjectHigh-Intensity Focused Ultrasound Ablation
dc.titleMaternal and fetal cardiometabolic recovery following ultrasound-guided high-intensity focused ultrasound placental vascular occlusion.
dc.typeJournal Article
rioxxterms.versionofrecord10.1098/rsif.2019.0013
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2019-05
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfJournal of the Royal Society, Interface
pubs.issue154
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Imaging for Radiotherapy Adaptation
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Therapeutic Ultrasound
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Imaging for Radiotherapy Adaptation
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Therapeutic Ultrasound
pubs.publication-statusPublished
pubs.volume16
pubs.embargo.termsNot known
icr.researchteamImaging for Radiotherapy Adaptation
icr.researchteamTherapeutic Ultrasound
dc.contributor.icrauthorRivens, Ian
dc.contributor.icrauthorCivale, John
dc.contributor.icrauthorTer Haar, Gail


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