Two types of umbilical venous pulsations and outcome of high-risk pregnancy

Normally, blood flows evenly in the umbilical vein, without fluctuation. A pulsating pattern has been reported during fetal heart failure and asphyxia . Recently we have noticed two types of pulsating pattern: its relationship to adverse outcome is unclear. In a prospective multicenter study, recording of umbilical cord venous bloo d flow was conducted in high-risk pregnancies admitted for routine artery D oppler. In cases of pulsating flow or signs of vascular resistance in the u mbilical artery. the examination was extended to the intra-abdominal part o f the umbilical vein. Venous pulsation, single or double, were noted and co rrelated to perinatal outcome. Venous flow pulsatility was noted in 83 fetu ses during 2 years, 26 had a double pulsating pattern. which was closely re lated to increased vascular resistance in the umbilical artery and perinata l mortality. A single pulsating venous pattern in one location had a good p rognosis. In conclusion a double pulsating venous pattern, especially if ex tending to the cord, is an ominous finding in high-risk pregnancy associate d with poor perinatal outcome. A single pulsating pattern predicted a much better outcome and might be an indication for delivery in the high-risk cas e. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.