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Hypercoiled cord can cause a reversible abnormal Doppler in ductus venosus in cases of fetal growth restriction
Author(s) -
Iwagaki Shigenori,
Takahashi Yuichiro,
Chiaki Rika,
Asai Kazuhiko,
Matsui Masako,
Mori Takahiro,
Kawabata Ichiro
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13722
Subject(s) - medicine , oligohydramnios , ductus venosus , cord , fetus , umbilical cord , surgery , pregnancy , anatomy , genetics , biology
Aim Although an absent or reversed a‐wave in ductus venosus (DV‐RAV) is reported to be the terminal finding of fetal growth restriction (FGR), we have seen DV‐RAV that disappears within a short span of time in some FGR cases with a hypercoiled cord. The purpose of this study was to investigate the relationship between hypercoiled cord and reversible DV‐RAV in FGR. Methods This was a retrospective study of 499 FGR cases, including 14 with DV‐RAV. Transabdominal amnioinfusion (AI) was performed when oligohydramnios was severe (maximum vertical pocket <2 cm) and/or variable deceleration was detected. DV‐RAV that disappeared quickly was defined as ‘temporary DV‐RAV’. DV‐RAV that continued until delivery or fetal death (FD) was defined as ‘persistent DV‐RAV’. A hypercoiled cord was defined as one with an umbilical coiling index >0.6 antenatally or >0.3 postnatally. Clinical characteristics and clinical courses of the two types of DV‐RAV were compared. Results DV‐RAV disappeared after AI in all five cases in which temporary DV‐RAV was identified. The incidence of a hypercoiled cord was significantly higher among temporary DV‐RAV cases (100%) than among persistent DV‐RAV cases (14.3%; P = 0.015). The time from detection of DV‐RAV to delivery or FD was significantly longer among temporary DV‐RAV cases (4.5 weeks) than among persistent DV‐RAV cases (0.7 weeks; P = 0.027). Conclusion Temporary DV‐RAV is suspected to be related to the combination of a hypercoiled cord and oligohydramnios. DV‐RAV may not be always be a terminal finding in FGR with a hypercoiled cord.