Abstract
Objective:To evaluate the correlation between reversed a-wave in ductus venosus at 16-20 weeks’ gestation and trisomy 21 and adverse perinatal outcomes.Materials and Methods:Our study included 174 pregnant women who were under follow-up at a tertiary center between May and September 2010. Ductus venosus Doppler (DVD) measurements were obtained throughout the 6-month period from women who underwent amniocentesis procedures due to increased risk for trisomy 21 in terms of first or second trimester screening test results. These women were followed up for enrollment of subsequent data about perinatal outcomes.Results:In 13 of 174 cases, Doppler studies indicated a reversed a-wave in the ductus venosus. Of these fetuses, 3 were diagnosed as having trisomy 21 after amniocentesis, which related to 60% (3 of 5 fetuses) of all fetuses with trisomy 21. The pregnant women with reversed a-wave in DVD also had an increased rate of preeclampsia (15%) and gestational diabetes mellitus (GDM) (23%) in late pregnancy.Conclusion:Reversed a-wave in ductus venosus between 16-20 weeks’ gestation is associated with increased risk of trisomy 21, preeclampsia, and GDM. If further prospective studies confirm its utility, DVD interrogation for trisomy 21 may be extended until 20 weeks’ gestation.
Highlights
The primary purpose of prenatal aneuploidy screening tests is early detection of pregnancies at high risk for Down syndrome, which is the most common autosomal trisomy among live births[1]
Following the demonstration of a correlation between abnormal ductal flow and nuchal translucency (NT), it has been proposed that a combined assessment of ductus venosus (DV) and NT thickness may increase the efficacy of early sonographic screening of trisomy 21
Some abnormalities have been found in Ductus venosus Doppler (DVD) ultrasonography during pregnancies with gestational hypertension (GHT), preeclampsia, and gestational diabetes mellitus (GDM)(9-11)
Summary
The primary purpose of prenatal aneuploidy screening tests is early detection of pregnancies at high risk for Down syndrome, which is the most common autosomal trisomy among live births[1]. First trimester combined screening tests can detect approximately 84% of trisomy cases with a false positive rate (FPR) of 5 percent[2]. Incorporation of assessment of nasal bone, tricuspid blood flow, and ductus venosus (DV) waveform to the combined test increases the detection rate to approximately 93-96% with a FPR of 2.5 percent. Following the demonstration of a correlation between abnormal ductal flow and nuchal translucency (NT), it has been proposed that a combined assessment of DV and NT thickness may increase the efficacy of early sonographic screening of trisomy 21. The aim of our study was to determine whether DV waveform abnormality in Doppler ultrasonography would aid in second trimester screening when the detection rate is relatively low, and whether it was correlated with maternal complications
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
