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Venous return and right ventricular diastolic function in ARED flow fetuses

J C Areias1, A Matias, N Montenegro

  • 1Paediatric Cardiology Unit, University Hospital of S. João, Porto, Portugal.

Journal of Perinatal Medicine
|October 17, 1998
PubMed
Summary
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Sequential changes in fetal venous return, including the umbilical vein and inferior vena cava, signal fetal compromise when umbilical artery flow is abnormal. This helps identify high-risk pregnancies needing closer monitoring.

Area of Science:

  • Perinatology
  • Fetal Physiology
  • Diagnostic Ultrasound

Background:

  • Umbilical artery (UA) absent or reversed end-diastolic flow indicates fetal compromise.
  • The sequential changes in venous return during fetal deterioration are not well understood.

Observation:

  • Longitudinal Doppler studies assessed venous return (inferior vena cava, ductus venosus, umbilical vein) and tricuspid valve flow in fetuses with intrauterine growth-retardation (IUGR).
  • Thirty-two serial Doppler studies were performed in six fetuses with IUGR.

Findings:

  • In fetuses with abnormal UA flow, venous return changes followed a specific sequence: umbilical vein pulsations, increased inferior vena cava retrograde flow, and altered ductus venosus flow.
  • Transtricuspid flow shifted to a restrictive pattern, preceding adverse outcomes like intrauterine and neonatal deaths.

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Implications:

  • Evaluating venous compartment hemodynamics and right ventricular filling in fetuses with IUGR provides insights into fetal deterioration.
  • These findings may offer indirect signs of severe fetal compromise, aiding in risk assessment and management.