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Reference values of ductus venosus blood flow velocities and waveform indices from 10 to 20 weeks of gestation

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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

Our objective was to establish reference values for ductus venosus flow velocities during ventricular systole (S wave) and diastole (D wave), the lowest forward velocity during atrial contraction (A wave) and different calculated indices [(S-A)/D), (S-A)/Vmean, (S-A)/S, S/A, S/D)].

Methods

Ductus venosus flow velocity waveforms were obtained from 329 singleton pregnancies at 10–20 weeks of gestation by pulsed-wave color Doppler. Reference values were constructed by means of a quadratic regression model after logarithmic transformation of original data.

Results

A significant increase in blood flow velocity during atrial contraction [A-wave, (3.5 cm/s to 9.9 cm/s and 12.9 cm/s to 66.3 cm/s respectively, 5–95% centile)], during ventricular systole [S-wave, (19.2 cm/s to 30.1 cm/s and 45.1 cm/s to 84.9 cm/s respectively, 5–95% centile)] and during early ventricular diastole [D-wave, (15.7 cm/s to 26.1 cm/s and 37.9 cm/s to 77.9 cm/s respectively, 5–95% centile)]. The venous indices values decreased with increasing gestational age. In 3 of 329 fetuses (0.91%) a reversed flow during atrial contraction was seen.

Conclusion

Assessment of ductus venosus blood flow velocities during first and second trimester is feasible by means of color Doppler flow. The reference ranges and calculated velocities established in this study may be utilized in studies dealing with the role of ductus venosus blood flow in chromosomal abnormal fetuses, fetuses with congenital heart disease or fetal myocardial insufficiency of hypoxic origin.

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References

  1. Bahlmann F, Wellek S, Reinhardt I, Merz E, Steiner E, Welter C (2000) Reference values of ductus venosus flow velocities and calculated waveform indices. Prenat Diagn 20:623–634

    Article  CAS  PubMed  Google Scholar 

  2. Bilardo CM, Müller MA, Zikulnig L, Schipper M, Hecher K (2001) Ductus venosus studies in fetuses at high risk for chromosomal or heart abnormalities: relationship with nuchal translucency measurement and fetal outcome. Ultrasound Obstet Gynecol 17:288–294

    CAS  PubMed  Google Scholar 

  3. Borrell A, Antolin E, Costa D, Farre MT, Martinez JM, Fortuny A (1998) Abnormal ductus venosus blood flow in trisomy 21 fetuses during early pregnancy. Am J Obstet Gynecol 179:1612–1617

    CAS  PubMed  Google Scholar 

  4. Carvalho JS (1999) Nuchal translucency, ductus venosus and congenital heart disease: an important association, a cautious analysis. Ultrasound Obstet Gynecol 14:302–306

    Article  CAS  PubMed  Google Scholar 

  5. Edelstone DI, Rudolph AM (1979) Preferential streaming of ductus venosus blood to the brain and heart in fetal lambs. Am J Physiol 237:724–729

    Google Scholar 

  6. Germer U, Kohl T, Smrcek JM, Geipel A, Berg C, Krapp M, Friedrich HJ, Diedrich K, Gembruch U (2002) Comparison of ductus venosus blood flow waveform indices of 607 singletons with 133 multiples at 10–14 weeks gestation—an evaluation in uncomplicated pregnancies. Arch Gynecol Obstet 266:187–192

    CAS  PubMed  Google Scholar 

  7. Hecher K (2001) Assessment of ductus venosus flow during the first and early second trimesters: what can we expect? Ultrasound Obstet Gynecol 17:285–287

    Google Scholar 

  8. Hecher K, Hackeloer BJ (1997) Cardiotocogram compared to Doppler investigation of the fetal circulation in the premature growth-retarded fetus: longitudinal observations. Ultrasound Obstet Gynecol 9:152–161

    Article  CAS  PubMed  Google Scholar 

  9. Hecher K, Campbell S, Doyle P, Harrington K, Nicolaides K (1995) Assessment of fetal compromise by Doppler ultrasound investigation of the fetal circulation. Circulation 91:129–138

    CAS  PubMed  Google Scholar 

  10. Hecher K, Snijders R, Campbell S, Nicolaides K (1995) Fetal venous, intracardiac and arterial blood flow measurements in intrauterine growth retardation: relationship with fetal blood gases. Am J Obstet Gynecol 173:10–15

    CAS  PubMed  Google Scholar 

  11. Kiserud T, Eik-Nes SH, Blaas HG, Hellevik LR, Simensen B (1994) Ductus venosus blood velocity and the umbilical circulation in the seriously growth-retarded fetus. Ultrasound Obstet Gynecol 4:109–114

    Article  CAS  PubMed  Google Scholar 

  12. Kiserud T, Eik-Nes SH, Hellevik LR, Blaas HG (1993) Ductus venosus blood velocity changes in fetal cardiac disease. J Matern Fetal Invest 3:15–20

    Google Scholar 

  13. Kiserud T, Rasmussen S, Skulstad S (2000) Blood flow and the degree of shunting through the ductus venosus in the human fetus. Am J Obstet Gynecol 182:147–153

    CAS  PubMed  Google Scholar 

  14. Matias A, Gomes C, Flack N, Montenegro N, Nicolaides KH (1998) Screening for chromosomal abnormalities at 10–14 weeks: the role of ductus venosus blood flow. Ultrasound Obstet Gynecol 12:380–384

    Article  CAS  PubMed  Google Scholar 

  15. Matias A, Huggon I, Areias JC, Montenegro N, Nicolaides KH (1999) Cardiac defects in chromosomally normal fetuses with abnormal ductus venosus flow at 10–14 weeks. Ultrasound Obstet Gynecol 14:307–310

    CAS  PubMed  Google Scholar 

  16. Montenegro N, Matias A, Arejas JC, Barros H (1997) Ductus venosus revisited: a Doppler blood flow evaluation in the first trimester of pregnancy. Ultrasound Med Biol 23:171–176

    Article  CAS  PubMed  Google Scholar 

  17. Prefumo F, Risso D, Venturini PL, de Biasio P (2002) Reference values for ductus venosus Doppler flow measurements at 10–14 weeks of gestation. Ultrasound Obstet Gynecol 20:42–46

    Article  CAS  PubMed  Google Scholar 

  18. Van Splunder P, Huisman TWA, de Ridder MAJ, Wladimiroff JW (1996) Fetal venous and arterial flow velocity wave forms between eight and twenty weeks of gestation. Pediatr Res 40:158–162

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Prenatal Medicine, Department of Obstetrics and Gynecology, Medical University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany

    R. Axt-Fliedner, S. Diler, M. Friedrich & K. Diedrich

  2. Institute of Epidemiology and Medical Statistics, University of Homburg/Saar, 66421, Homburg/Saar, Germany

    T. Georg

Authors
  1. R. Axt-Fliedner
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  2. S. Diler
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  3. T. Georg
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  4. M. Friedrich
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  5. K. Diedrich
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Correspondence to R. Axt-Fliedner.

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Axt-Fliedner, R., Diler, S., Georg, T. et al. Reference values of ductus venosus blood flow velocities and waveform indices from 10 to 20 weeks of gestation. Arch Gynecol Obstet 269, 199–204 (2004). https://doi.org/10.1007/s00404-003-0484-y

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  • DOI: https://doi.org/10.1007/s00404-003-0484-y

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