A Reference for Ductus Venosus Blood Flow at 11-13⁺⁶ Weeks of Gestation

Abstract

Objective: To establish reference ranges for ductus venosus (DV) blood flow assessment obtained transabdominally at 11-13⁺⁶ weeks of gestation. Methods: A cross-sectional study was conducted on singleton pregnancies with a crown-rump length (CRL) ranging from 45 to 84 mm, normal fetus, and subsequent newborn birth weight appropriate for gestational age. Measurements of DV Doppler variables were performed by experienced sonographers: peak velocity during ventricular systole (S-wave) and diastole (D-wave), nadir during atrial contraction (A-wave), time-averaged maximum velocity (TA_max), pulsatility index for veins (PIV), and peak velocity index for veins (PVIV). Results: A total of 304 fetuses were included. The mean CRL was 60.7 ± 7.2 mm (range: 45.9-75.5). The mean nuchal translucency measurement was 1.4 ± 0.4 mm. The S-wave, D-wave, A-wave, and TA_max values varied significantly with gestational age (p < 0.05) and regression models were constructed for each variable. The remaining variables, systolic/atrial wave ratio, preload index, PVIV, and PIV, did not vary significantly with gestational age within this CRL range. Conclusion: Reference ranges for DV Doppler assessment were established in normal fetuses. These ranges may be a useful tool for evaluation of anueploidy and fetal cardiac function.

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

“…In another study by Pruksanusak et al on 304 fetuses, the 5 th , 50 th and 95 th percentiles of DVPI were 0.69, 0.92, and 1.13 respectively. In their study, DVPI did not vary signi cantly with gestational age between 11-13w+6d [12]. However, our results were not in line with those of Teixeira et al They showed a biphasic pattern for DVPI with an ascending pattern to CRL 63 mm and descending pattern thereafter to 12w +6d [13].…”

“…Reference ranges for the DVPI in the rst trimester of pregnancy have been established in different countries [8][9][10][11][12][13].…”

Doppler assessment of the ductus venosus and the tricuspid valve at 11-13+6 weeks: Reference ranges and development of sonographic quality assurance standards

“…which is markedly higher than all others, the PIV values across these various reference ranges differ by 9% at 11 weeks, increasing to 18% by 14 weeks. Four show a small but significant negative relationship with gestation, whereas this study shows no significant change over gestation after careful model evaluation, which is supported by the recent study by Pruksanusak et al . PIV values are generally lower when the angle of insonation increases and if there is contamination from surrounding vessels.…”

“…Over the past decade there have been at least seven reported 11–14 week DV PIV reference ranges . Two of these lie above the current study mean and four lie below it, including three of the most recent publications.…”

The Predictive Values of Ductus Venosus Pulsatility Index and ''A Wave'' for Chromosomal Abnormalities

“…16 We presented DV PIV reference values (0.78-1.21) for 11 +0 to 13 +6 weeks of gestation which is rather similar to the literature. [17][18][19] The rate of fetuses with DV PIV beyond the 95th centile was 69.4% in pregnancies involving fetuses with chromosomal abnormalities and 8.6% in pregnancies with normal fetuses. According to Antolin et al, the overall detection rate of chromosomal abnormalities was 65%, similar to our findings when using the 95th centile DV PIV pulsatility index as a cut-off.…”