Abnormal ductus venosus flow in first-trimester fetuses with increased nuchal translucency: relationship with the type of cardiac defect?
OBJECTIVE
The purpose of this study was to evaluate ductus venosus flow velocities and a possible relationship with the type of cardiac defect in fetuses with increased nuchal translucency (NT).


METHODS
Seventy-two fetuses with normal NT and 137 fetuses with increased NT (>95th percentile) were evaluated. The ductus venosus pulsatility index for veins (PIV), late diastolic velocity (velocity during atrial contraction [a-V]), and intracardiac velocities were evaluated. In cases of pregnancy termination, a postmortem examination was performed. Cardiac defects were grouped into septal defects, left and right inflow obstruction, left and right outflow obstruction, and other defects. Data were evaluated by multilevel analysis.


RESULTS
A cardiac defect was found in 45 fetuses with increased NT. Fetuses with increased NT showed a higher ductus venosus PIV and a lower a-V compared to fetuses with normal NT (P < .05). Within the group of fetuses with increased NT, a higher PIV and a lower a-V were found in cases with a cardiac defect compared to cases with a normal heart (P < .001). No differences in PIV and a-V were found between the types of cardiac defects. Intracardiac velocities showed no differences between fetuses with normal and increased NT, irrespective of the presence of a cardiac defect.


CONCLUSIONS
Ductus venosus flow velocities in fetuses with increased NT are not related to a certain type of cardiac defect. This indicates that the altered ductus venosus flow velocities found in fetuses with increased NT cannot be explained by cardiac failure due to a specific altered cardiac anatomy.
de Mooij
Yolanda M
YM
Department of Obstetrics and Gynecology, VU University Medical Center, Suite PK6 -170, Postbus 7057, 1007-MB Amsterdam, the Netherlands. ym.demooij@vumc.nl
Haak
Monique C
MC
Bartelings
Margot M
MM
Twisk
Jos W
JW
Gittenberger-de Groot
Adriana
A
van Vugt
John M G
JM
Bekker
Mireille N
MN
D001783:Blood Flow Velocity; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000196:embryology* / Q000503:physiopathology*; D006801:Humans; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011263:Pregnancy Trimester, Third