Hemodynamics of the maternal venous compartment: a new area to explore in obstetric ultrasound imaging

Gyselaers, Wilfried

doi:10.1002/uog.6113

Cited by 21 publications

(23 citation statements)

References 5 publications

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“…RIVI is defined as (max velocity – min velocity)/max velocity. Minimum venous flow velocity has been linked to a sudden deceleration of forward flow due to the counteractive force of the right atrial systole, which causes intravenous backflow into the venous system by lack of valve between atrium and vena cava [27]. At the level of HV, this counteraction is responsible for reversal of the venous A-wave, leading to a triphasic pattern of HV Doppler waves in PE [26].…”

Section: Discussionmentioning

confidence: 99%

“…It is likely that increased venous tone in PE is associated with a faster and more distant rebound of atrial contraction throughout the venous circulation, up to the level of the kidneys. Figure 2 suggests that only in EPE, this rebound reaches the left kidney, which is more distant from the heart than the liver and right kidney [27]. As such, increased RIVI, with or without VPAN, can be considered a reflection of pulsatile counteraction of forward venous flow from the kidneys, which intermittently counteracts renal outflow during each atrial contraction [10].…”

Section: Discussionmentioning

confidence: 99%

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Maternal venous hemodynamics in gestational hypertension and preeclampsia

Gyselaers

Tomsin

Staelens

et al. 2014

BMC Pregnancy Childbirth

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BackgroundTo evaluate characteristics of venous hemodynamics, together with cardiac and arterial function, in uncomplicated pregnancies (UP), non-proteinuric gestational hypertension (GH) and preeclampsia (PE).MethodsIn this observational cross-sectional study, venous hemodynamics was assessed using a standardised protocol for combined electrocardiogram (ECG)-Doppler ultrasonography, together with a non-invasive standardised cardiovascular assessment using impedance cardiography (ICG) in 13 women with UP, 21 with GH, 34 with late onset PE ≥ 34 w (LPE) and 22 with early onset PE < 34 w (EPE). ECG-Doppler parameters were impedance index at the level of hepatic veins (HVI) and renal interlobar veins (RIVI) together with venous pulse transit times (VPTT), as well as resistive and pulsatility index, and arterial pulse transit time (APTT) at the level of uterine arcuate arteries. ICG parameters were aortic flow velocity index (VI), acceleration index (ACI) and thoracic fluid content. Mann Whitney U-test, Kruskall-Wallis test and linear regression analysis with heteroskedastic variance was used for statistical analysis.ResultsRIVI in both kidneys was >15% higher (P ≤ .010) in LPE and EPE, as compared to GH and UP. Next to this, >30% lower values for VI and ACI (P ≤ .029), and > 15% lower values for APTT (P ≤ .012) were found in GH, LPE and EPE, as compared to GH.ConclusionIn comparison to UP, similar abnormalities of central arterial function and APTT were found in GH, EPE and LPE. Proteinuria of LPE and EPE was associated with increased RIVI, this was not observed in GH.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Maternal venous hemodynamics in gestational hypertension and preeclampsia

Gyselaers

Tomsin

Staelens

et al. 2014

BMC Pregnancy Childbirth

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“…Vasoconstriction and vasodilatation, which can be secondary to infection or inflammation, can change the circulatory situation in the periphery. It has been reported that in pre‐eclamptic women the retrograde flow wave during right atrial contraction causes periodic depressions or even reversals of venous flow in maternal hepatic12 and renal16, 17 veins. In the present study, four of 10 women with pre‐eclampsia (40%) had UtV flow of Type II or III (i.e.…”

Section: Discussionmentioning

confidence: 99%

Uterine venous blood flow in normal and complicated pregnancies: a methodological study

Thuring

Laurini

Maršál

2010

Ultrasound in Obstet & Gyne

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“…RIVI was found to be higher in pre‐eclamptic than in normal pregnancies and this was associated with fast decelerating forward flow during the last hundred milliseconds of the venous Doppler wave12. This phenomenon, the so‐called ‘venous pre‐acceleration nadir’ (VPAN), was linked to backflow of blood from the heart into the venous circulation during atrial contraction, due to lack of a valve mechanism13.…”

Section: Introductionmentioning

confidence: 99%

Maternal renal interlobar vein impedance index is higher in early‐ than in late‐onset pre‐eclampsia

Gyselaers

Mesens

Tomsin

et al. 2010

Ultrasound in Obstet & Gyne

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Objectives To test the hypothesis that Doppler characteristics of maternal renal interlobar veins (RIV) are different between pregnancies affected by early-onset pre-eclampsia (EP) and those affected by late-onset pre-eclampsia (LP). Methods LP (0.41 ± 0.07 vs. 0.37 ± 0.06, P = 0.04, and 0.38 ± 0.12 vs. 0.30 ± 0.05, P = 0.009). RIVI was higher in pregnancies with EP than in those with LP (P ≤ 0.01), and this difference was associated with lower median birth-weight percentiles (22.5 (interquartile range (IQR),

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Hemodynamics of the maternal venous compartment: a new area to explore in obstetric ultrasound imaging

Cited by 21 publications

References 5 publications

Maternal venous hemodynamics in gestational hypertension and preeclampsia

Maternal venous hemodynamics in gestational hypertension and preeclampsia

Uterine venous blood flow in normal and complicated pregnancies: a methodological study

Maternal renal interlobar vein impedance index is higher in early‐ than in late‐onset pre‐eclampsia

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