title: Arterial and ductus venosus Doppler in fetuses with absent or reverse end-diastolic flow in the umbilical artery: longitudinal analysis.
abstract: OBJECTIVE
  To evaluate alterations of arterial and ductus venosus blood flow velocities during deterioration and their interdependence.
  
  
  METHODS
  37 high-risk pregnancies complicated by umbilical absent or reverse end-diastolic flow velocities (AREDV) were monitored by measurement of the pulsatility index of the umbilical artery, middle cerebral artery and ductus venosus waveforms.
  
  
  RESULTS
  The mean observation period was 16.5 days. There was a significant change in the pulsatility of waveforms in all vessels over the observation period. Compared with the ductus venosus, pulsatility of waveforms in the middle cerebral artery diverged from the normal range 2.2 weeks earlier. Increase in pulsatility in the umbilical artery was concomitant with venous but not with cerebral flow alterations. In addition, there was a correlation between the increase of venous but not arterial pulsatility and perinatal acidemia. Variability of pulsatility index values of the umbilical artery and the ductus venosus but not of the middle cerebral artery increased towards delivery.
  
  
  CONCLUSIONS
  Ductus venosus Doppler allows detection of further deterioration in centralized fetuses with umbilical AREDV. However, striking short-term variability has to be taken into account when considering this parameter.
authors.affiliation: Department of Obstetrics and Gynecology, University of Würzburg, Germany. t.muellerdog@mail.uni-wuerzburg.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller
authors.forename: Ralph
authors.initials: R
authors.lastname: Nanan
authors.forename: Monika
authors.initials: M
authors.lastname: Rehn
authors.forename: Peter
authors.initials: P
authors.lastname: Kristen
authors.forename: Johannes
authors.initials: J
authors.lastname: Dietl
mesh_terms: D001783:Blood Flow Velocity; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology; D005333:Fetus / Q000098:blood supply*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008099:Liver / Q000098:blood supply; D008137:Longitudinal Studies; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D011247:Pregnancy; D011673:Pulsatile Flow; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging