Relative uteroplacental insufficiency of labor
Abstract Relative 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...
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| Format: | Article |
| Language: | English |
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Wiley
2024-10-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14937 |
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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 |
| author_sort | Tullio Ghi |
| collection | DOAJ |
| description | Abstract Relative 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. |
| format | Article |
| id | doaj-art-d89a1d1b107247ad8aaff09ad583f83f |
| institution | DOAJ |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-d89a1d1b107247ad8aaff09ad583f83f2025-08-20T03:22:18ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-10-01103101910191810.1111/aogs.14937Relative uteroplacental insufficiency of laborTullio Ghi0Stefania Fieni1Ruben Ramirez Zegarra2Susana Pereira3Andrea Dall'Asta4Edwin Chandraharan5Department of Medicine and Surgery, Obstetrics and Gynecology Unit University of Parma Parma ItalyDepartment of Medicine and Surgery, Obstetrics and Gynecology Unit University of Parma Parma ItalyDepartment of Medicine and Surgery, Obstetrics and Gynecology Unit University of Parma Parma ItalyFetal Medicine Unit, The Royal London Hospital Barts Health NHS Trust London UKDepartment of Medicine and Surgery, Obstetrics and Gynecology Unit University of Parma Parma ItalyGlobal Academy of Medical Education and Training Ltd London UKAbstract Relative 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.https://doi.org/10.1111/aogs.14937active laborbaseline fetal heart ratecardiotocographycatecholamine responsedecelerationsfetal growth restriction |
| spellingShingle | Tullio Ghi Stefania Fieni Ruben Ramirez Zegarra Susana Pereira Andrea Dall'Asta Edwin Chandraharan Relative uteroplacental insufficiency of labor Acta Obstetricia et Gynecologica Scandinavica active labor baseline fetal heart rate cardiotocography catecholamine response decelerations fetal growth restriction |
| title | Relative uteroplacental insufficiency of labor |
| title_full | Relative uteroplacental insufficiency of labor |
| title_fullStr | Relative uteroplacental insufficiency of labor |
| title_full_unstemmed | Relative uteroplacental insufficiency of labor |
| title_short | Relative uteroplacental insufficiency of labor |
| title_sort | relative uteroplacental insufficiency of labor |
| topic | active labor baseline fetal heart rate cardiotocography catecholamine response decelerations fetal growth restriction |
| url | https://doi.org/10.1111/aogs.14937 |
| work_keys_str_mv | AT tullioghi relativeuteroplacentalinsufficiencyoflabor AT stefaniafieni relativeuteroplacentalinsufficiencyoflabor AT rubenramirezzegarra relativeuteroplacentalinsufficiencyoflabor AT susanapereira relativeuteroplacentalinsufficiencyoflabor AT andreadallasta relativeuteroplacentalinsufficiencyoflabor AT edwinchandraharan relativeuteroplacentalinsufficiencyoflabor |