Fetal Ductus Venosus Pulsatility Index and Diameter during Second and Third Trimester of Gestation
DOI:
https://doi.org/10.31729/jnma.3042Keywords:
ductus venosus diameter; gestational age; Pulsatility Index.Abstract
Introduction: The ductus venosus is a small funnel shaped vessel found posterior to the fetal liver connecting the intra-abdominal umbilical vein and the inferior vena cava. It is one of the three physiological shunts in the fetus. The main objective of this study is to construct the reference table and normogram for fetal ductus venosus Pulsatility Index and diameter with gestational age.
Methods: This was a prospective cross sectional study conducted during August 2011 to July 2012 taking 294 uncomplicated pregnancies using systemic random sampling method. Three measurements were made for ductus venosus diameter and Pulsatility Index in each fetus during period of fetal quiescence.
Results: The ductus venosus diameter at <20weeks, 20-25 weeks, 25-30 weeks, >30 weeks were 1.16, 1.31, 1.62, 1.81 and Pulsatility Index at <20weeks, 20-25 weeks, 25-30 weeks, >30 weeks were 0.41, 0.44, 0.41 and 0.41 respectively.
Conclusions: The mean diameter of the ductus venosus was linear across gestational age. The Pulsatility Index shows a scattered distribution across the gestational age.
Keywords: ductus venosus diameter; gestational age; Pulsatility Index.
References
1. Kiserud T, Eik-Nes S, Blaas H, Hellevik L. Ultrasonographic velocimetry of the fetal ductus venosus. The Lancet. 1991;338(8780):1412-4. PubMed
2. Kiserud T, Eikâ€Nes S, Blaas HG, Hellevik L. Foramen ovale: an ultrasonographic study of its relation to the inferior vena cava, ductus venosus and hepatic veins. Ultrasound in Obstetrics & Gynecology. 2003;2(6):389-96. PubMed
3. Axt-Fliedner R, Wiegank U, Fetsch C, Friedrich M, Krapp M, Georg T, et al. Reference values of fetal ductus venosus, inferior vena cava and hepatic vein blood flow velocities and waveform indices during the second and third trimester of pregnancy. Archives of Gynecology and Obstetrics. 2004;270(1):46-55. PubMed
4. Axt-Fliedner R, Diler S, Georg T, Friedrich M, Diedrich K. Reference values of ductus venosus blood flow velocities and waveform indices from 10 to 20 weeks of gestation. Archives of Gynecology and Obstetrics. 2004;269(3):199-204. PubMed
5. Baschat A, Gembruch U, Reiss I, Gortner L, Weiner C, Harman C. Relationship between arterial and venous Doppler and perinatal outcome in fetal growth restriction. Ultrasound in Obstetrics & Gynecology. 2002;16(5):407-13. PubMed
6. Borrell A, Grande M, Bennasar M, Borobio V, Jimenez JM, Stergiotou I, et al. First trimester detection of cardiac defects with the use of ductus venosus blood flow. Ultrasound in Obstetrics & Gynecology. 2012. PubMed
7. Ortigosa C, Nomura RMY, Costa VN, Miyadahira S, Zugaib M. Fetal venous Doppler in pregnancies with placental dysfunction and correlation with pH at birth. Journal of Maternal-Fetal and Neonatal Medicine. 2012(00):1-21. PubMed
8. Tseng CC, Wang HI, Wang PH, Yang MJ, Juang CM, Horng HC, et al. Ductus venosus Doppler velocimetry in normal pregnancies from 11 to 13+ 6 weeks' gestation—A Taiwanese study. Journal of the Chinese Medical Association 2012. Full Text
9. Demirturk F, Caliskan AC, Aytan H, Sahin S. A preliminary retrospective study about the relationship between ductus venosus Doppler indices, nuchal translucency (NT) and biochemical markers in the first and second trimester screening tests. Gynecological Endocrinology. 2012;28(5):378-81. PubMed
10. Tongprasert F, Srisupundit K, Luewan S, Wanapirak C, Tongsong T. Normal reference ranges of ductus venosus Doppler indices in the period from 14 to 40 weeks' gestation. Gynecologic and obstetric investigation. 2012;73(1):32-7. Epub 2011/08/19. PubMed
11. Tsuchiya M, Kikuchi A, Takakuwa K, Tanaka K. Increased pulsatility of the ductus venosus blood velocity in the first trimester is associated with the delivery of small for gestational age or low birth weight infants. Journal of Obstetrics and Gynaecology Research. 2010;36(6):1151-60. PubMed
12. Timmerman E, Clur S, Pajkrt E, Bilardo C. Firstâ€trimester measurement of the ductus venosus Pulsatility Index and the prediction of congenital heart defects. Ultrasound in Obstetrics & Gynecology. 2010;36(6):668-75. PubMed
13. Rudolph AM. Hepatic and ductus venosus blood flows during fetal life. Hepatology1983. p. 254-8. PubMed
14. Kiserud T, Hellevik L, Eik-Nes S, Angelsen B, Blaas HG. Estimation of the pressure gradient across the fetal ductus venosus based on Doppler velocimetry. Ultrasound in medicine & biology. 1994;20(3):225-32. PubMed
15. Kiserud T, Rasmussen S, Skulstad S. Blood flow and the degree of shunting through the ductus venosus in the human fetus. American journal of obstetrics and gynecology. 2000;182(1):147-53. PubMed
16. Edelstone DI, Rudolph AM. Preferential streaming of ductus venosus blood to the brain and heart in fetal lambs. American Journal of Physiology-Heart and Circulatory Physiology. 1979;237(6):H724-H9. PubMed
17. Coceani F, Olley P. The control of cardiovascular shunts in the fetal and perinatal period. Canadian journal of physiology and pharmacology. 1988;66(8):1129-34. PubMed
18. Kiserud T, Stratford L, Hanson MA. Umbilical flow distribution to the liver and the ductus venosus: an in vitro investigation of the fluid dynamic mechanisms in the fetal sheep. American journal of obstetrics and gynecology. 1997;177(1):86-90. PubMed
19. Chanthasenanont A, Pongrojpaw D, Somprasit C. Fetal ductus venosus Pulsatility Index and diameter during 20-30 weeks gestation. Medical journal of the Medical Association of Thailand. 2008;91(6):794.PubMed
20. Chanthasenanont A, Pongrojpaw D, Somprasit C. Effect of fetal gender on ductus venosus Pulsatility Index and diameter at gestational age 17-37 weeks. 2009. PubMed
21. Kessler J, Rasmussen S, Hanson M, Kiserud T. Longitudinal reference ranges for ductus venosus flow velocities and waveform indices. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2006;28(7):890-8. Epub 2006/11. PubMed
22. Marcolin AC, Berezowski AT, Crott GC et al. Longitudinal reference values for ductus venosus Doppler in low-risk pregnancies. Ultrasound Med Biol. 2010 Mar;36(3):392-6. Epub 2010 Feb 4. PubMed
Downloads
Published
How to Cite
Issue
Section
License
JNMA allow to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. The author(s) are allowed to retain publishing rights without restrictions. The JNMA work is licensed under a Creative Commons Attribution 4.0 International License. More about Copyright Policy.
