Fetal vascular response to maternal deep-vein thrombosis and subsequent heparin therapy.
The fetal umbilical and cerebral Doppler changes were recorded in a 27-year-old primigravida referred at 38 weeks for the treatment of an iliofemoral vein thrombosis. On admission and in comparison to a previous Doppler assessment systematically performed during growth scan at 37 weeks, the umbilical resistance index (URI) demonstrated an increase of 19%, the cerebral resistance index (CRI) a reduction of 15% and the cerebral-umbilical (C/U) ratio a decrease of 29% reaching the lowest value of 1.05. Under intravenous heparin therapy, Doppler normalisation was observed within 1 week and the mother delivered a healthy, non-hypoxemic baby by caesarean section at 39 weeks and 2 days. This observation suggests that deep-vein thrombosis (DVT) may, in some cases, be responsible for transient fetal hypoxia. Moreover, treatment with intravenous heparin had a direct beneficial effect on the fetus as it improved placental hemodynamics and fetal oxygenation.
Perrotin
F
F
Inserm U316, Département Médecine Nucléaire et Ultrasons, Centre Hospitalier Universitaire, F-37044 Tours Cedex, France. f.perr@infonie.fr
Tobal
N
N
Georgescu
M
M
Herve
P
P
Lansac
J
J
Arbeille
P
P
D002585:Cesarean Section; D005260:Female; D005333:Fetus / Q000098:blood supply* / Q000187:drug effects; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D020246:Venous Thrombosis / Q000188:drug therapy*
D005343:Fibrinolytic Agents; D006493:Heparin