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Reference ranges for Doppler‐assessed pulmonary venous blood flow velocities and pulsatility indices in normal human fetuses
Author(s) -
Lenz Franka,
Chaoui Rabih
Publication year - 2002
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.410
Subject(s) - gestation , cardiology , medicine , diastole , fetus , blood flow , doppler effect , doppler echocardiography , hemodynamics , pregnancy , pulsatile flow , gestational age , cardiac cycle , blood pressure , physics , biology , genetics , astronomy
Objectives To establish reference ranges with gestation for Doppler parameters of fetal pulmonary venous blood flow during the second half of pregnancy, including not only peak velocities, but also relative indices reflecting left atrial pressure changes. Methods In this cross‐sectional study, 114 normal singleton pregnancies between 19 and 37 weeks' gestation were examined by Doppler echocardiography. In 98 fetuses, peak systolic velocity (S), peak diastolic velocity (D), end‐diastolic velocity (A), and time velocity integral (TVI) were measured, and S/D ratio, pulsatility index for veins (PIV), as well as peak velocity index for veins (PVIV), were calculated. Regression analysis was used to determine reference ranges with gestation. Results With advancing gestation, a significant increase in S, D and A velocities as well as in TVI, was observed. Whereas the S/D ratio remained constant, PVIV and PIV decreased significantly during the second half of pregnancy. Conclusions During the second half of pregnancy the increase in left atrial and ventricular compliance is reflected by the observed decrease in PIV and PVIV, which could be mainly due to the increased flow during atrial contraction. Such relative Doppler indices are better comparable than absolute values and are independent from the insonation angle. Potential clinical applications for such Doppler indices are conditions with possibly impaired left atrial function, like heart defects with left atrial obstruction or late stages of severe intrauterine growth retardation. Copyright © 2002 John Wiley & Sons, Ltd.