Estimation of the pressure gradient across the fetal ductus venosus based on Doppler velocimetry

In the fetus, the umbilical vein is directly linked to the inferior vena cava by the narrow ductus venosus. Thus, the ductus venosus blood velocity probably reflects the pressure gradient between the umbilical vein and the central venous system. In a longitudinal study that included 29 normal fetuses, pulsed Doppler velocimetry was carried out in the umbilical vein and the ductus venosus during the last half of the pregnancy. By applying the Bernoulli equation, we estimated the pressure gradient across the ductus venosus to vary between 0-3 mm Hg during the heart cycle; it remained within those ranges during gestational weeks 18-40. During fetal inspiratory movement, pressure gradients up to 22 mm Hg were estimated. The estimated ductus venosus pressure gradient seems to be within ranges compatible with known umbilical venous pressures, and may provide a new opportunity to understand central venous hemodynamics and respiratory force in the fetus once methodological limitations are controlled.