Feasibility of Ductus Venosus Doppler Screening During First Trimester Ultrasound: Prospective Multicenter Study

Background and Objectives: Doppler abnormalities in the ductus venosus (DV) during the first trimester can serve as an early marker for the detection of congenital heart defects (CHDs), but the feasibility of systematically assessing the DV remains underexplored. This study aimed to evaluate the feasibility of performing DV assessments during routine first-trimester ultrasound screenings. Materials and Methods: A multicenter, prospective, and descriptive study was conducted, including singleton pregnancies undergoing routine ultrasound screening between 11 + 0 and 13 + 6 weeks of gestation. Sonographers were instructed to acquire DV Doppler images during the scan, and each image was blindly reviewed by an expert using predefined quality criteria. The images were categorized as "good", "medium", or "unsatisfactory", and feasibility was defined as the proportion of "good" images. Factors associated with feasibility were analyzed, including sonographer satisfaction, the Herman score and the acquisition time. Results: Of the 87 patients included in this study, a suitable DV Doppler image was feasible in 58.6% of cases. The feasibility was significantly higher when the sonographer was satisfied with the image, when the Herman score exceeded seven (p = 0.01), and when the acquisition time was less than five minutes. A strong correlation was observed between the expert's assessment and the sonographer's satisfaction. However, the gestational age, maternal BMI, parity, and operator-perceived image quality were not significantly associated with feasibility. Conclusions: The Doppler assessment of the ductus venosus during first-trimester ultrasound screening is feasible and reproducible in routine clinical practice without significantly increasing the examination time. This suggests DV measurements to enhance the early nuchal translucency measurement to enhance the early detection of congenital heart defects during the first trimester.