Maternal hepatic vein Doppler velocimetry during uncomplicated pregnancy and pre-eclampsia.
Changes of Doppler velocity measurements of distinct hepatic vein (HV) Doppler wave components were evaluated during uncomplicated pregnancy (UP) as a reference to measurements in pre-eclampsia (PE). Women with UP (n = 13) were submitted to standardised duplex scanning of HV at 11 stages of pregnancy between 10 and 38 weeks. For each stage, mean +/- SD was calculated for HV A-, X-, V- and Y-peaks. Women with PE (n = 30) were evaluated once, and mean +/- SD was calculated for pregnancies <32 weeks, 32-34(+6) weeks and > or =35 weeks. PE and UP values at corresponding gestational age were compared statistically using t-test. HV A-velocity measurements changed markedly from negative values in early uncomplicated pregnancy, converting around 22-24 weeks to positive values until term. Changes throughout gestation were less prominent for HV X-, V- and Y-velocities. HV A-velocity measurements were significantly lower in PE than in UP, the difference being more pronounced at 30 weeks (-3.59 +/- 3.41 vs. 6.12 +/- 3.43, p = 0.0001) than at 37 weeks (2.35 +/- 4.54 vs. 5.32 +/- 1.92, p = 0.04). From our results, we conclude that HV Doppler velocimetry shows a gradual shift from central venous reversed flow during atrial contraction in uncomplicated early pregnancy to constantly forward moving flow until term. HV A-velocities are significantly lower in PE than in UP, the differences being more pronounced in late second trimester than near term.
Gyselaers
Wilfried
W
Department of Obstetrics and Gynecology, East Limburg Hospital, Genk, Belgium and Hasselt University, Diepenbeek, Belgium. wilfried.gyselaers@zol.be
Molenberghs
Geert
G
Mesens
Tinne
T
Peeters
Louis
L
D001783:Blood Flow Velocity; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D005865:Gestational Age; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011264:Pregnancy Trimesters; D011446:Prospective Studies; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D018616:Ultrasonography, Doppler, Duplex; D016216:Ultrasonography, Prenatal