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Venous Doppler in the evaluation of fetal hydrops.

Hofstaetter C, Gudmundsson S - Obstet Gynecol Int (2010)

Bottom Line: Abnormal HV and DV blood velocities were recorded in 39 and 34 cases, respectively and were strongly related to mortality (P < .04 and P < .003, resp.).UV pulsations were noted in 49 fetuses and were significantly related to mortality (P < .04).Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Perinatology, University of Marburg, 30559 Hannover, Germany.

ABSTRACT
Objective. To examine venous blood flow velocity in different types of fetal hydrops and its value in the prediction of outcome of pregnancies. Methods. Venous Doppler sonography was performed in 100 hydropic fetuses from 15 to 37 weeks of gestation. Blood velocity was recorded in the right hepatic vein (HV), the ductus venosus (DV) and in the intra-abdominal part of the umbilical vein (UV). Blood velocity indices were calculated and pulsations in the umbilical vein noted and grouped into a single, double or triple flow pattern. Blood velocity was related to cause of hydrops. Results. Mortality was noted in 51 cases of which 19 were by termination of pregnancy. Mortality in the 30 with normal venous blood velocity was 35%, but 58% in cases of abnormal Doppler. Abnormal HV and DV blood velocities were recorded in 39 and 34 cases, respectively and were strongly related to mortality (P < .04 and P < .003, resp.). UV pulsations were noted in 49 fetuses and were significantly related to mortality (P < .04). Mortality and abnormal venous velocities were most frequent in the low-output hydrops group (79% and 75%, resp.). Conclusions. Abnormal venous blood velocity is related to mortality in pregnancies complicated by fetal hydrops. Venous Doppler sonography should be a part of the routine work-up of pregnancies complicated by fetal hydrops.

No MeSH data available.


Related in: MedlinePlus

Umbilical venous pulsations in relationship with ductus venosus z-score of pulsatility index for veins. 0 = normal blood velocity; 1 = flow with a single pulsation; 2 = double pulsation; 3 = triple pulsating flow pattern.
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fig3: Umbilical venous pulsations in relationship with ductus venosus z-score of pulsatility index for veins. 0 = normal blood velocity; 1 = flow with a single pulsation; 2 = double pulsation; 3 = triple pulsating flow pattern.

Mentions: Umbilical venous blood flow was recorded in all but one case. No pulsation was recorded in 49 fetuses and 50 had umbilical venous pulsations, that is, 26 with a single pulsation, 23 with a double pulsation, and one with a triple-phased pulsation. The relationship between UV pulsations and increased HV and DV PIV is given in Table 3 as well as mortality. There were 8 cases (16%) with no UV pulsations although the DV PIV was increased (PIV > 95th percentile). The DV PIV z-score and mortality increased with a higher degree of UV pulsatility (P < .0001, Figure 3, Table 2). All parameters of the DV waveform were related to UV pulsatility, but only the ES- and A-velocity in the HV blood velocity waveform. Reversal of DV flow in end-diastole was seen in 6 cases, 3 with single and 3 with double UV pulsations. Mortality was strongly related to the degree of UV-pulsatility (Table 3).


Venous Doppler in the evaluation of fetal hydrops.

Hofstaetter C, Gudmundsson S - Obstet Gynecol Int (2010)

Umbilical venous pulsations in relationship with ductus venosus z-score of pulsatility index for veins. 0 = normal blood velocity; 1 = flow with a single pulsation; 2 = double pulsation; 3 = triple pulsating flow pattern.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2864890&req=5

fig3: Umbilical venous pulsations in relationship with ductus venosus z-score of pulsatility index for veins. 0 = normal blood velocity; 1 = flow with a single pulsation; 2 = double pulsation; 3 = triple pulsating flow pattern.
Mentions: Umbilical venous blood flow was recorded in all but one case. No pulsation was recorded in 49 fetuses and 50 had umbilical venous pulsations, that is, 26 with a single pulsation, 23 with a double pulsation, and one with a triple-phased pulsation. The relationship between UV pulsations and increased HV and DV PIV is given in Table 3 as well as mortality. There were 8 cases (16%) with no UV pulsations although the DV PIV was increased (PIV > 95th percentile). The DV PIV z-score and mortality increased with a higher degree of UV pulsatility (P < .0001, Figure 3, Table 2). All parameters of the DV waveform were related to UV pulsatility, but only the ES- and A-velocity in the HV blood velocity waveform. Reversal of DV flow in end-diastole was seen in 6 cases, 3 with single and 3 with double UV pulsations. Mortality was strongly related to the degree of UV-pulsatility (Table 3).

Bottom Line: Abnormal HV and DV blood velocities were recorded in 39 and 34 cases, respectively and were strongly related to mortality (P < .04 and P < .003, resp.).UV pulsations were noted in 49 fetuses and were significantly related to mortality (P < .04).Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Perinatology, University of Marburg, 30559 Hannover, Germany.

ABSTRACT
Objective. To examine venous blood flow velocity in different types of fetal hydrops and its value in the prediction of outcome of pregnancies. Methods. Venous Doppler sonography was performed in 100 hydropic fetuses from 15 to 37 weeks of gestation. Blood velocity was recorded in the right hepatic vein (HV), the ductus venosus (DV) and in the intra-abdominal part of the umbilical vein (UV). Blood velocity indices were calculated and pulsations in the umbilical vein noted and grouped into a single, double or triple flow pattern. Blood velocity was related to cause of hydrops. Results. Mortality was noted in 51 cases of which 19 were by termination of pregnancy. Mortality in the 30 with normal venous blood velocity was 35%, but 58% in cases of abnormal Doppler. Abnormal HV and DV blood velocities were recorded in 39 and 34 cases, respectively and were strongly related to mortality (P < .04 and P < .003, resp.). UV pulsations were noted in 49 fetuses and were significantly related to mortality (P < .04). Mortality and abnormal venous velocities were most frequent in the low-output hydrops group (79% and 75%, resp.). Conclusions. Abnormal venous blood velocity is related to mortality in pregnancies complicated by fetal hydrops. Venous Doppler sonography should be a part of the routine work-up of pregnancies complicated by fetal hydrops.

No MeSH data available.


Related in: MedlinePlus