Umbilical vein pulsations: A physiologic finding in early gestation

Abstract

The purpose of this study was to establish the incidence of umbilical vein pulsations in normal early pregnancies and to evaluate whether these pulsations are related to Doppler-measured vascular resistances in umbilical artery or central venous flow patterns. We performed a cross-sectional study on 257 uneventful pregnancies at 7 to 16 weeks of gestation by means of transvaginal color and pulsed Doppler ultrasonography. Blood flow velocity waveforms were recorded from the umbilical artery, umbilical vein and, in 48 cases, also from fetal inferior vena cava. Pulsations in the umbilical vein were evidenced in all cases until 8 weeks. From this gestational age on pulsations progressively disappeared, becoming completely absent at greater than or equal to 13 weeks. The incidence of pulsations in the umbilical vein was unrelated to umbilical artery pulsatility index values, the incidence of absent end-diastolic flow in umbilical artery, and fetal heart rate. In the inferior vena cava, reverse flow during atrial contraction was significantly higher (p less than or equal to 0.002) in cases with umbilical vein pulsations than in those cases without pulsations at a similar gestational age. Pulsations in the umbilical vein are physiologically present during the first trimester of pregnancy and seem to be related to inferior vena cava flow patterns.