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F54Different types of umbilical venous pulsations and clinical implications
Author(s) -
Gudmundsson S.,
Hofstaetter C.,
Dubiel M.
Publication year - 2000
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 - 10.1046/j.1469-0705.2000.00015-1-54.x
Subject(s) - medicine , umbilical artery , umbilical cord , umbilical vein , fetus , asphyxia , placenta , vein , perinatal asphyxia , obstetrics , pregnancy , blood flow , cardiology , surgery , anatomy , biochemistry , genetics , chemistry , biology , in vitro
Objective Normally, blood flows evenly in the umbilical vein, without fluctuation. A pulsating pattern has been reported during fetal heart failure and asphyxia. Recently we have noticed different types of pulsating pattern, its physiological implication and relationship to outcome of pregnancy was analysed. Study design In a prospective multicenter study, recording of umbilical cord venous blood flow was conducted in high‐risk pregnancies admitted for umbilical artery Doppler. In cases of pulsating flow or signs of vascular resistance in the umbilical artery, the examination was extended to the intra‐abdominal part of the umbilical vein. Venous pulsation, single or double, were noted and correlated to perinatal outcome. Results Venous flow pulsatility was noted in 83 fetuses during two years, 26 had a double pulsating pattern, which was closely related to increased vascular resistance in the umbilical artery and perinatal mortality. A single end‐diastolic pulsation only in the cord was noted in some of the fetuses with absent or reversed flow in the umbilical artery, probably due to decreased forward flow over the placenta. A single pulsating venous pattern in one location had good prognosis. Conclusion A double pulsating venous pattern, especially if extending to the cord, is an ominous finding associated with poor perinatal outcome in high‐risk pregnancy. A single pulsating pattern predicted a much better outcome and might be an indication for delivery in the high‐risk case.