Fetal vascular response to maternal deep-vein thrombosis and subsequent heparin therapy

The fetal umbilical and cerebral Doppler changes were recorded in a 27-year -old primigravida referred at 38 weeks for the treatment of an iliofemoral vein thrombosis. On admission and in comparison to a previous Doppler asses sment systematically performed during growth scan at 37 weeks, the umbilica l resistance index (URI) demonstrated an increase of 19%, the cerebral resi stance index (CRI) a reduction of 15% and the cerebral-umbilical (C/U) rati o a decrease of 29% reaching the lowest value of 1.05. Under intravenous he parin therapy, Doppler normalisation was observed within 1 week and the mot her delivered a healthy, non-hypoxemic baby by caesarean section at 39 week s and 2 days. This observation suggests that deep-vein thrombosis (DVT) may , in some cases, be responsible for transient fetal hypoxia. Moreover, trea tment with intravenous heparin had a direct beneficial effect on the fetus as it improved placental hemodynamics and fetal oxygenation. (C) 2001 Elsev ier Science Ireland Ltd. All rights reserved.