Fetal ductus venosus flow assessment
Updates to Article Attributes
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Fetal ductus venosus flow assessmentcan be sonographically assessed in a number of situations in fetal ultrasound:
- first trimester screening for aneuploidic anomalies
- second trimester scanning when there are concerns regarding
Of all the pre-cardial veins, the ductus venosus allows the most accurate interpretation of fetal cardiac function as well as myocardial haemodynamics 9.
Radiographic assessment
Ultrasound
Technique
- the fetus should be as still as possible
- the probe is ideally focused so sampling is done where the umbilical vein joins the ductus venosus
- a right ventral mid-sagittal view of the fetal trunk should be obtained and color flow mapping used to demonstrate the umbilical vein, ductus venosus and fetal heart
- the probe is ideally angled to allow a mid sagittal plane or a transverse oblique plane through the fetal abdomen
- the image should be magnified enough for the fetal thorax and abdomen to occupy the whole screen
- do not contaminate the ductus venosus
fromflow with the flow from the fetal inferior vena cava, for this the Doppler sample should be small ( 0.5- 1 mm) - the
fetusinsonationa angle should beas still as possible30° - the sweep speed should be high (2–3 cm/s) so that the waveforms are spread allowing better assessment of the a-wave
Waveform
On Doppler ultrasound the flow in the ductus venosus has a characteristic triphasic waveform where in a normal physiological situation flow should always be in the forward direction 7 (i.e. towards the fetal heart).
This triphasic waveform comprises of:
- S wave: corresponds to fetal ventricular systolic contraction and is the highest peak
- D wave: corresponds to fetal early ventricular diastole and is the second highest peak
- A wave (or rather trough): corresponds to fetal atrial contraction and is the lowest point in the wave form albeit still being in the forward direction
See also
-<p><strong>Fetal ductus venosus flow assessment </strong>can be sonographically assessed in a number of situations in fetal ultrasound:</p><ul>- +<p><strong>Fetal ductus venosus flow assessment </strong>can be sonographically assessed in a number of situations in fetal ultrasound:</p><ul>
-<li><a href="/articles/intra-uterine-growth-restriction-2">intrauterine growth restriction (IUGR)</a></li>- +<li><a href="/articles/intrauterine-growth-restriction">intrauterine growth restriction (IUGR)</a></li>
- +<li>the fetus should be as still as possible</li>
- +<li> a right ventral mid-sagittal view of the fetal trunk should be obtained and color flow mapping used to demonstrate the umbilical vein, ductus venosus and fetal heart</li>
-<li>do not contaminate the ductus venosus from flow from the fetal inferior vena cava</li>-<li>the fetus should be as still as possible</li>-</ul><h6>Waveform</h6><p>On Doppler ultrasound the flow in the ductus venosus has a characteristic <strong>triphasic</strong> waveform where in a <strong>normal physiological situation</strong> flow should always be in the forward direction <sup>7</sup> (i.e. towards the fetal heart).</p><p>This triphasic waveform comprises of:</p><ul>- +<li>the image should be magnified enough for the fetal thorax and abdomen to occupy the whole screen</li>
- +<li>do not contaminate the ductus venosus flow with the flow from the fetal inferior vena cava, for this the Doppler sample should be small ( 0.5- 1 mm)</li>
- +<li>the insonationa angle should be 30°</li>
- +<li>the sweep speed should be high (2–3 cm/s) so that the waveforms are spread allowing better assessment of the a-wave </li>
- +</ul><p>On Doppler ultrasound the flow in the ductus venosus has a characteristic <strong>triphasic</strong> waveform where in a <strong>normal physiological situation</strong> flow should always be in the forward direction <sup>7</sup> (i.e. towards the fetal heart).</p><p>This triphasic waveform comprises of:</p><ul>