title: Reversed end-diastolic umbilical flow in a first-trimester fetus with congenital heart disease.
abstract: Reversed end-diastolic umbilical artery velocities and a reduced chorionic sac were first seen at 10 weeks in a pregnancy subsequently showing a normal male karyotype on chorionic villi. Four weeks later Doppler studies demonstrated normal umbilical artery waveforms. At 20 weeks, ultrasound examination of the fetus revealed a mild pericardic effusion, hypoplastic righ heart with hypertrophic myocardium and a single umbilical artery, suggesting pulmonary atresia. After neonatal death, pathological studies confirmed pulmonary atresia. This case suggests that reversed end-diastolic umbilical flow in the first trimester may identify a subgroup of fetuses with a lethal abnormality (heart defect, severe intra-uterine retardation, aneuploidy or others).
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital Clinic IDIBAPS, University of Barcelona Medical School, Catalonia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Borrell
authors.forename: D
authors.initials: D
authors.lastname: Costa
authors.forename: J M
authors.initials: JM
authors.lastname: Martinez
authors.forename: M T
authors.initials: MT
authors.lastname: Farré
authors.forename: M
authors.initials: M
authors.lastname: Palacio
authors.forename: C
authors.initials: C
authors.lastname: Mortera
authors.forename: A
authors.initials: A
authors.lastname: Fortuny
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D015193:Chorionic Villi Sampling; D003971:Diastole; D017809:Fatal Outcome; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000503:physiopathology*; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011247:Pregnancy; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000002:abnormalities* / Q000503:physiopathology*