Utility of ductus venosus blood flow in the study of cardiac function in fetuses with intracardiac echogenic focus.

Abstract

The purpose of this study was to investigate fetal ductus venosus (DV) wave velocities, DV velocity ratios, and DV diastolic time intervals to derive additional information on fetal cardiac function in the presence of an intracardiac echogenic focus (IEF). Seventy fetuses at 19-28 weeks of gestation with an IEF and 63 control fetuses were screened using two-dimensional and power Doppler echocardiography. DV wave velocities, DV velocity ratios, and diastolic time intervals were measured. The aortic peak velocity, pulmonary artery peak velocity, left ventricular shortening fraction, and right ventricular shortening fraction, atrioventricular early-diastolic filling velocity (E), atrial contraction velocity (A), and E/A ratio were also measured. The study and control groups were similar in terms of maternal age, body mass index, and gestational age in weeks at the time of examination (p > 0.05). Significant between-group differences were found in DV v-descent (p = 0.03) and a-wave velocities (p = 0.04). Although the presence of an IEF in the fetal heart does not influence conventional measurements (DV velocity ratios and DV diastolic time intervals), it is associated with changes in DV v-descent and a-wave velocities. These changes may be indirectly related to reduced end-systolic relaxation and augmented atrial contraction in the fetal heart. We therefore suggest examination of DV flow velocities in fetuses with IEF.