Ductus venosus blood flow evaluation: Its importance in the screening of chromosomal abnormalities

ABSTRACT Ductus venosus (DV) is a tiny vessel with a central role in fetal circulation both in singletons and multiples. In the present review we detail the contribution of DV evaluation in twin pregnancies in the first trimeter of pregnancy. The higher prevalence of abnormal A-wave in fetuses with abnormal karyotype and/or cardiac defects made DV evaluation a useful marker for the screening of chromosomal abnormalities and fetal cardiac anomalies. In dichorionic (DC) pregnancies, DV blood flow assessment reproduces the role of NT in the screening for aneuploidies, just as in singleton pregnancies. In monochorionic (MC) twin pregnancies, the Doppler assessment of DV blood flow improves the detection of those at higher risk of developing twin-to-twin transfusion syndrome or growth discrepancy later in pregnancy. As for singletons, DV should be systematically evaluated in all first trimester scans for a more performant screening in multiples. How to cite this article Matias A, Montenegro N. Improving our Knowledge in Twins: The Role of Ductus Venosus in the First Trimester. Donald School J Ultrasound Obstet Gynecol 2013;7(4):409-414.

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Reference values for Ductus Venosus pulsatility index between 11 and 13 + 6 weeks of Gestation: A Single-center Observational Study in a Tertiary Care Hospital

10.21203/rs.3.rs-804501/v1 ◽

2021 ◽

Author(s):

Somayeh Haji Ahmadi ◽

Alireza Rezaei Adariani ◽

Ehsan Amini

Keyword(s):

Blood Flow ◽

Observational Study ◽

Pulsatility Index ◽

Chromosomal Abnormalities ◽

Tertiary Care ◽

First Trimester ◽

Ductus Venosus ◽

Care Hospital ◽

Cross Sectional ◽

Expert Radiologist

Abstract BackgroundThe ductus venosus pulsatility index(DVPI) has been evolved as an important marker of the first trimester screening sonography. The aim of this study is to define a reference for ductus venosus pulsatility index at 11–13 +6 weeks of gestation.MethodsIn this cross sectional observational study, 415 women with singleton pregnancies and crown lump length(CRL) between 45 and 84 mm were included. Exclusion criteria were abnormal biochemical screening results, presence of fetal structural malformation or chromosomal abnormalities such as thickened nuchal fold, abnormal perinatal outcomes, and newborns with a chromosomal abnormality. Transabdominal U/S was performed in all participants by an expert radiologist in obstetric sonography. CRL, nuchal translucency(NT), and blood flow indices of ductus venosus (DV) in each fetus were measured. The collected data were analyzed by IBM SPSS software version 20. Linear regression was performed to demonstrate the association between CRL DVPI. Further, 5th, 50th, and 95th percentiles of DV blood flow indices were calculated for each gestational age.ResultThe mean value of DVPI ranged from 1.05 at CRL 42mm to 1.3 at CRL 82mm. DVPI and CRL did not show any significant linear association (Regression coefficient B=0.001, R2=0.003, P=0.31)Conclusion: We defined means and ranges of DVPI, while determining the 5th, 50th, and 95th percentiles of DVPI for each CRL at our institution which were approximately similar to previous studies.

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Anticipating twin–twin transfusion syndrome in monochorionic twin pregnancy. Is there a role for nuchal translucency and ductus venosus blood flow evaluation at 11–14 weeks?

Twin Research ◽

10.1375/136905200320565490 ◽

2000 ◽

Vol 3 (2) ◽

pp. 65-70 ◽

Cited By ~ 16

Author(s):

A Matias ◽

N Montenegro ◽

JC Areias

Keyword(s):

Blood Flow ◽

Twin Pregnancy ◽

Nuchal Translucency ◽

Ductus Venosus ◽

Monochorionic Twin ◽

Blood Flow Evaluation

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Ductus Venosus: A Love Story of 14 Years

Donald School Journal of Ultrasound in Obstetrics & Gynecology ◽

10.5005/jp-journals-10009-1190 ◽

2011 ◽

Vol 5 (2) ◽

pp. 141-149 ◽

Cited By ~ 1

Author(s):

Nuno Montenegro ◽

Alexandra Matias

Keyword(s):

Blood Flow ◽

Chromosomal Abnormalities ◽

False Positive Rate ◽

First Trimester ◽

Nuchal Translucency ◽

Ductus Venosus ◽

Love Story ◽

Positive Rate ◽

Trimester Screening ◽

Twin Pregnancies

ABSTRACT Ductus venosus is a tiny vessel with a central role in fetal circulation. Combining B-mode with color and pulsed Doppler is feasible to identify this vessel and evaluate the blood flow waveform at 11 to 13 weeks. The higher prevalence of abnormal A-wave in fetuses with abnormal karyotype and/or cardiac defects turned DV evaluation into a useful marker for chromosomal abnormalities and cardiopathies. Even when combined with nuchal translucency (NT) or biochemical markers, DV blood flow evaluation contributes to an increase in sensitivity and reduces false-positive rate. Abnormal ductal flow is also related to a worse fetal and perinatal outcome. In monochorionic twin pregnancies, in addition to NT measurement at 11 to 14 weeks, the Doppler assessment of DV blood flow increases relevantly the performance of screening for those at higher risk of developing twin-to-twin transfusion syndrome. This story of 14 years surely contributed to change the way first trimester screening is being implemented.

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