Umbilical vein blood flow in growth-restricted fetuses.
OBJECTIVE
To determine whether umbilical blood flow is reduced in a subset of growth-restricted (IUGR) fetuses when expressed as flow per kilogram or flow per unit of specific sonographic fetal measurements.


METHODS
Prospective.


METHODS
Thirty-seven IUGR fetuses were examined by Doppler ultrasound within 4 h of the last non-stress test prior to delivery. This population was divided into three groups of varying clinical severity according to the characteristics of umbilical arterial pulsatility index (PI) and heart rate.


METHODS
Absolute and weight-specific umbilical vein (UV) flow were calculated from measurements of UV diameter and UV mean velocity. Umbilical vein diameter, velocity and UV flow were calculated also per unit head (HC) or abdominal circumference (AC) and correlated with gestational age.


RESULTS
Umbilical vein flow (UVf) per kilogram fetal weight was significantly lower in the more severe IUGR fetuses (abnormal umbilical arterial PI) than in normally grown comparable fetuses (P < 0.001). Umbilical vein flow per unit HC was significantly lower in the three groups (P < 0.001) than in the control population. The UV diameter/HC ratio was normal whereas UV velocity/HC ratio was significantly lower in IUGR fetuses than in comparable controls.


CONCLUSIONS
The present study clearly establishes that umbilical venous blood flow is reduced in IUGR fetuses on a weight-specific basis. The sonographic growth parameter which best distinguishes umbilical flow differences of IUGR fetuses from normal fetuses is the head circumference.
Ferrazzi
E
E
Department of Obstetrics and Gynecology, Biomedical Sciences Institute Luigi Sacco, University of Milan via GB Grassi, 20157 Milan, Italy.
Rigano
S
S
Bozzo
M
M
Bellotti
M
M
Giovannini
N
N
Galan
H
H
Battaglia
F C
FC
D000328:Adult; D000704:Analysis of Variance; D001783:Blood Flow Velocity; D003430:Cross-Sectional Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014471:Umbilical Veins / Q000000981:diagnostic imaging*