EP14.09: A hypercoiled cord can cause an atypical ductus venosus Doppler in cases of fetal growth restriction

Abstract

Although an absent or reversed a-wave in ductus venosus (DV-RAV) is reported to be the terminal finding of fetal growth restriction (FGR), we have seen a DV-RAV that disappears in a short span of time, causing us to reconsider the mechanism of DV-RAV in FGR. This was a retrospective study of 499 FGR cases, including 14 with DV-RAV. Transabdominal amnioinfusion (AI) was performed when oligohydramnios was severe and/or a sign of cord compression was detected. DV-RAV that disappeared in a short span of time was defined as “temporary DV-RAV”. DV-RAV that continued until delivery or fetal death (FD) was defined as “persistent DV-RAV”. The clinical characteristics and clinical courses were compared between the two types of DV-RAV. Temporary DV-RAV was detected in five cases. DV-RAV disappeared after AI in all of the temporary DV-RAV cases. The incidence of a hypercoiled cord was significantly higher in temporary DV-RAV cases than in persistent DV-RAV cases. The time from detection of DV-RAV to delivery or FD was significantly longer in temporary DV-RAV cases than in persistent DV-RAV cases. Temporary DV-RAV may be related to disturbed umbilical cord blood flow. DV-RAV may not be always be a terminal finding in FGR with a hypercoiled cord.