Preload Index of the Inferior Vena Cava as a Possible Predictive Marker of Hydropic Changes in Fetuses With Ebstein Anomaly

Hidaka, Noriaki; Sugitani, Maiko; Fujita, Yasuyuki; Fukushima, Kotaro; Tsukimori, Kiyomi; Wake, Norio

doi:10.7863/jum.2009.28.10.1369

Cited by 11 publications

(9 citation statements)

References 27 publications

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“…While these changes were unrelated to intrauterine survival in tricuspid atresia and pulmonary atresia, hydropic fetuses with EA had higher rates of reversal of flow during atrial contraction and elevated venous pulsatility indices. These preload conditions were also observed in the inferior vena cava in another small case series of fetuses with EA [27]. However, in our current cohort reversal of flow in the ductus venosus did not correlate with intrauterine survival or the presence of hydrops fetalis.…”

Section: Discussionsupporting

confidence: 72%

Ebstein’s Anomaly of the Tricuspid Valve in the Fetus – A Multicenter Experience

Gottschalk

Stressig

et al. 2016

Ultraschall in Med

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To assess the spectrum of associated anomalies, the intrauterine course, the outcome and possible prognostic markers in prenatally diagnosed Ebstein's anomaly (EA). All cases of EA diagnosed over a period of 13 years with a minimum follow-up of 1 year were retrospectively collected in 4 tertiary referral centers in Germany. In the study period 76 cases of EA were prenatally diagnosed. The mean gestational age at diagnosis was 25.0 weeks (range: 13 - 35). 41 (53.9 %) cases were isolated and 35 (46.1 %) had other cardiac and/or extracardiac anomalies. 19 (25.0 %) pregnant women opted for termination of pregnancy, intrauterine fetal death occurred in 7 cases (9.2 %), neonatal death in 14 cases (18.4 %), death in infancy or childhood in 9 cases (11.8 %) and 27 children (35.5 %) were alive at the last follow-up. After exclusion of terminations, the only parameter inversely correlated with intrauterine survival was hydrops fetalis. Prognostic parameters significantly associated with postnatal non-survival were an abnormal Celermajer index (right atrium/heart ratio > 0.7), cardiomegaly (cardiothoracic circumference ratio > 0.5), absence of antegrade flow over the pulmonary valve and earlier diagnosis in pregnancy. Prenatally diagnosed EA has a high morbidity and mortality with the highest loss rate in the intrauterine and neonatal period. In our study, hydrops fetalis was the only parameter significantly associated with intrauterine demise, while other prenatal markers were only significantly associated with postnatal mortality.

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Section: Discussionsupporting

confidence: 72%

Ebstein’s Anomaly of the Tricuspid Valve in the Fetus – A Multicenter Experience

Gottschalk

Stressig

et al. 2016

Ultraschall in Med

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“…A total of 694 women were recruited into the study and 49 were excluded due to fetal growth disorders,1, 4 fetal structural abnormalities,5 or chromosomal abnormalities 3. Of the remaining 645 measurements, the average number of measurements available for each week of gestational age was 21 ± 5 (mean ± SD), ranging from 12 to 30.…”

Section: Resultsmentioning

confidence: 99%

“…Doppler flow measurements of IVC have an increasingly important role in the evaluation of various fetal circulatory and cardiac conditions, permitting evaluation of cardiac preload. Therefore, IVC Doppler indices are helpful in the assessment of cardiac function, especially in cardiac compromise secondary to fetal growth restriction,1, 2 or congenital heart defects 3. During ventricular systole, pressure in the right atrium is lower than that in the IVC, resulting in forward flow from the IVC into the right atrium, represented by the S wave.…”

mentioning

confidence: 99%

Normal reference ranges of inferior vena cava doppler indices from 14 to 40 weeks of gestation

Luewan

Srisupundit

Tongprasert

et al. 2012

J of Clinical Ultrasound

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“…Hidaka, et al [36] conducted retrospective study on Five cases of prenatally diagnosed Ebstein anomaly they aimed to investigate whether the preload index of the inferior vena cava (PLI-IVC) is of diagnostic value in predicting hydropic changes in fetuses with Ebstein anomaly.…”

Section: Discussionmentioning

confidence: 99%

Fetal Venous Doppler Study for Evaluation of Fetuses with Non-Immune Hydrops Fetalis

Awad¹,

Ashkar²,

Dayem³

et al. 2018

Gynecol Reprod Health

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Objective:The aim of this study was to evaluate the role of inferior vena cava, ductus venosus, and intrahepatic portion of umbilical vein Doppler in evaluation of cases of nonimmune fetal hydrops. Material and Method:This study was conducted at the Department of Obstetrics and Gynecology, faculty of medicine, Alexandria University on 37 pregnant females in second and third trimester pregnancy selected from the attendees of El-Shatby Maternity university hospital. The cases were allocated into 2 main groups: group 1: twenty seven pregnant women with nonimmune fetal hydrops. Group 2: ten normal pregnant women without non-immune fetal hydrops (control group). We excluded from our study cases of immune fetal hydrops.We studied preload index of inferior vena cava, preload index and A wave of ductus venosus, and intrahepatic umbilical vein maximal velocity. Result: Our results showed the presence of high statistical significant correlation between abnormally elevated preload index of inferior vena cava, ductus venosus and abnormal A wave of ductus venosus and nonimmunefetal hydrops group. There were also high statistical significant correlation between intrahepatic umbilical vein decreased maximal velocity and nonimmune fetal hydrops. These changes of the velocimetry in the Inferior vena cava, Ductus venosus, and Intrahepatic umbilical vein corresponding to changes in cardiac function and could be of value in predicting prognosis and outcome of pregnancy.Conclusion: Doppler velocimetry in the IVC, DV, and intrahepatic portion of UV is a useful tool in the workup of hydropic fetuses.

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Preload Index of the Inferior Vena Cava as a Possible Predictive Marker of Hydropic Changes in Fetuses With Ebstein Anomaly

Abstract: The upward trend of the PLI-IVC rather than the maintenance of a high value can be considered a sign of cardiac failure. The blood flow pattern in the IVC should be carefully monitored in fetuses with Ebstein anomaly for the early identification of fetal impairment.

Cited by 11 publications

References 27 publications

Ebstein’s Anomaly of the Tricuspid Valve in the Fetus – A Multicenter Experience

Ebstein’s Anomaly of the Tricuspid Valve in the Fetus – A Multicenter Experience

Normal reference ranges of inferior vena cava doppler indices from 14 to 40 weeks of gestation

Fetal Venous Doppler Study for Evaluation of Fetuses with Non-Immune Hydrops Fetalis

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