Venous Doppler velocimetry in the surveillance of severely compromised fetuses
(2002) In Ultrasound in Obstetrics & Gynecology 20(3). p.233-239- Abstract
- Objective To investigate whether venous Doppler velocimetric signs of cardiac decompensation might predict fetal demise in severely compromised fetuses. Material and methods This was a prospective study involving 154 growth-restricted fetuses, 37 of which were found to have reversed flow in the umbilical artery (BFC III). Doppler velocimetry of the right hepatic vein and ductus venosus were investigated serially and the presence of umbilical venous pulsations also registered. Only the final examination prior to birth or fetal demise was accepted for analysis and related to obstetric outcome defined as gestational age at birth, birth weight and perinatal mortality. In cases of BFC III the venous velocimetry of 15 nonsurviving fetuses was... (More)
- Objective To investigate whether venous Doppler velocimetric signs of cardiac decompensation might predict fetal demise in severely compromised fetuses. Material and methods This was a prospective study involving 154 growth-restricted fetuses, 37 of which were found to have reversed flow in the umbilical artery (BFC III). Doppler velocimetry of the right hepatic vein and ductus venosus were investigated serially and the presence of umbilical venous pulsations also registered. Only the final examination prior to birth or fetal demise was accepted for analysis and related to obstetric outcome defined as gestational age at birth, birth weight and perinatal mortality. In cases of BFC III the venous velocimetry of 15 nonsurviving fetuses was compared to that of the 22 survivors. Results There was a significant correlation between venous blood velocity and placental vascular resistance. In the right hepatic vein there was a significant decrease in peak systolic and end-systolic velocities and an increase of maximum velocity during atrial contraction and pulsatility (P < 0.05). A decrease of all velocities and increase of pulsatility were noted in the ductus venosus (P < 0.05). A reversed flow in the ductus venosus was found in 9/37 fetuses and double umbilical venous pulsations in 16/37 fetuses. However, the hepatic vein seemed to be a better predictor of impending mortality than the ductus venosus. Changes in diastolic venous blood velocity and a double pulsation in the umbilical vein were closely related to perinatal mortality, although these parameters did not provide a useful threshold to optimize the timing of delivery. Conclusion Diastolic venous velocimetry changes significantly in severely compromised fetuses. These changes might be of great clinical value in deciding on the timing of delivery to minimize damage to the fetus and newborn. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/892625
- author
- Hofstaetter, C ; Gudmundsson, Saemundur LU and Hansmann, M
- organization
- publishing date
- 2002
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- growth restriction, placental insufficiency, perinatal mortality, venous Doppler velocimetry, reversed blood flow
- in
- Ultrasound in Obstetrics & Gynecology
- volume
- 20
- issue
- 3
- pages
- 233 - 239
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- wos:000178003000007
- pmid:12230444
- scopus:0036381025
- ISSN
- 1469-0705
- DOI
- 10.1046/j.1469-0705.2002.00791.x
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pediatrics/Urology/Gynecology/Endocrinology (013240400)
- id
- 77a258a7-c105-41b1-95c1-96e8dbe16885 (old id 892625)
- date added to LUP
- 2016-04-01 16:44:22
- date last changed
- 2022-01-28 21:50:22
@article{77a258a7-c105-41b1-95c1-96e8dbe16885,
abstract = {{Objective To investigate whether venous Doppler velocimetric signs of cardiac decompensation might predict fetal demise in severely compromised fetuses. Material and methods This was a prospective study involving 154 growth-restricted fetuses, 37 of which were found to have reversed flow in the umbilical artery (BFC III). Doppler velocimetry of the right hepatic vein and ductus venosus were investigated serially and the presence of umbilical venous pulsations also registered. Only the final examination prior to birth or fetal demise was accepted for analysis and related to obstetric outcome defined as gestational age at birth, birth weight and perinatal mortality. In cases of BFC III the venous velocimetry of 15 nonsurviving fetuses was compared to that of the 22 survivors. Results There was a significant correlation between venous blood velocity and placental vascular resistance. In the right hepatic vein there was a significant decrease in peak systolic and end-systolic velocities and an increase of maximum velocity during atrial contraction and pulsatility (P < 0.05). A decrease of all velocities and increase of pulsatility were noted in the ductus venosus (P < 0.05). A reversed flow in the ductus venosus was found in 9/37 fetuses and double umbilical venous pulsations in 16/37 fetuses. However, the hepatic vein seemed to be a better predictor of impending mortality than the ductus venosus. Changes in diastolic venous blood velocity and a double pulsation in the umbilical vein were closely related to perinatal mortality, although these parameters did not provide a useful threshold to optimize the timing of delivery. Conclusion Diastolic venous velocimetry changes significantly in severely compromised fetuses. These changes might be of great clinical value in deciding on the timing of delivery to minimize damage to the fetus and newborn.}},
author = {{Hofstaetter, C and Gudmundsson, Saemundur and Hansmann, M}},
issn = {{1469-0705}},
keywords = {{growth restriction; placental insufficiency; perinatal mortality; venous Doppler velocimetry; reversed blood flow}},
language = {{eng}},
number = {{3}},
pages = {{233--239}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Ultrasound in Obstetrics & Gynecology}},
title = {{Venous Doppler velocimetry in the surveillance of severely compromised fetuses}},
url = {{http://dx.doi.org/10.1046/j.1469-0705.2002.00791.x}},
doi = {{10.1046/j.1469-0705.2002.00791.x}},
volume = {{20}},
year = {{2002}},
}