Aims-To investigate the ductus venosus flow velocity (DVFV) in infants with
persistent pulmonary hypertension of the newborn (PPHN); to evaluate the D
VFV pattern as a possible diagnostic supplement in neonates with PPHN and o
ther conditions with increased right atrial pressure.
Methods-DVFV was studied in 16 neonates with PPHN on days 1-4 of postnatal
life using Doppler echocardiography. DVFV was compared with that in mechani
cally ventilated neonates with increased intrathoracic pressure, but withou
t signs of PPHN (n=11); with neonates with congenital heart defects resulti
ng in right atrial pressure (n=6); and with preterm neonates without PPHN (
n=46); and healthy term neonates (n=50).
Results-Infants with PPHN and congenital heart defects with increased right
atrial pressure were regularly associated with an increased pulsatile patt
ern and a reversed flow velocity in ductus venosus during atrial contractio
n. A few short instances of reversed velocity were also noted in normal neo
nates before the circulation had settled during the first day after birth.
Conclusions-A reversed velocity in the ductus venosus during atrial contrac
tion at this time signifies that central venous pressure exceeds portal pre
ssure. This negative velocity deflection is easily recognised during Dopple
r examination and can be recommended for diagnosing increased right atrial
pressure and PPHN.