This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Reed, K. L. Articles by Sahn, D. J. Search for Related Content PubMed PubMed Citation Articles by Reed, K. L. Articles by Sahn, D. J.

Circulation, Vol 81, 498-505, Copyright © 1990 by American Heart Association

ARTICLES

Doppler studies of vena cava flows in human fetuses. Insights into normal and abnormal cardiac physiology

KL Reed, CP Appleton, CF Anderson, L Shenker and DJ Sahn
Department of Obstetrics and Gynecology, Arizona Health Sciences Center, Tucson 85724.

We examined vena cava Doppler flow velocity tracings from 69 fetuses between 22 and 40 weeks' gestation. Twenty-three fetuses had arrhythmias. Fifteen fetuses had absent end-diastolic Doppler velocities in the umbilical artery, a condition associated with intrauterine growth retardation, and 15 normal fetuses with normal umbilical artery Doppler velocity ratios were matched by gestational age. In studies in 16 additional fetuses, inferior vena cava Doppler velocity waveforms were compared with superior vena cava Doppler velocity waveforms. Peak velocities and time-velocity integrals of forward or reverse flow during systole, early diastole, and atrial contraction were measured. In addition, the time-velocity integral during flow coincident with atrial contraction (a wave) was expressed as a percent of the time-velocity integral of total forward flow during both systole and early diastole. Systolic-to-diastolic ratios of inferior vena cava forward time-velocity integrals were not significantly different from systolic-to-diastolic ratios of superior vena cava forward time-velocity integrals (p = 0.86), but the percent of blood moving in a reverse direction during atrial contraction in the inferior vena cava was greater than the percent of blood moving in a reverse direction in the superior vena cava (p less than 0.05). Relative forward flow in early diastole in the group of normal fetuses increased with advancing gestational age (r = 0.60, p less than 0.05). During premature atrial contractions flow in the inferior vena cava was reversed, and the percent of reverse flow during atrial systole increased significantly from 4.5 +/- 0.3% to 28.3 +/- 3.7% (mean +/- SEM, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				M. Taketazu, C. Barrea, J. F. Smallhorn, G. J. Wilson, and L. K. Hornberger Intrauterine pulmonary venous flow and restrictive foramen ovale in fetal hypoplastic left heart syndrome J. Am. Coll. Cardiol., May 19, 2004; 43(10): 1902 - 1907. [Abstract] [Full Text] [PDF]

				H M Gardiner Fetal echocardiography: 20 years of progress Heart, December 1, 2001; 86(90002): ii12 - 22. [Full Text] [PDF]

				P Johnson, D J Maxwell, M J Tynan, and L D Allan Intracardiac pressures in the human fetus Heart, July 1, 2000; 84(1): 59 - 63. [Abstract] [Full Text] [PDF]

				M. Kluckow and N. Evans Superior vena cava flow in newborn infants: a novel marker of systemic blood flow Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2000; 82(3): 182F - 187. [Abstract] [Full Text]

				P. van Splunder, T. Stijnen, and J. W. Wladimiroff Fetal Atrioventricular Flow-Velocity Waveforms and Their Relation to Arterial and Venous Flow-Velocity Waveforms at 8 to 20 Weeks of Gestation Circulation, September 15, 1996; 94(6): 1372 - 1378. [Abstract] [Full Text]

				K. G. Schmidt, N. H. Silverman, and A. M. Rudolph Assessment of Flow Events at the Ductus VenosusInferior Vena Cava Junction and at the Foramen Ovale in Fetal Sheep by Use of Multimodal Ultrasound Circulation, February 15, 1996; 93(4): 826 - 833. [Abstract] [Full Text]

				M. A. Salim, T. G. DiSessa, K. L. Arheart, and B. S. Alpert Contribution of Superior Vena Caval Flow to Total Cardiac Output in Children : A Doppler Echocardiographic Study Circulation, October 1, 1995; 92(7): 1860 - 1865. [Abstract] [Full Text]

				K. Hecher, S. Campbell, P. Doyle, K. Harrington, and K. Nicolaides Assessment of Fetal Compromise by Doppler Ultrasound Investigation of the Fetal Circulation : Arterial, Intracardiac, and Venous Blood Flow Velocity Studies Circulation, January 1, 1995; 91(1): 129 - 138. [Abstract] [Full Text]