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Umbilical vein constriction at the umbilical ring: a longitudinal study.

G Acharya¹, T Wilsgaard, G K Rosvold Berntsen

¹Department of Obstetrics and Gynecology, University Hospital of Northern Norway, N-9038 Tromsø, Norway. ganesh.acharya@unn.no

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology

|May 13, 2006

Summary

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Umbilical vein constriction in fetuses is common during late pregnancy and appears to be a normal physiological process, not linked to adverse outcomes. This study establishes reference ranges for umbilical vein velocities.

Area of Science:

Fetal physiology and hemodynamics
Maternal-fetal medicine
Obstetric ultrasound

Background:

Umbilical vein (UV) constriction at the umbilical ring has been hypothesized to influence fetal hemodynamics.
The frequency and extent of this phenomenon require further investigation.

Purpose of the Study:

To determine the occurrence and degree of umbilical vein constriction in low-risk singleton pregnancies.
To establish reference ranges for umbilical vein velocities during the second half of gestation.

Main Methods:

Prospective longitudinal study of 129 low-risk singleton pregnancies.
Serial ultrasound measurements of umbilical vein velocities at the umbilicus between 19 and 42 weeks' gestation.
Multilevel modeling to construct reference ranges and analyze associations.

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Main Results:

Established gestational age-specific reference percentiles for umbilical vein velocities.
Demonstrated significant fetal capacity to alter UV velocities, indicating variable constriction.
Found that UV constriction did not impact umbilical artery pulsatility or perinatal outcomes.

Conclusions:

Umbilical vein constriction at the abdominal wall is a common finding in low-risk fetuses during the latter half of pregnancy.
This constriction appears to be a physiological adaptation or regulatory mechanism, rather than a risk factor for complications.