Umbilical vein blood volume flow rate and umbilical artery pulsatility as ‘venous–arterial index’ in the prediction of neonatal compromise

Tchirikov, M.; Rybakowski, C.; Hüneke, B.; Schoder, Volker; Schröder, Helmut

doi:10.1046/j.1469-0705.2002.00832.x

Cited by 51 publications

(69 citation statements)

References 18 publications

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“…The determination of the maximal vessel diameter has proven to be essential for the assessment of the umbilical vein blood volume flow rate in the second trimester [19]. In our study, filling in the color of the E-flow, the interior of the umbilical vein allowed an easy identification of the vessel walls and of the diameter of the vein.…”

Section: Couples Of Twinsmentioning

confidence: 94%

Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

Zoppi¹,

Iuculano²,

Monni³

2014

Journal of Perinatal Medicine

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We investigated the umbilical vein volume flow (UVVF) at 11-14 weeks in monochorionic-diamniotic (MCDA) twins, focusing on the occurrence of complications. We considered 87 MCDA pregnancies. We used "E-flow" to detect the umbilical vein and measured the mean velocities and diameters of veins, also calculating the UVVF. Pregnancies were divided into four groups: a (twin-to-twin transfusion, TTTS); b (selective intrauterine growth restriction, sIUGR); c (discordance of fluid, DF); and d (with "normal" outcome). The main outcome of the study was the assessment of the difference of UVVF between twin 1 and twin 2 (larger and smaller twin). In eight of eight pairs of group a and seven of seven pairs of group b, the UVVF of fetuses 1 were significantly different than fetuses 2 (P<0.05). The UVVFs of fetuses 2 of group a were significantly lower in respect to the UVVFs of fetuses 2 of group d (P<0.05). We provide evidence of an important difference in UVVF in pairs that successively developed TTTS or sIUGR. The smaller fetuses of group a (TTTS) showed a lower venous return than fetuses 2 of group d (normal). First-trimester UVVF is lower in fetuses with a smaller crown-rump length in twin pairs at risk of TTTS or IUGR.

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Section: Couples Of Twinsmentioning

confidence: 94%

Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

Zoppi¹,

Iuculano²,

Monni³

2014

Journal of Perinatal Medicine

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“…In a recent publication, Tchirikov et al [8] demonstrated that the venous-arterial ratio was superior to isolated arterial (umbilical and uterine) Doppler in the prediction of neonatal adverse outcomes. This could be attributed the capacity of evaluating cardiac post-load through venous Doppler.…”

Section: Discussionmentioning

confidence: 99%

“…Tchirikov et al [8] presented a venous-arterial ratio involving umbilical vein velocimetry and umbilical artery pulsatility index (UA PI). Using 100 ml/min/kg as their cut-off value, these authors had 85% sensibility and 15% false-positives in prediction of neonatal complications.…”

Section: Venous-arterial Doppler Ratios In Acidemiamentioning

confidence: 99%

Venous-Arterial Doppler Ratios in the Prediction of Acidemia at Birth in Pregnancies with Placental Insufficiency

Carvalho¹,

Moron²,

Mattar³

et al. 2006

Fetal Diagn Ther

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Objectives: Investigate the prediction of birth acidemia in pregnancies with placental insufficiency using two newly created venous-arterial Doppler ratios: pulsatility index (PI) of the ductus venosus (DV) over PI of the middle cerebral artery (MCA) and PI of the DV over PI of the umbilical artery and establish cut-off values for this prediction. Methods: This was a prospective cross-sectional study involving 47 patients with placental insufficiency managed in two Brazilian hospitals. All pregnancies were singleton, over 26 weeks of age and without structural or chromosome anomalies. A ROC curve was calculated for the venous-arterial ratios (independent variable) and acidemia (dependent variable). Results: The DV/AU PI ratio was not a good predictor of acidemia at birth. The DV/MCA PI ratio was related to fetal acidemia (area under the ROC curve 0.785, p = 0.004). The cut-off value was 0.582, sensibility 66.7%, specificity 77.1% and accuracy 74.5%. Conclusions: The DV/MCA PI ratio is adequate for the diagnosis of acidemia at birth in pregnancies with placental insufficiency. The cut-off value was 0.582.

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“…At the beginning of these studies, umbilical venous blood flow velocity was estimated from the maximum values of the waveforms [40,41]. Soon after, Doppler intensity-weighted mean velocity measurements were introduced [43,44] and its accuracy was improved.…”

Section: Umbilical Venous Blood Flowmentioning

confidence: 99%

“…They reported that umbilical venous blood velocity changed during fetal breathing movement [39] (Figure 1). Umbilical venous blood flow velocity waveforms have been used for assessing blood volume of placental perfusion [40][41][42][43][44] because the flow velocity is usually constant and it is easy to estimate the diameter of the vessels. At the beginning of these studies, umbilical venous blood flow velocity was estimated from the maximum values of the waveforms [40,41].…”

Section: Umbilical Venous Blood Flowmentioning

confidence: 99%

Accurate diagnosis of umbilical circulation

Nakai

Tachibana

Yamamasu

2006

The Ultrasound Review of Obstetrics & Gynecology

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Umbilical arterial flow velocity has been widely used for the estimation of fetal status. This is clinically useful, but affected by physiological characteristics or other factors such as maternal drug administration. Otherwise, umbilical venous pulsation is also used for fetal estimation. But, this particular pattern appeared not only from fetal cardiac problems, but from umbilical cord characteristics. We summarized the various factors which affect the umbilical circulation.

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Umbilical vein blood volume flow rate and umbilical artery pulsatility as ‘venous–arterial index’ in the prediction of neonatal compromise

Abstract: Objective To assess the diagnostic power of the umbilical venous−arterial index (VAI) for the prediction of poor fetal outcome. Subjects and methods

Cited by 51 publications

References 18 publications

Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

Venous-Arterial Doppler Ratios in the Prediction of Acidemia at Birth in Pregnancies with Placental Insufficiency

Accurate diagnosis of umbilical circulation

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