Fetal right hepatic venous blood velocimetry in normal and high-risk pregnancies
- 作者：Hofstaetter ; C. ; Gudmundsson ; S. ; Dubiel ; M. ; Marsal ; K.
- 关键词：Doppler ultrasound ; Fetus ; Hepatic circulation ; Fetal heart sparing ; Perinatal outcome
- 刊名：European Journal of Ultrasound
- 出版年：1996
- 期刊代码：20_09298266
- 类别：ph
- 出版时间：December, 1996
- 卷：4
- 期：3
- 页码：153-160
- 文件大小：547 K
摘要
Objective: To evaluate hepatic venous blood velocity in normal and high-risk pregnancies. Methods: In a cross-sectional study, blood velocities in the fetal left and right hepatic veins (HVs) were recorded by Doppler ultrasound in 87 normal singleton pregnancies from 18 to 43 weeks of gestation and in 91 high risk pregnancies in a prospective study. The blood velocity waveforms were analyzed for peak velocity during ventricular systole (S), end-systole (ES), diastole (D), and end-diastolic blood velocity corresponding to atrial contraction (A). As the reverse flow during atrial contraction was significantly more pronounced in the right than in the left hepatic vein, only right hepatic venous blood velocimetry was used for evaluation. Results: Right HV velocity manifested increasing S velocity towards the heart and a reduction in reversed blood velocity during atrial contraction with increasing gestational age. ES, D and A blood velocities were unchanged throughout gestation. In the prospective study, the final ratio before birth was abnormal in only seven cases (7.7%). These seven infants were delivered earlier then the rest of the group, and stayed longer in the neonatal intensive care unit. Otherwise, outcome was similar in the pregnancies with normal and abnormal HV blood velocity. HV blood velocity in cases with normal umbilical artery (UA) velocimetry (n = 35), increased UA Pulsatility Index (n = 42), and absent or reversed diastolic blood velocity (n = 14) differed only by a decrease in ES blood velocity in the latter group, suggesting an increase in cardiac afterload in relation to absent end-diastolic blood velocity in the UA. Conclusion: The minimal changes in fetal hepatic venous blood velocimetry in severely complicated pregnancies suggest the presence of ‘fetal heart sparing.’