Ductus venosus velocimetry in high-risk pregnancies.

OBJECTIVE

Umbilical venous (UV) blood velocity pulsations have been considered as a late sign of fetal hypoxemia in high-risk pregnancies. Ductus venosus (DV) functions as a pressure filter as it conducts umbilical blood into the inferior vena cava of the fetus. The aim of this paper was to evaluate whether DV Doppler velocimetry might give earlier indication of fetal hypoxemia than does UV blood velocity.

DESIGN

Recording of DV blood velocity in complicated pregnancies referred for umbilical artery (UA) velocimetry as one aspect of fetal surveillance.

METHOD

DV and UV blood velocities were recorded serially by Doppler ultrasound in 87 high-risk pregnancies and the results of the last examination before delivery were correlated to perinatal outcome.

RESULTS

Abnormal DV blood velocity waveforms recorded in 26 pregnancies were not correlated to perinatal outcome, except for low Apgar score at one minute of life. Abnormal UV blood velocity pulsations in the cord were recorded in 11 fetuses, of which only 6 had abnormal DV velocimetry. UV pulsations were related to adverse perinatal outcome and all these fetuses had abnormal UA velocimetry.

CONCLUSION

Abnormal DV blood velocity is more frequently recorded in high-risk pregnancies than UV pulsations, but appears to be a poor indicator of adverse perinatal outcome.