Premium
Influence of nuchal cord on ductus venosus assessment at 11 to 13 + 6 weeks' gestation
Author(s) -
Plasencia W.,
Lopez P.,
Esparza M.,
Garcia R.,
Barber M. A.,
Garcia J. A.
Publication year - 2010
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.7564
Subject(s) - ductus venosus , medicine , gestation , fetus , gestational age , cardiology , pregnancy , biology , genetics
Objectives To assess the influence of the presence of nuchal cord (NC) on the evaluation of the fetal ductus venosus flow velocity waveform (DV‐FVW). Methods This prospective study included 1174 normal non‐selected singleton pregnancies between 11 and 13 + 6 weeks' gestation. We recorded the presence or absence of NC around the fetal neck, and assessed its relationship with the qualitative assessment and quantitative measurement of the DV‐FVW. Results We observed NC around the fetal neck in 6.73% of cases and detected reversed flow of the a‐wave of the DV‐FVW in 2.98% of cases. In the group without NC, 21 of 1095 had reversed flow in the DV‐FVW (1.9%; 95% CI, 1.28–3.02), whereas in the group with NC, 14 of 79 had reversed flow in the DV‐FVW (17.7%; 95% CI, 16.67–40.35). We found a lower pulsatility index in fetuses without NC in comparison to those with NC ( P < 0.001). We also found an association between the presence of NC and an increased occurrence of absent and reversed a‐wave of the flow velocity waveforms ( P < 0.001). On multivariate logistic regression analysis, a much higher occurrence of reversed DV‐FVW a‐wave was detected in fetuses with NC and smaller crown–rump length, and a much higher occurrence of absent DV‐FVW a‐wave was found in fetuses with NC and a higher maternal body mass index. Conclusions The presence of NC modifies the sonographic findings in the qualitative and quantitative evaluation of the DV‐FVW. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.