Middle cerebral artery peak systolic and ductus venosus velocity waveforms in the hydropic fetus.
OBJECTIVE
The purpose of this study was to assess whether Doppler assessment of the middle cerebral artery (MCA) peak systolic velocity (PSV) and ductus venosus (DV) velocity waveforms during sonography of hydropic fetuses may specify the cause of fetal hydrops.


METHODS
A level II sonographic examination was performed in 16 hydropic fetuses, and the MCA PSV and DV velocity waveforms were assessed. The MCA PSV values divided hydropic fetuses into anemic (group 1) and nonanemic (group 2) fetuses. In group 2 fetuses, the DV was defined as normal or abnormal. Sonographic examination and Doppler assessment of these vessels specified the cause of hydrops and indicated the use of specific investigations for diagnosing the etiology of fetal hydrops.


RESULTS
Seven of 16 fetuses had MCA PSV values greater than 1.50 multiples of the median (group 1). Nine of 16 fetuses had normal MCA PSV values (group 2); among them, 7 of 9 had either absent or reversed flow in the DV, and 2 had a normal DV. In group 1, the cause of fetal anemia was investigated by maternal serum tests, and 5 cordocentesis procedures were performed. In group 2, 7 of 9 fetuses had reversed flow in the DV, which suggested a cardiac abnormality confirmed by echocardiography. Five cordocentesis procedures were performed for fetal karyotype, and in 2 fetuses, the cause of hydrops was idiopathic.


CONCLUSIONS
Our data suggest that assessment of the MCA PSV and DV velocity waveforms in the hydropic fetus may further our knowledge of the etiology of hydrops and may indicate which investigations among the many available should be used for diagnosing the cause of fetal hydrops.
Cosmi
Erich
E
Department of Gynecological Science and Reproductive Medicine, University of Padua School of Medicine, Via Giustiniani 3, 35100 Padua, Italy. ecosmi@hotmail.com
Dessole
Salvatore
S
Uras
Luisa
L
Capobianco
Giampiero
G
D'Antona
Donato
D
Andrisani
Alessandra
A
Litta
Pietro
P
Ambrosini
Guido
G
D001783:Blood Flow Velocity; D005260:Female; D005865:Gestational Age; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011247:Pregnancy; D013599:Systole / Q000502:physiology; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal