Ductus venosus blood flow in chromosomally abnormal fetuses at 11 to 14 weeks of gestation.
This article reviews the role of ductus venosus (DV) Doppler evaluation in the screening for aneuploidies at 11 to 14 weeks of gestation. Ductus venosus flow velocity waveforms were obtained immediately before fetal karyotyping in 515 consecutive singleton pregnancies at 11 to 14 weeks. We found 446 normal and 69 abnormal karyotypes. Abnormal flow in the DV was the only significant difference between both groups. Sensitivity of the test was 80% and false positive rate < 1%. Normal karyotype but abnormal flow in the DV was recorded in 17 of 446 cases, 7 presenting a cardiac defect. Increased nuchal translucency seems to be related, in most cases, to early cardiac dysfunction. Chromosomal abnormalities and/or cardiac defects were often found in cases with increased nuchal translucency and abnormal flow in the DV. We suggest that the evaluation of ductal flow between 11 to 14 weeks of gestation should be adopted as a second level screening test to reduce invasive test rate derived from the exclusive measurement of nuchal translucency.
Matias
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Department of Obstetrics and Gynecology, University Hospital of S. João, Porto, Portugal. almatias@mail.telepac.pt
Montenegro
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N
D000293:Adolescent; D000328:Adult; D000782:Aneuploidy; D001783:Blood Flow Velocity / Q000502:physiology; D002869:Chromosome Aberrations / Q000000981:diagnostic imaging* / Q000503:physiopathology; D025063:Chromosome Disorders; D005189:False Positive Reactions; D005260:Female; D005865:Gestational Age; D006801:Humans; D007621:Karyotyping; D008875:Middle Aged; D011247:Pregnancy; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014471:Umbilical Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging* / Q000503:physiopathology