FIRST EXPERIENCES WITH VENOUS DOPPLER ULT RASONOGRAPHY IN HIGH-RISK PREGNANCIES WITH REVERSE FLOW IN THE UMBILICAL ARTERY

This observational study reports on the changes in blood flow waveform s recorded from the ductus venosus (DV) and the umbilical vein (UV) in six high-risk pregnancies presenting with reverse flow in the umbilic al artery. Five fetuses were growth-retarded (IUGR), and one fetus had congenital heart disease. Results: Three fetuses (27, 33 and 36 weeks ) with IUGR, reverse end-diastolic velocities in the DV and UV pulsati ons died in the perinatal period. In two of these fetuses, typical sig ns of heart decompensation (mild pleural effusion and/or ascites) coul d also be visualised by B-mode sonography. Two other growth-retarded f etuses (28 and 29 weeks) and the infant with truncus arteriosus commun is (37 weeks), showed end-diastolic forward flow in the venous vessels ; all of them survived. Conclusions: End-diastolic reverse flow in the DV and UV pulsations indicate right heart failure as the terminal sta ge of placental dysfunction. In special cases, venous Doppler sonograp hy may assist in managing pregnancies with compromised fetuses showing pathological arterial blood flow waveforms.