Normal fetal pulmonary venous blood flow velocity

Laudy, J. A. M.; Huisman, Tjeerd W.A.; Ridder, Maria A. J. de; Wladimiroff, J. W.

doi:10.1046/j.1469-0705.1995.06040277.x

Cited by 47 publications

(70 citation statements)

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“…Hong and Choi 22 verified that the pattern of pulmonary vein flow in fetuses results from the low pulmonary flow and the reduced capacity of the pulmonary system. The pattern of the pulmonary venous waveform was also described by Laudy et al 23 , and reinforces that it has a biphasic flow profile with a systolic and a diastolic component. The nature of the fetal pulmonary venous flow waveform pattern suggests positive pressures towards the left atrium thorough the cardiac cycle.…”

Section: Discussionsupporting

confidence: 78%

Pulmonary vein pulsatility in fetuses of diabetic mothers: prenatal Doppler echocardiographic study

Zielinsky¹,

Piccoli²,

Teixeira³

et al. 2003

Arq. Bras. Cardiol.

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The incidence of insulin-dependent diabetes mellitus is about 0.8%, and gestational diabetes is 3-5%. Both are evidence of the metabolic disturbances of carbohydrates during pregnancy 1 . The incidence of congenital malformation is 3 to 4 times greater in children from diabetic mothers than in the general population 2 . Among those malformations, 50% are congenital cardiac diseases 3 . Maternal diabetes is a risk factor for congenital heart disease and an indication for fetal echocardiography [4][5][6][7][8][9][10][11][12] .Maternal hyperglycemia and the excess of glucose transferred to the fetus encourage fetal pancreatic islets to increase the production of insulin, leading to hyperinsulinism, which is responsible for fetal complications. Fetal myocardial hypertrophy is the most frequent abnormality found in newborns from diabetic mothers, and it may be found in up to 35% of these newborns 13 . The interventricular septum is particularly rich in insulin receptors 14 , which would justify increased hypertrophy in this segment, secondary to myocardial cell hyperplasia and hypertrophy due to the increased synthesis of fat and proteins.Fetal Doppler echocardiography has increased our knowledge about the cardiocirculatory changes in the prenatal period. Recent studies have shown significant changes in the cardiovascular flow of fetuses from diabetic mothers, especially in pregnancies with inadequate glycemic control 15 .With the introduction of echocardiography, several clinical studies have demonstrated normal patterns of pulmonary venous flow in children and adults through transesophageal and transthoracic echocardiography 16,17 . The use of the pulmonary vein pulsatility index as a parameter for diastolic function evaluation during fetal life has not yet been reported. Thus, we have tested the hypothesis that the pulmonary vein pulsatility index in fetuses from diabetic mothers is greater than that in fetuses from nondiabetic mothers, based on the idea that a less complacent left ventricle would increase presystolic flow impedance in the pulmonary vein, corresponding to the atrial contraction phases. Consequently, it would increase the pulsatility index in this vessel. Objective -To verify the hypothesis that the pulmonary vein pulsatility index is higher in fetuses of diabetic mothers than it is in normal fetuses of nondiabetic mothers. Methods -

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Section: Discussionsupporting

confidence: 78%

Pulmonary vein pulsatility in fetuses of diabetic mothers: prenatal Doppler echocardiographic study

Zielinsky¹,

Piccoli²,

Teixeira³

et al. 2003

Arq. Bras. Cardiol.

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“…This mirrors the flow patterns described in late pregnancy by previous studies [7,10,11]. A pulmonary vein A-wave reversal was only described in 0.55 % of normal fetuses.…”

Section: Detection Of Fetal Pulmonary Venous Flow Waveforms During Easupporting

confidence: 88%

Evaluation of Fetal Pulmonary Veins During Early Gestation by Pulsed Doppler Ultrasound: A Feasibility Study

Schenone

Giugni

Schenone

et al. 2015

Journal of Fetal Medicine

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Congenital heart disease (CHD) is the leading cause of infant mortality. Nevertheless, routine prenatal ultrasound only detects 30 %-50 % of CHD cases. Therefore, emphasis should be placed on early predictors of CHD that allow physicians to timely refer high-risk patient to specialized fetal echocardiography, in order to maximize chances of improved outcomes. The fetal venous system has been the focus of attention as a marker of heart function. Yet, there exist inconsistent data about the acquisition of pulmonary venous flow in early pregnancy. This study aims to determine the feasibility of fetal pulmonary venous flow acquisition in early pregnancy, and the association between pulmonary vein (A-wave) flow reversal and the presence of CHD. Total of 211 consecutive pregnant women, between 12 and 15 weeks of gestation, underwent routine obstetric ultrasound along with basic fetal echocardiography including fetal pulmonary venous flow assessment. The pulmonary venous flow velocity waveforms were acquired by either Doppler or Doppler plus enhance flow technique based on equipment availability. All the cases were re-evaluated by specialized fetal echocardiography during late pregnancy to identify congenital heart anomalies. The acquisition of fetal pulmonary vein, between 12 and 15 weeks of gestation, was successfully accomplished in 87.7 % of cases. Five out of seven fetuses with end-diastolic (A-wave) pulmonary venous flow reversal were associated with confirmed cardiac anomaly. In this pilot study, pulmonary venous (A-wave) flow reversal was associated with cardiac anomalies in 86.8 % of cases (p = 0.001). This pilot study proposes that Doppler interrogation of fetal pulmonary vein flow during early pregnancy is feasible. Furthermore, the presence of pulmonary vein (A-wave) reversal might represent a marker of major cardiac anomalies. Further investigation is needed to confirm these findings.

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“…Recently, a number of reports have appeared on pulmonary venous flow velocity patterns during fetal life [1][2][3][4][5] . These patterns, which show great similarity with flow velocity waveforms originating from the ductus venosus, are characterized by a systolic and early diastolic forward flow component followed by a late diastolic forward flow [3][4][5] , absent or reverse flow 4,5 component coincident with atrial contraction.…”

Section: Introductionmentioning

confidence: 99%

Fetal pulmonary venous flow into the left atrium relative to diastolic and systolic cardiac time intervals

Brezinka

Laudy

Ursem

et al. 1999

Ultrasound in Obstet & Gyne

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Normal fetal pulmonary venous blood flow velocity

Cited by 47 publications

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Pulmonary vein pulsatility in fetuses of diabetic mothers: prenatal Doppler echocardiographic study

Pulmonary vein pulsatility in fetuses of diabetic mothers: prenatal Doppler echocardiographic study

Evaluation of Fetal Pulmonary Veins During Early Gestation by Pulsed Doppler Ultrasound: A Feasibility Study

Fetal pulmonary venous flow into the left atrium relative to diastolic and systolic cardiac time intervals

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