Abnormal ductus venosus blood flow: a clue to umbilical cord complication

We report a case of umbilical cord complication causing. fetal hypoxemia an d acidemia. At 30 weeks of gestation, the patient was referred because of s lightly increased amniotic fluid volume and a non-reactive cardiotocogram. Biometry was appropriate for gestational age. Umbilical artery and fetal ao rtic Doppler findings were normal, whereas diastolic blood flow velocities in the middle cerebral artery were increased and the ductus venosus showed severely abnormal flow velocity waveforms with reversal of pow during atria l contraction. Since other reasons for fetal hypoxemia could be excluded ca reful examination of the umbilical cord was performed. Traction of the hype rcoiled umbilical cord due to its course around the fetal neck and shoulder s was suspected. Cesarean section. confirmed the sonographic findings and f etal blood gases revealed fetal acidemia. This case indicates that investig ation of fetal venous blood flow may also help to identify fetal jeopardy d ue to reasons other than Increased placental vascular resistance.