F125Fetal pulmonary venous Doppler flow velocity waveforms in congenital heart defects

Abstract

Aim of the studyis to analyze blood flow velocity waveforms (FVW) in the pulmonary veins using pulsed Doppler ultrasound in fetuses with a prenatally detected congenital heart defect (CHD).MethodsIn 96 fetuses with various CHD Doppler FVW from the pulmonary veins were assessed. Gestational age varied between 18 and 38 weeks. Following Doppler parameters were analyzed and compared to reference ranges: systolic (S), diastolic (D) peak velocity, end‐diastolic velocity during atrial contraction (A), peak velocity index for veins (PVIV) and Pulsatility Index for veins (PIV).ResultsWe could distinguish 5 different patterns of FVW reflecting different stages of pulsatility and preload within the left atrium. Abnormal patterns were mainly observed in fetuses with left atrial obstruction and a restrictive foramen ovale having a reversed A‐wave as well as in mitral regurgitation.ConclusionsAbnormal FVW in fetal cardiac defects depend from the left atrial pressure rather than on the cardiac defect itself. Patterns of FVW can help in quick differentiation of increased interatrial pressure, which can impair early neonatal outcome.