Blood velocity in the fetal vein of Galen and the outcome of high-risk pregnancy

Background: Pulsation in the flow velocity waveform in the umbilical vein i s related to perinatal mortality but the flow velocity waveform in the feta l vein of Galen is normally even and without fluctuation. Objectives: To es tablish whether blood flow velocity pulsations in the vein of Galen in high -risk pregnancies are related to outcome. Study Design: The vein of Galen w as located by colour Doppler ultrasound in 102 pregnancies complicated by s evere pregnancy-induced hypertension. The blood velocity waveform was recor ded by pulsed Doppler within 2 days of delivery and the presence pulsations related to pregnancy outcome, including emergency operative intervention a nd neonatal distress. Umbilical artery and vein and uterine artery blood fl ow velocity waveform were also recorded at the same time. The clinicians ma naging the women were unaware of the venous flow results. Results: Pulsatio n were present in the vein of Galen in 68 cases and in the umbilical vein i n 21. Both were significantly related to adverse outcome. Pulsations in the vein of Galen were seen in all seven perinatal deaths. Conclusions: Since umbilical venous pulsation are a late sign of fetal compromise, and pulsati ons in the vein of Galen seem to appear earlier, thus being an intermediate sign of fetal compromise that might be of great value for fetal surveillan ce. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.