Understanding hemodynamic remodelling in intrauterine growth restriction: a computational modelling study

Intrauterine growth restriction (IUGR) is an important cause of fetal morbidity and mortality. It is defined as a rate of fetal growth that is below normal, often resulting from insufficient nutrient supply from the mother. This condition is associated with the redistribution of blood flow across various vessels within the placental circulation, which is believed to be caused by increased placental and peripheral resistances and cerebral artery vasodilation, which results in reduced cerebral resistance. All these changes are related to worse perinatal, neurodevelopmental and cardiovascular outcome.

To better understand hemodynamic remodelling, computational models of the fetal circulation can be used to estimate different vascular and hemodynamic properties that cannot be non-invasively and/or easily assessed during clinical practice. Therefore, this thesis aims to use our current computational model of the fetal circulation to estimate placental stiffness in a high-risk population during the third trimester of gestation. We will investigate hemodynamic changes in IUGR, including the brain-sparing mechanism, to understand how blood redistribution occurs to ensure sufficient oxygen supply to critical organs, particularly the brain and heart. This will be done in collaboration with obstetricians from Hospital Sant Joan de Déu and Maternitat de Barcelona, who will provide real clinical data.

Requisites:

  • Python and Matlab programming.
  • Basic knowledge of cardiac physiology.

References:

  • Villanueva, M. I., López, M., Sánchez, S., Garcia-Cañadilla, P., Randanne, P. C., Hawkins, A., Eixarch, E., Bonet-Carne, E., Gratacós, E., Crispi, F., Bijnens, B., & Bernardino, G. (2022). Haemodynamic Changes in the Fetal Circulation Post-connection to an Artificial Placenta: A Computational Modelling Study. Lecture Notes in Computer Science (Including Subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), 13593 LNCS, 46–55. https://doi.org/10.1007/978-3-031-23443-9_5.
  • Garcia-Canadilla, P., Crispi, F., Cruz-Lemini, M., Triunfo, S., Nadal, A., Valenzuela-Alcaraz, B., Rudenick, P. A., Gratacos, E., & Bijnens, B. H. (2015). Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation. Placenta, 36(9), 981–989. https://doi.org/10.1016/j.placenta.2015.07.130.
  • Sharma D, Shastri S, Sharma P (2016). Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. Clinical Medicine Insights. Pediatrics, 14(10), 67-83. doi: https://doi.org/10.4137/CMPed.S40070.

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