Hofstaetter C, Gudmundsson S
Department of Obstetrics and Perinatology, University of Marburg, 30559 Hannover, Germany.
Obstet Gynecol Int. 2010;2010:430157. doi: 10.1155/2010/430157. Epub 2010 May 5.
Objective. To examine venous blood flow velocity in different types of fetal hydrops and its value in the prediction of outcome of pregnancies. Methods. Venous Doppler sonography was performed in 100 hydropic fetuses from 15 to 37 weeks of gestation. Blood velocity was recorded in the right hepatic vein (HV), the ductus venosus (DV) and in the intra-abdominal part of the umbilical vein (UV). Blood velocity indices were calculated and pulsations in the umbilical vein noted and grouped into a single, double or triple flow pattern. Blood velocity was related to cause of hydrops. Results. Mortality was noted in 51 cases of which 19 were by termination of pregnancy. Mortality in the 30 with normal venous blood velocity was 35%, but 58% in cases of abnormal Doppler. Abnormal HV and DV blood velocities were recorded in 39 and 34 cases, respectively and were strongly related to mortality (P < .04 and P < .003, resp.). UV pulsations were noted in 49 fetuses and were significantly related to mortality (P < .04). Mortality and abnormal venous velocities were most frequent in the low-output hydrops group (79% and 75%, resp.). Conclusions. Abnormal venous blood velocity is related to mortality in pregnancies complicated by fetal hydrops. Venous Doppler sonography should be a part of the routine work-up of pregnancies complicated by fetal hydrops.
目的。研究不同类型胎儿水肿时的静脉血流速度及其在预测妊娠结局中的价值。方法。对100例妊娠15至37周的水肿胎儿进行静脉多普勒超声检查。记录右肝静脉（HV）、静脉导管（DV）和脐静脉腹腔内部分（UV）的血流速度。计算血流速度指数，记录脐静脉的搏动情况，并将其分为单、双或三血流模式。血流速度与水肿原因相关。结果。51例中有死亡记录，其中19例因终止妊娠死亡。静脉血流速度正常的30例中死亡率为35%，但多普勒异常的病例中死亡率为58%。分别在39例和34例中记录到HV和DV血流速度异常，且与死亡率密切相关（分别为P <.04和P <.003）。49例胎儿出现UV搏动，且与死亡率显著相关（P <.04）。低输出量水肿组的死亡率和静脉速度异常最为常见（分别为79%和75%）。结论。静脉血流速度异常与胎儿水肿合并妊娠的死亡率相关。静脉多普勒超声检查应作为胎儿水肿合并妊娠常规检查的一部分。
