Imperial College London
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DrCarolineShaw

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Clinical Lecturer
 
 
 
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Contact

 

c.shaw13

 
 
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Location

 

Queen Charlottes and Chelsea HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Shaw:2018:10.1038/s41598-018-31914-4,
author = {Shaw, CJ and Rivens, I and Civale, J and Botting, KJ and Ter, Haar G and Giussani, DA and Lees, CC},
doi = {10.1038/s41598-018-31914-4},
journal = {Scientific Reports},
pages = {13631--13631},
title = {Trans-abdominal in vivo placental vessel occlusion using High Intensity Focused Ultrasound.},
url = {http://dx.doi.org/10.1038/s41598-018-31914-4},
volume = {8},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Pre-clinically, High Intensity Focused Ultrasound (HIFU) has been shown to safely and effectively occlude placental blood vessels in the acute setting, when applied through the uterus. However, further development of the technique to overcome the technical challenges of targeting and occluding blood vessels through intact skin remains essential to translation into human studies. So too does the assessment of fetal wellbeing following this procedure, and demonstration of the persistence of vascular occlusion. At 115 ± 10 d gestational age (term~147 days) 12 pregnant sheep were exposed to HIFU (n = 6), or to a sham (n = 6) therapy through intact abdominal skin (1.66 MHz, 5 s duration, in situ ISPTA 1.3-4.4 kW.cm-2). Treatment success was defined as undetectable colour Doppler signal in the target placental vessel following HIFU exposures. Pregnancies were monitored for 21 days using diagnostic ultrasound from one day before HIFU exposure until term, when post-mortem examination was performed. Placental vessels were examined histologically for evidence of persistent vascular occlusion. HIFU occluded 31/34 (91%) of placental vessels targeted, with persistent vascular occlusion evident on histological examination 20 days after treatment. The mean diameter of occluded vessels was 1.4 mm (range 0.3-3.3 mm). All pregnancies survived until post mortem without evidence of significant maternal or fetal iatrogenic harm, preterm labour, maternal or fetal haemorrhage or infection. Three of six ewes exposed to HIFU experienced abdominal skin burns, which healed without intervention within 21 days. Mean fetal weight, fetal growth velocity and other measures of fetal biometry were not affected by exposure to HIFU. Fetal Doppler studies indicated a transient increase in the umbilical artery pulsatility index (PI) and a decrease in middle cerebral artery PI as a result of general anaesthesia, which was
AU  - Shaw,CJ
AU  - Rivens,I
AU  - Civale,J
AU  - Botting,KJ
AU  - Ter,Haar G
AU  - Giussani,DA
AU  - Lees,CC
DO  - 10.1038/s41598-018-31914-4
EP  - 13631
PY  - 2018///
SN  - 2045-2322
SP  - 13631
TI  - Trans-abdominal in vivo placental vessel occlusion using High Intensity Focused Ultrasound.
T2  - Scientific Reports
UR  - http://dx.doi.org/10.1038/s41598-018-31914-4
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30206278
UR  - http://hdl.handle.net/10044/1/62681
VL  - 8
ER  -
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