Abnormal ductus venosus waveforms

Changed by Owen Kang, 16 Jul 2017

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Abnormal ductus venosus waveforms can arise in a number of conditions ranging from aneuploidy to vascular malformations and fetal tumours.

Pathology

Abnormal waveforms in fetal ductus venosus flow assessment can occur in a number of situations:

aneuploidic anomalies
- Down syndrome: around 80% are thought to have abnormal waveforms
congenital cardiac anomalies
- fetal pulmonary arterial anomalies
  - congenital pulmonary stenosis
  - pulmonary atresia
fetal arteriovenous malformations leading to shunting
- vein of Galen malformation
fetal tumours that lead to arteriovenous shunting
- sacrococcygeal teratoma
- epignathus
twin ~~to twin~~-to-twin transfusion syndrome: recipient twin
maternal diabetes: may exhibit increased PI values ⁷
"a" wave reversal can be seen in 5% of euploid fetuses ⁹

Radiographic features

Abnormal waveforms include:

reduced flow in ductus venosus A wave
absent flow in ductus venosus A wave
reversal of flow in ductus venosus A wave
abnormal indices:
- abnormal pulsatility index (PI)
- abnormal S wave to A wave ratio (S:A)
- abnormal peak velocity index

Treatment and prognosis

Growth restricted fetuses with abnormal ductus venosus flow have worse perinatal ~~outcome~~outcomes compared to those where the flow abnormality is confined to the umbilical or middle cerebral artery ⁸.

~~-<a href="/articles/twin-twin-transfusion-syndrome-1">twin to twin transfusion syndrome</a>: recipient twin</li>~~
+<a href="/articles/twin-twin-transfusion-syndrome-1">twin-to-twin transfusion syndrome</a>: recipient twin</li>
-</ul><h4>Treatment and prognosis</h4><p>Growth restricted fetuses with abnormal ductus venosus flow have worse perinatal outcome compared to those where flow abnormality is confined to the umbilical or middle cerebral artery <sup>8</sup>.</p>
+</ul><h4>Treatment and prognosis</h4><p>Growth restricted fetuses with abnormal ductus venosus flow have worse perinatal outcomes compared to those where the flow abnormality is confined to the umbilical or middle cerebral artery <sup>8</sup>.</p>