Relationship between aortic isthmus and ductus venosus velocity waveforms in severe growth restricted fetuses

• Published in: Prenatal diagnosis Vol. 28; no. 11; pp. 1042 - 1047
• Main Authors: Rizzo, Giuseppe, Capponi, Alessandra, Vendola, Marianne, Pietrolucci, Maria Elena, Arduini, Domenico
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.11.2008; Wiley
• Subjects: Aorta, Thoracic - diagnostic imaging; Aorta, Thoracic - embryology; Apgar Score; Biological and medical sciences; Birth Weight; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - epidemiology; Delivery, Obstetric; Delivery. Postpartum. Lactation; doppler ultrasound; ductus venosus; Female; fetal aortic isthmus; Fetal Death; Fetal Growth Retardation - diagnostic imaging; Fetal Growth Retardation - mortality; Fundamental and applied biological sciences. Psychology; Genetics of eukaryotes. Biological and molecular evolution; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; IUGR; Medical sciences; Molecular and cellular biology; Multivariate Analysis; Pregnancy; Pregnancy Trimester, Second; Ultrasonography, Prenatal; Doppler ultrasound study; Sonography; Waveform; Aortic isthmus; doppler ultrasound; Intrauterine growth retardation; Pregnancy disorders; Arantius canal; fetal aortic isthmus; Gynecology; ductus venosus; Neonatology; Velocity; Pregnancy; Fetal diseases; IUGR; Echography; Fetus; Genetics; Ultrasound
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.2121

Objective To evaluate the incidence of abnormalities in velocity waveforms from ductus venosus (DV) and aortic isthmus (AoI) in fetuses with intrauterine growth restriction (IUGR) and their reciprocal temporal relationship. Methods DV and AoI velocity waveforms were recorded in 31 IUGR fetuses characterized either by absent end diastolic (20) or reverse flow (11) in umbilical artery. Abnormal velocity waveforms in DV and AoI were defined in presence of reverse diastolic flows. Results Abnormal DV velocity waveforms were present in 10 fetuses and were always associated with abnormalities. Abnormal AoI flows were also present in 10 fetuses of the remaining 21 fetuses with normal DV velocity waveforms (47.6%). Longitudinal monitoring of fetuses with normal DV flows showed a significantly shorter time interval in the onset of reverse flow in DV when abnormalities in AoI were present (4 vs 14 days p = 0.001) irrespectively of gestational age or other potential confounding variables. Conclusions Our data suggest that AoI velocity waveforms become abnormal at an earlier stage of fetal compromise than DV. Copyright © 2008 John Wiley & Sons, Ltd.