title: [Fetal pulmonary venous Doppler flow patterns in hypoplastic left heart syndrome].
abstract: OBJECTIVE
  To discuss the value of fetal pulmonary venous Doppler flow patterns in hypoplastic left heart syndrome (HLHS).
  
  
  METHODS
  Forty-six HLHS and 180 normal singleton fetuses at 24+0 to 37+6 weeks of gestation were enrolled in this study. The blood flow of pulmonary vein (PV) was detected by color Doppler ultrasound. The systolic wave of ventricle (S-wave), diastolic wave of ventricle (D-wave), atrial contraction wave (A-wave) and S/D ratio of PV were measured. The statistical difference in the above parameters between HLHS and normal fetuses was compared. The diagnosis was also confirmed by autopsy in still birth or postnatal follow-up when the baby was alive.
  
  
  RESULTS
  The PV blood flow in HLHS fetuses had a high possibility of reversed A wave, and the velocity of S wave and S/D ratio were higher than the matched normal controls (P<0.001). There were 3 types of PV blood flow patterns among all fetuses with HLHS. Both the cases with right to left shunt through foramen ovale (FO) and the cases with restricted left to right shunt at FO showed the triphasic patterns of PV with antegrade S wave, D wave and retrograde A wave. However, the latter had a higher velocity of retrograde A wave (P<0.001), lower D wave (P<0.001), and obviously elevated S wave and S/D ratio (P<0.001). The cases with intact interatrial septum showed short and apparent pulsatile back and forth blood flow in the PV, which displayed as absence of D wave.
  
  
  CONCLUSIONS
  The 3 types of PV blood flow patterns in the fetuses with HLHS reflect the severity of hypertension in the left atrium, which is extremely vital for the prognosis and the perinatal treatment plan.
authors.affiliation: Department of Ultrasonography, Second Xiangya Hospital, Central South University, Changsha 410011, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Qichang
authors.initials: Q
authors.lastname: Zhou
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Peng
authors.forename: Shi
authors.initials: S
authors.lastname: Zeng
authors.forename: Jiawei
authors.initials: J
authors.lastname: Zhou
mesh_terms: D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D005333:Fetus; D006325:Heart Atria; D006352:Heart Ventricles; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000175:diagnosis*; D011247:Pregnancy; D011667:Pulmonary Veins; D013599:Systole; D016216:Ultrasonography, Prenatal