Venous Doppler ultrasonography in the fetus with nonimmune hydrops

Article Abstract:

In nonimmune hydrops fetalis, a potentially fatal condition for the fetus, excess fluid accumulates in the body cavities of the fetus. The condition of hydrops fetalis is ''nonimmune'' when maternal and fetal blood groups are compatible. A common cause of this disorder is fetal heart failure (in which the fetal heart cannot supply enough blood for the body's needs). To evaluate diagnostic methods in nonimmune hydrops fetalis, 18 pregnant women with fetuses suspected of having the disease were studied using Doppler ultrasound. The blood velocity of the fetal umbilical artery and vein was measured (to determine flow velocity characteristics as blood leaves and enters the fetus); in 10 cases, blood velocities were measured in the vena cava (the main vessel returning blood to the heart from the body). Umbilical vein velocities were recorded from the fetuses of 27 pregnant staff volunteers, who served as a normal comparison group. Results showed that blood velocity in the normal umbilical vein did not fluctuate except during fetal breathing between 20 and 40 weeks' gestation, while pulsations in velocity were seen in 14 of the 18 cases with nonimmune hydrops fetalis. The four suspected cases without pulsations turned out to have intrauterine viral infections (documented in three, suspected in one); in these cases, and in one of the other 14, hydrops resolved before birth. Thus hydrops was present at birth in 13 cases; five of these fetuses died in utero (all had abnormal pulsations). Measurements of the vena cava showed extreme fluctuations in velocity, with abnormal reversals of blood velocities. Total mortality for fetuses with venous pulsations was 10 out of 14, compared with no deaths among those without pulsations. Velocity in the umbilical artery was not a valuable predictor of fetal outcome, but Doppler studies of flow in the umbilical vein and vena cava of the fetus can provide important information on the heart's function. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Diagnosis, Physiological aspects, Umbilical cord, Prenatal diagnosis, Hydrops fetalis, Ultrasonics in obstetrics

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Fetal branch pulmonary arterial vascular impedance during the second half of pregnancy

Article Abstract:

Impedance of blood flow in the fetus may decrease in the second half of pregnancy, and may be measured noninvasively by ultrasonography. Researchers analyzed the circulation of 100 fetuses using color Doppler ultrasound between 18 and 41 weeks of pregnancy to determine normal impedance measurements of the major artery of the lung. Impedance measurements significantly decreased in the second half of pregnancy, corresponding with a significant increase in lung size in later pregnancy. The number of resistance blood vessels also increases in the second half of pregnancy, and may be related to the decrease in impedance. Ultrasound studies of fetal circulation should identify the measurement point in the branch artery of the lung to distinguish impedance values of near and far arteries.

Blood flow, Measurement, Blood flow measurement

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Spontaneous closure of the human fetal ductus arteriosus - a cause of fetal congestive heart failure

Article Abstract:

The ductus arteriosus of the fetus may close on its own before birth in rare cases, and may be detected prenatally by two-dimensional and Doppler echocardiography. Researchers managed four pregnant women in the last trimester whose fetuses were diagnosed with closure of the fetal ductus arteriosus. Diagnoses were based on abnormal cardiotocograms, abnormal four-chamber heart ultrasonographic findings, and abnormal fetal echocardiogram results. Fetuses were delivered shortly after diagnoses were made, and congestive heart failure subsided after birth. Some infants may continue to experience right ventricular dysfunction. Closure of the ductus arteriosus has been linked with maternal ingestion of nonsteroidal antiinflammatory drugs, but such drugs were not used in these cases.

Abnormalities, Causes of, Congestive heart failure, Doppler echocardiography, Ductus arteriosus

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