Fetal ductus venosus flow assessment
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DuctusFetal ductus venosus (DV) flow assessment is a parameter that can be sonographically assessed in a number of situations in fetal ultrasound, including:
- first trimester screening for aneuploidic anomalies
- second trimester scanning when there are concerns regarding
Of all the pre-cardial veins, the ductus venosus allows the most accurate interpretation of fetal cardiac function as well as myocardial haemodynamics 9.
Radiographic assessment
Ultrasound
Technique
- the probe is ideally focused so sampling is done where the umbilical vein joins the ductus venosus
- the probe is ideally angled to allow a mid sagittal plane or a transverse oblique plane through the fetal abdomen
- do not contaminate the ductus venosus from flow from the fetal inferior vena cava
- the fetus should be as still as possible
Waveform
On Doppler ultrasound the flow in the ductus venosus has a characteristic triphasic waveform where in a normal physiological situation flow should always be in the forward direction 7 (i.e. towards the fetal heart).
This triphasic waveform comprises of:
- S wave: corresponds to fetal ventricular systolic contraction and is the highest peak
- D wave: corresponds to fetal early ventricular diastole and is the second highest peak
- A wave (or rather trough): corresponds to fetal atrial contraction and is the lowest point in the wave form albeit still being in the forward direction
See also
-<p><strong>Ductus venosus (DV) flow </strong>is a parameter that can be sonographically assessed in a number of situations in fetal ultrasound, including</p><ul>-<li>first trimester screening for <a href="/articles/aneuploidic-anomalies" title="aneuploidic anomalies">aneuploidic anomalies</a>-</li>- +<p><strong>Fetal ductus venosus flow assessment </strong>can be sonographically assessed in a number of situations in fetal ultrasound:</p><ul>
- +<li>first trimester screening for <a href="/articles/aneuploidic-anomalies">aneuploidic anomalies</a>
- +</li>
-<li><a href="/articles/intra-uterine-growth-restriction-2" title="Intrauterine growth restriction (IUGR)">intrauterine growth restriction (IUGR)</a></li>-<li><a href="/articles/fetal-cardiac-compromise" title="fetal cardiac compromise">fetal cardiac compromise</a></li>- +<li><a href="/articles/intra-uterine-growth-restriction-2">intrauterine growth restriction (IUGR)</a></li>
- +<li><a href="/articles/fetal-cardiac-compromise">fetal cardiac compromise</a></li>
-</li>- +</li>
-<li>the probe is ideally focused so sampling is done where the umbilical vein joins the ductus venosus </li>-<li>the probe is ideally angled to allow a mid sagittal plane or a transverse oblique plane through the fetal abdomen</li>-<li>do not contaminate the ductus venosus from flow from the fetal inferior vena cava</li>-<li>the fetus should be as still as possible</li>-</ul><h6>Waveform</h6><p>On Doppler ultrasound the flow in the ductus venosus has a characteristic <strong>triphasic</strong> waveform where in a <strong>normal physiological situation</strong> flow should always be in the forward direction <sup>7</sup> (i.e. towards the fetal heart)</p><p>This triphasic waveform comprises of </p><ul>-<li>-<strong>S wave</strong> : corresponds to fetal ventricular systolic contraction and is the highest peak</li>-<li>-<strong>D wave</strong> : corresponds to fetal early ventricular diastole and is the second highest peak</li>-<li>-<strong>A wave</strong> (or rather <em>trough</em>) : corresponds to fetal atrial contraction and is the lowest point in the wave form albeit still being in the forward direction</li>- +<li>the probe is ideally focused so sampling is done where the umbilical vein joins the ductus venosus </li>
- +<li>the probe is ideally angled to allow a mid sagittal plane or a transverse oblique plane through the fetal abdomen</li>
- +<li>do not contaminate the ductus venosus from flow from the fetal inferior vena cava</li>
- +<li>the fetus should be as still as possible</li>
- +</ul><h6>Waveform</h6><p>On Doppler ultrasound the flow in the ductus venosus has a characteristic <strong>triphasic</strong> waveform where in a <strong>normal physiological situation</strong> flow should always be in the forward direction <sup>7</sup> (i.e. towards the fetal heart).</p><p>This triphasic waveform comprises of:</p><ul>
- +<li>
- +<strong>S wave</strong>: corresponds to fetal ventricular systolic contraction and is the highest peak</li>
- +<li>
- +<strong>D wave</strong>: corresponds to fetal early ventricular diastole and is the second highest peak</li>
- +<li>
- +<strong>A wave</strong> (or rather trough): corresponds to fetal atrial contraction and is the lowest point in the wave form albeit still being in the forward direction</li>
-<li><a href="/articles/abnormal-ductus-venosus-waveforms" title="Abnormal ductus venosus waveforms">abnormal ductus venosus waveforms</a></li>-<li><a href="/articles/ductus-venosus" title="ductus venosus">ductus venosus</a></li>-<li><a href="/articles/uteroplacental-blood-flow-assessment" title="Uteroplacental blood flow assessment">utero-placental flow assessment</a></li>- +<li><a href="/articles/abnormal-ductus-venosus-waveforms">abnormal ductus venosus waveforms</a></li>
- +<li><a href="/articles/ductus-venosus">ductus venosus</a></li>
- +<li><a href="/articles/uteroplacental-blood-flow-assessment">utero-placental flow assessment</a></li>