Blood velocity in the fetal vein of Galen and the outcome of high-risk pregnancy.
BACKGROUND
Pulsation in the flow velocity waveform in the umbilical vein is related to perinatal mortality but the flow velocity waveform in the fetal vein of Galen is normally even and without fluctuation.


OBJECTIVE
To establish whether blood flow velocity pulsations in the vein of Galen in high-risk pregnancies are related to outcome.


METHODS
The vein of Galen was located by colour Doppler ultrasound in 102 pregnancies complicated by severe pregnancy-induced hypertension. The blood velocity waveform was recorded by pulsed Doppler within 2 days of delivery and the presence pulsations related to pregnancy outcome, including emergency operative intervention and neonatal distress. Umbilical artery and vein and uterine artery blood flow velocity waveform were also recorded at the same time. The clinicians managing the women were unaware of the venous flow results.


RESULTS
Pulsation were present in the vein of Galen in 68 cases and in the umbilical vein in 21. Both were significantly related to adverse outcome. Pulsations in the vein of Galen were seen in all seven perinatal deaths.


CONCLUSIONS
Since umbilical venous pulsation are a late sign of fetal compromise, and pulsations in the vein of Galen seem to appear earlier, thus being an intermediate sign of fetal compromise that might be of great value for fetal surveillance.
Dubiel
M
M
Department of Perinatology and Gynaecology, University School of Medical Sciences, University Hospital, Poznan, Poland.
Breborowicz
G H
GH
Laurini
R
R
Gudmundsson
S
S
D001237:Asphyxia / Q000000981:diagnostic imaging; D001724:Birth Weight; D001783:Blood Flow Velocity; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000196:embryology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging; D011256:Pregnancy Outcome; D018615:Ultrasonography, Doppler, Color; D014471:Umbilical Veins / Q000000981:diagnostic imaging