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Doppler in non-immune hydrops fetalis.
G Tulzer1, S Gudmundsson, D C Wood
1Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Summary
Abnormal umbilical vein pulsations in fetal ultrasound are key indicators of non-immune hydrops, significantly differing between survivors and non-survivors. This finding aids in predicting fetal outcomes.
Area of Science:
- Perinatology
- Fetal Cardiology
- Medical Imaging
Background:
- Non-immune hydrops fetalis is a serious condition with high mortality.
- Assessing fetal hemodynamics is crucial for predicting outcomes in affected pregnancies.
- Echocardiographic and Doppler parameters require further evaluation for prognostic value.
Purpose of the Study:
- To evaluate echocardiographic and cardiovascular Doppler parameters for assessing hemodynamics in fetuses with non-immune hydrops.
- To identify parameters useful in predicting outcomes for these fetuses.
Main Methods:
- Fetal ultrasound studies were performed on 24 fetuses diagnosed with non-immune hydrops.
- Echocardiographic and cardiovascular Doppler parameters were analyzed.
- Umbilical vein pulsations and inferior vena cava waveforms were specifically examined.
Main Results:
- Abnormal umbilical vein pulsations were the only cardiovascular parameter significantly different between survivors and non-survivors (p < 0.001).
- Survivors showed a lower percentage of retrograde flow in the inferior vena cava and a higher E/V velocity ratio.
- Fetuses with abnormal umbilical venous pulsations had poorer outcomes, particularly those with hydrops due to twin-to-twin transfusion or congenital heart disease.
Conclusions:
- Abnormal umbilical vein pulsations are a significant predictor of outcome in non-immune hydrops fetalis.
- Doppler assessment of umbilical venous flow and inferior vena cava can provide valuable prognostic information.
- Further research into specific hemodynamic alterations may improve management strategies for non-immune hydrops.