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Venous Doppler velocimetry in the surveillance of severely compromised fetuses

Hofstaetter, C; Gudmundsson, Saemundur LU and Hansmann, M (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)
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author
organization
publishing date
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
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
id
77a258a7-c105-41b1-95c1-96e8dbe16885 (old id 892625)
date added to LUP
2008-01-23 11:30:23
date last changed
2017-01-01 07:13:48
@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 &lt; 0.05). A decrease of all velocities and increase of pulsatility were noted in the ductus venosus (P &lt; 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},
  keyword      = {growth restriction,placental insufficiency,perinatal mortality,venous Doppler velocimetry,reversed blood flow},
  language     = {eng},
  number       = {3},
  pages        = {233--239},
  publisher    = {John Wiley & Sons},
  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},
  volume       = {20},
  year         = {2002},
}