Fetal ductus venosus Doppler as a predictor of pregnancy outcome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20230520Keywords:
Fetus, Pregnancy, Doppler, Outcomes, Ductus venosusAbstract
Background: The ductus venosus (DV) transports oxygenated blood to the developing heart and brain by avoiding the hepatic circulation. Due to the anatomical location of the DV, measurement of DV blood flow velocity waveforms indirectly disclose the cardiac functions and health of the foetus, which represents the pressure gradient between the umbilical vein and right atrium. The aim of this study was to evaluate the value of ductus venosus pulstality index of veins in early pregnancy in prediction of adverse pregnancy outcomes.
Methods: 50 pregnant women with a single viable foetus between 13 and 24 weeks participated in this prospective cross-sectional study from 2021 to 2022 at Tanta University Hospital.
Results: PI in normal group ranged from 0.80-1.20 with mean value 0.90±0.130 and in abnormal group ranged from 0.46-0.50 with mean value 0.522±0.069. S/a ration in normal group ranged from 1.74-3.18 with mean value 2.30±0.40 and in abnormal group ranged from 1.50-2.05 with mean value 1.833±0.212. There was statistically significant difference between outcomes of pregnancy with ultrasound findings (p<0.05).
Conclusions: Numerous foetal disorders that might result in cardiovascular deterioration and other aberrant outcomes in newborns can be managed clinically and predicted perinatally using the DV Doppler examination.
References
Kiserud T, Eik-Nes SH, Blaas HG, Hellevik LR. Ultrasonographic velocimetry of the fetal ductus venosus. Lancet. 1991;338:1412-4.
Gürses C, Karadağ B, İsenlik BST. Normal variants of ductus venosus spectral Doppler flow patterns in normal pregnancies. J Matern Fet Neonat Med. 2020;33:1288-94.
Ghosh R, Oza H, Meel S. Third trimester Doppler ultrasound as prediction of obstetric outcome in high-risk pregnancy, Gujarat, India. Int J Reprod Contracept Obstet Gynecol. 2017;6:3519-23.
Borrell A, Grande M, Bennasar M, Borobio V, Jimenez JM, Stergiotou I, et al. First-trimester detection of major cardiac defects with the use of ductus venosus blood flow. Ultrasound Obstet Gynecol. 2013;42:51-7.
Pennati G, Bellotti M, Ferrazzi E, Rigano S, Garberi A. Hemodynamic changes across the human ductus venosus: a comparison between clinical findings and mathematical calculations. Ultrasound Obstet Gynecol. 1997;9:383-91.
Rizzo G, Capponi A, Arduini D, Romanini C. Ductus venosus velocity waveforms in appropriate and small for gestational age fetuses. Early Hum Dev. 1994;39:15-26.
Rizzo G, Capponi A, Talone PE, Arduini D, Romanini C. Doppler indices from inferior vena cava and ductus venosus in predicting pH and oxygen tension in umbilical blood at cordocentesis in growth-retarded fetuses. Ultrasound Obstet Gynecol. 1996;7:401-10.
Allam IS, Abuelghar W, Fathy H, Enin LA, Sayed M. Prediction of neonatal acidosis by ductus venosus Doppler pattern in high risk pregnancies. Middle East Fertil Soc J. 2013;18:47-52.
Bahlmann F, Wellek S, Reinhardt I, Merz E, Steiner E, Welter C. Reference values of ductus venosus flow velocities and calculated waveform indices. Prenat Diagn. 2000;20:623-34.
Baschat AA. Neurodevelopment following fetal growth restriction and its relationship with antepartum parameters of placental dysfunction. Ultrasound Obstet Gynecol. 2011;37:501-14.
Ertan AK, Taniverdi HA. Doppler sonography in obstetrics. Donald School J Ultrasound Obstet Gynecol. 2013;7:128-48.
Lees C, Marlow N, Arabin B, Bilardo CM, Brezinka C, Derks JB, et al. Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (TRUFFLE). Ultrasound Obstet Gynecol. 2013;42:400-8.
