WS15‐05Fetal venous Doppler: is it helpful in timing of delivery of hypoxic fetus?

Abstract

BackgroundThe aim of this study was to investigate the potential of fetal venous Doppler in detection of fetal hypoxia and timing of the delivery.MethodsThe study group consisted of patients with increased risk for developing fetal hypoxia. These were patients with diagnosed fetal intrauterine growth retardation (IUGR) and patients with pregnancy induced hypertension (PIH), or a combination of both problems. All patients had Doppler assessment of fetal arterial (umbilical artery, aorta, middle cerebral artery) and venous circulation (ductus venosus and umbilical vein), and cardiotocography 24 h before delivery. Collection of postnatal data included pH of umbilical chord blood, admission in neonatal intensive care unit, and perinatal death.ResultsA total of 360 patients were included in the study (IUGR 48%, PIH 20%, IUGR + PIH 32%). Deterioration in fetal venous return developed after fetal arterial circulation had been severely compromised. The decrease in end‐diastolic flow in ductus venosus anticipated development of umbilical vein pulsatile flow. Patients with pulsations in umbilical vein blood flow had high incidence of perinatal acidosis, morbidity, and mortality.ConclusionDelivery should be performed before umbilical vein pulsations develop. Careful monitoring of ductus venosus blood flow is helpful predictor of this event.