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Abnormal ductus venosus pulsatility index in the absence of concurrent umbilical venous pulsations does not indicate worsening fetal condition.

Dahlbäck, Charlotte LU ; Pihlsgård, Mats LU and Gudmundsson, Saemundur LU (2013) In Ultrasound in Obstetrics & Gynecology 42(3). p.322-328
Abstract
OBJECTIVE: Recordings of blood flow velocity waveform in the ductus venosus (DV) and the umbilical vein (UV) are routinely used in order to predict the fetal condition in high-risk pregnancies. This study investigates the relationship between pathological blood flow in the two vessels and perinatal outcome. METHODS: High-risk pregnancies (n=11865) admitted during 1993-2011 for blood flow examinations, including recordings of DV pulsatility index for veins (PIV) and UV pulsations, were included. The results were related to perinatal outcome, using the last Doppler examination prior to delivery in analysis. RESULTS: Abnormal DV PIV was observed in 3,96%, intra-abdominal UV-pulsations in 1,3% and pulsations in the cord in 0,7% of the cases.... (More)
OBJECTIVE: Recordings of blood flow velocity waveform in the ductus venosus (DV) and the umbilical vein (UV) are routinely used in order to predict the fetal condition in high-risk pregnancies. This study investigates the relationship between pathological blood flow in the two vessels and perinatal outcome. METHODS: High-risk pregnancies (n=11865) admitted during 1993-2011 for blood flow examinations, including recordings of DV pulsatility index for veins (PIV) and UV pulsations, were included. The results were related to perinatal outcome, using the last Doppler examination prior to delivery in analysis. RESULTS: Abnormal DV PIV was observed in 3,96%, intra-abdominal UV-pulsations in 1,3% and pulsations in the cord in 0,7% of the cases. As expected, the rate of UV-pulsations increased with increasing DV PIV z-score. Fetuses with a pathological DV PIV, but without UV pulsations showed no signs of compromise. This was also true for cases with a DV PIV >4 SD above the mean (53.7 % had a steady flow in the UV). In contrast, the occurrence of UV-pulsations seems to be an indicator of fetal compromise regardless of level of DV PIV. CONCLUSIONS: Abnormal fetal venous blood velocity is related to adverse outcome of high-risk pregnancies. However, abnormal DV PIV is not an indicator of fetal compromise unless UV-pulsations are concurrently present and should be regarded as an artifact and not an indication for emergency delivery. (Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Ultrasound in Obstetrics & Gynecology
volume
42
issue
3
pages
322 - 328
publisher
John Wiley & Sons Inc.
external identifiers
  • wos:000323746000011
  • pmid:23355102
  • scopus:84883537471
  • pmid:23355102
ISSN
1469-0705
DOI
10.1002/uog.12411
language
English
LU publication?
yes
id
2b602198-4aa0-48e0-8e35-951bcf321210 (old id 3438228)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23355102?dopt=Abstract
date added to LUP
2016-04-01 09:54:39
date last changed
2022-02-17 04:49:04
@article{2b602198-4aa0-48e0-8e35-951bcf321210,
  abstract     = {{OBJECTIVE: Recordings of blood flow velocity waveform in the ductus venosus (DV) and the umbilical vein (UV) are routinely used in order to predict the fetal condition in high-risk pregnancies. This study investigates the relationship between pathological blood flow in the two vessels and perinatal outcome. METHODS: High-risk pregnancies (n=11865) admitted during 1993-2011 for blood flow examinations, including recordings of DV pulsatility index for veins (PIV) and UV pulsations, were included. The results were related to perinatal outcome, using the last Doppler examination prior to delivery in analysis. RESULTS: Abnormal DV PIV was observed in 3,96%, intra-abdominal UV-pulsations in 1,3% and pulsations in the cord in 0,7% of the cases. As expected, the rate of UV-pulsations increased with increasing DV PIV z-score. Fetuses with a pathological DV PIV, but without UV pulsations showed no signs of compromise. This was also true for cases with a DV PIV >4 SD above the mean (53.7 % had a steady flow in the UV). In contrast, the occurrence of UV-pulsations seems to be an indicator of fetal compromise regardless of level of DV PIV. CONCLUSIONS: Abnormal fetal venous blood velocity is related to adverse outcome of high-risk pregnancies. However, abnormal DV PIV is not an indicator of fetal compromise unless UV-pulsations are concurrently present and should be regarded as an artifact and not an indication for emergency delivery.}},
  author       = {{Dahlbäck, Charlotte and Pihlsgård, Mats and Gudmundsson, Saemundur}},
  issn         = {{1469-0705}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{322--328}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Ultrasound in Obstetrics & Gynecology}},
  title        = {{Abnormal ductus venosus pulsatility index in the absence of concurrent umbilical venous pulsations does not indicate worsening fetal condition.}},
  url          = {{http://dx.doi.org/10.1002/uog.12411}},
  doi          = {{10.1002/uog.12411}},
  volume       = {{42}},
  year         = {{2013}},
}