Fetal Compromise Assessed byDoppler Ultraso und of Venous Flow in Pregnancy-Induced Hypertension

Abstract

The purpose of this study was to determine the change of venous flow patterns in the inferior vena cava of fetuses in pregnancy-induced hypertension (PIH). We studied 80 normal pregnant women and 46 pregnant women with PIH and their fetuses. We determined the pulsatility index (PI) for arterial vessels, the ratio of peak flow velocities in early diastole and late diastole (E/A) in atrioventricular valves, and the preload index for the inferior vena cava. Twelve of the 46 PIH women showed an umbilical artery PI higher than the 95th percentile in normal pregnant women. Five of them demonstrated a decreased middle cerebral artery PI. Three of the 5 had an increased mitral E/A. Two of them had a decreased tricuspid E/A, an increased preload index, and a poor prognosis. An increased preload index suggests severe compromise in fetuses with a redistribution of arterial and intracardiac blood flow.

Evaluation of Conventional Doppler Fetal Cardiac Function Parameters: E/A Ratios, Outflow Tracts, and Myocardial Performance Index

“…However, Ochi et al [19] showed an increment in the ratios in early and severely affected IUGR fetuses. In a longitudinal study, Figueras et al [20] followed 22 IUGR fetuses and reported significantly lower E/A ratios in both AV valves compared to normally grown fetuses with early deterioration of the right E/A ratios.…”