Reference ranges for umbilical vein blood flow in the second half of pregnancy based on longitudinal data.
OBJECTIVE
To construct new reference ranges for serial measurements of umbilical vein (UV) blood flow.


METHODS
Prospective longitudinal study of blood flow velocities and diameter of the UV measured at four-weekly intervals during 19 to 42 weeks' gestation in 130 low-risk singleton pregnancies. Regression models and multilevel modeling were used to construct the reference ranges.


RESULTS
On the basis of 511 sets of longitudinal observations, we established new reference percentiles of UV diameter, blood flow velocities, volume flow, and blood flow normalized for fetal weight and abdominal circumference. They reflected some of the developmental patterns of previous cross-sectional studies, but with important differences, particularly near term. The UV blood flow showed a continuous increase until term, whereas the flow normalized per unit fetal weight, a corresponding reduction. Calculating the blood flow on the basis of intensity-weighted mean velocity or 0.5 of the maximum velocity gave almost interchangeable results for most fetuses.


CONCLUSIONS
New reference ranges for UV blood flow based on longitudinal observations appear slightly different from cross-sectional studies, and should be more appropriate for serial evaluation of fetal circulation.
Acharya
Ganesh
G
Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway. ganesh.acharya@unn.no
Wilsgaard
Tom
T
Rosvold Berntsen
Gro K
GK
Maltau
Jan Martin
JM
Kiserud
Torvid
T
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology; D005333:Fetus / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D008137:Longitudinal Studies; D011247:Pregnancy / Q000502:physiology*; D011446:Prospective Studies; D011673:Pulsatile Flow; D012016:Reference Values; D016216:Ultrasonography, Prenatal; D014471:Umbilical Veins / Q000000981:diagnostic imaging / Q000502:physiology*