Premium
Absence of an anatomical origin for altered ductus venosus flow velocity waveforms in first‐trimester human fetuses with increased nuchal translucency
Author(s) -
Burger Nicole B.,
Matias Alexandra,
Kok Evelien,
Groot Christianne J. M.,
Christoffels Vincent M.,
Bekker Mireille N.,
Haak Monique C.
Publication year - 2016
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.4820
Subject(s) - ductus venosus , fetus , anatomy , trisomy , intracardiac injection , medicine , biology , pregnancy , genetics
Objective To perform a morphological evaluation of the ductus venosus, heart and jugular lymphatic sac (JLS) in first‐trimester human fetuses with normal and abnormal ductus venosus flow velocity waveforms (DV‐FVWs) and normal and increased nuchal translucency (NT). Method Postmortem examination was performed on fetuses with increased NT or structural malformations with previous NT and DV‐FVW measurements. Ductus venosus morphology was examined using markers for endothelium, smooth muscle actin (SMA), nerves and elastic fibers. Fetal hearts were studied by microscopy. The nuchal region was analyzed using markers for lymphatic vessels, endothelium, SMA and nerves. Results Two trisomy 21 and two trisomy 18 fetuses with increased NT and abnormal DV‐FVWs were analyzed. As a control, one euploid anencephalic fetus with normal NT, cardiac anatomy and DV‐FVWs was examined. Similar endothelial and SMA expression was observed in the ductus venosus in all fetuses. Nerve and elastic fiber expression were not detected. Three trisomic fetuses showed cardiac defects, one trisomic fetus demonstrated normal cardiac anatomy. The JLS was abnormally enlarged or contained red blood cells in all trisomic fetuses. The control fetus showed a normal JLS. Conclusion Abnormal DV‐FVWs are not justified by alterations in ductus venosus morphology. DV‐FVWs most probably reflect intracardiac pressure. © 2016 John Wiley & Sons, Ltd.