Absent End-Diastolic Flow in First Trimester Umbilical Artery

Fisk, N. M.; MacLachlan, Neil; Ellis, Cheryl; Tannirandorn, Yuen; Tonge, H.M.; Rodeck, C. H.

doi:10.1016/s0140-6736(88)90854-9

Cited by 42 publications

(16 citation statements)

References 6 publications

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“…The immaturity of establishment of fetomaternal circulation reflects the high resistance in the umbilical artery as absent end-diastolic frequencies, which was absent in all fetuses prior to 11 weeks of gestation, and present in all fetuses with 14 weeks of gestation onward. In the transitional period, 12 or 13 weeks of gestation, fetuses had either absent or present end-diastolic frequencies equally [18]. This finding may explain why our results from the DV Doppler indices during the first trimester period were contradictory to those of Teixeira et al [10], who showed a decrease in PIV with CRL 63 mm onward, corresponding to 12 +6 weeks of gestation.…”

Section: Discussionmentioning

confidence: 72%

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

Pruksanusak¹,

Kor-anantakul²,

Suntharasaj³

et al. 2014

Gynecol Obstet Invest

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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.

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Section: Discussionmentioning

confidence: 72%

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

Pruksanusak¹,

Kor-anantakul²,

Suntharasaj³

et al. 2014

Gynecol Obstet Invest

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“…Gestational sac measurements, yolk sac diameter, and fetal heart rate were within the normal range for gestational age in all cases. Umbilical blood flow velocity waveforms were obtained from the proximal segment of the cord in six pregnancies, demonstrating the expected pattern of absent end diastolic flow in the umbilical artery 15 and pulsation in the umbilical vein 16 in all of these cases (Fig. 3).…”

Section: Methodsmentioning

confidence: 82%

Clinical significance of first trimester umbilical cord cysts.

Sepúlveda

Leíble

Ulloa

et al. 1999

Journal of Ultrasound in Medicine

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A cystic mass of the umbilical cord was identified by transvaginal sonography in 10 first trimester pregnancies at a mean gestational age of 8 weeks 4 days (range, 8 weeks 1 day to 9 weeks 3 days) and at a mean crown‐rump length of 20.5 mm (range, 15 to 25 mm). The cyst was solitary in all cases, the mean diameter was 4.6 mm (range, 3 to 6 mm), and the location was closer to the fetal insertion in two cases, in the middle of the cord in seven cases, and closer to the placental insertion in one case. Gestational sac and yolk sac diameters as well as the fetal heart rate were within normal ranges for gestational age in all cases. Information on detailed second trimester scans was available in nine cases, demonstrating complete resolution of the cyst and normal fetal anatomic survey in each case. These nine pregnancies were followed to delivery, and normal healthy infants were delivered at term in all cases. This series suggests that the incidental detection of umbilical cord cysts in early pregnancy is not associated with an adverse pregnancy outcome.

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“…Further studies are required before any conclusions concerning the utility of Doppler measurements at this stage of pregnancy can be drawn. We used the pulsatility index during the first trimester because it analyses cord blood flow velocities over time and does not depend on the presence of end-diastolic velocity, which is usually absent until 12-13 weeks of gestation (Fisk et al, 1988). Therefore, our findings are not influenced by the appearance of end-diastolic velocities.…”

Section: Resultsmentioning

confidence: 99%

“…However, its application during the first trimester is not well established, although several reports show an increasing interest in the evaluation of its clinical use in assessing normal and abnormal early pregnancy (Arduini et al, 1991;Jauniaux et al, 1991;Fisk et al, 1988;Wladimiroff et al, 1991).…”

Section: Introductionmentioning

confidence: 99%