What is Vascular Disruption Theory?

Vascular Disruption Phenomena (Theory):

According to the VDP theory, structural fetal anomalies result from damage or interruption of normal embryonic or fetal development of the vascular system (arteries, veins and capillaries).
The types of structural anomalies depend on:

• The timing of the tissue damage.
• The severity of the tissue damage.
• The location of the tissue damage.

Any maternal, fetal or placental event that results in hypotension or hypertension may lead to VDP. Chronic bleeding is one cause (1).

• Monozygotic Twins
  Numerous vascular placental anastomoses are present and VDP has been confirmed with the death of a co-twin (2-6).
• Singleton Pregnancy
  VDP may occur in singleton pregnancy. Drugs such as cocaine have a vasoconstrictive effect and affect fetal development (2). 35% of twin pregnancies at 10 weeks are singleton at 40 weeks, suggesting that placental anastomoses exist in supposed singleton pregnancies (1).

In twin or singleton pregnancies, occlusion of the internal carotid or mesenteric arteries are the most frequent complication of VDP, however brain, spleen, kidney and liver infarcts have been reported associated with various structural defects (2-6).
 

ANOMALIES ASSOCIATED WITH VDP

9.2% of fetuses with structural anomalies identified on ultrasound result from VDP (2).

• Hydranencephaly.
• Schizencephaly.
• Holoprosencephaly.
• Hepatic infarcts.
• Subhepatic cysts.
• Hypospadias.
• Trap sequence.

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