Correlation between Ductus Venosus Pulsatility Index and Umbilical Venous Pulsation in Prediction and Detection of Fetal Condition in High Risk Pregnancies
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- Category: Vol. 85, June 2017
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Correlation between Ductus Venosus Pulsatility Index and Umbilical Venous Pulsation in Prediction and Detection of Fetal Condition in High Risk Pregnancies, YEHIA A. WAFA, HASSAN M. AL-AGEIZY, MOHAMED I. EL-MOHANDES and MOHAMED ABDEL-WANIS
Abstract
Objective: The aim of this study was to evaluate the use of ductus venosus pulsatility index and umbilical venous pulsation in detection and prediction of fetal condition and outcome in high risk pregnancies.
Setting: The study was conducted in Al-Galaa teaching hospital during the period between November 2013 to July 2016.
Patients and Methods: This prospective study involved 300 women divided into 4 groups; Hypertensive group includ-ing 100 women with preeclampsia, Diabetic group including 100 women with DM, Cardiac group including 50 women with heart disease and control group of 50 women with uneventful pregnancy. Women of the four studied groups were selected with gestational age between 28 and 32 weeks and examined with umbilical artery Doppler (UA PI and UA RI), umbilical vein Doppler, middle cerebral artery Doppler (PSV and PI) and ductus venosus pulsatility index for vein (DV PIV). The fetus was assessed using ultrasonographic evaluation of amount of liquor and biophysical profile and the results were correlated with outcome of the pregnancy.
Results: We observed that venous Doppler is superior to arterial Doppler in predicting poor perinatal outcome. The presence of umbilical venous pulsation is positively correlated with poor pregnancy outcome in the 4 studied groups with high diagnostic accuracy in prediction of neonatal acidosis. Our study suggests that the occurrence of UV pulsations is an indicator of fetal compromise regardless of the DV-PIV value. The results implied that when an isolated elevation of DV-PIV is found in a high-risk pregnancy, immediate delivery is not mandatory in cases of prematurity. A better alternative might be to keep the pregnancy under close surveillance by repeat examination.
Conclusions: Abnormal fetal venous blood velocity is related to adverse outcome in high-risk pregnancies. However, abnormal DV-PIV is not a reliable indicator of fetal compro-mise unless UV pulsations are concurrently present, and should not be regarded an indication for emergency delivery.