Abstract
We report a case of a singleton pregnancy with severe intrauterine growth retardation diagnosed at 24 + 0 weeks' gestation. Pulsed wave Doppler sonography revealed unilateral elevation of the pulsatility index with a diastolic notch in one uterine artery in association with reversed end-diastolic flow in the umbilical artery. From 24 + 3 weeks onwards there were pathological indices in the descending aorta, inferior vena cava and ductus venosus, with biphasic pulsatile flow in the umbilical vein, while indices in the middle cerebral artery were normal. Coronary blood flow was demonstrated in both coronary arteries with the use of color-coded and pulsed wave Doppler sonography. The clinical course was marked by minimal growth and persistence of pathological venous indices. At 29 + 3 weeks' gestation the venous flow pattern in the umbilical vein was noted to be triphasic pulsatile. At this time there was cardiac dilatation with tricuspid and mitral insufficiency. The parents did not want active management and intrauterine fetal death was diagnosed at 30 + 4 weeks' gestation. This case illustrates the fact that prolonged intrauterine survival, despite highly pathological Doppler indices in the venous and arterial circulation, is possible, indicating the extreme adaptability of some fetuses with early onset intrauterine growth retardation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 201-205 |
| Number of pages | 5 |
| Journal | Ultrasound in Obstetrics and Gynecology |
| Volume | 8 |
| Issue number | 3 |
| State | Published - Sep 1996 |
| Externally published | Yes |
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Keywords
- Doppler sonography
- Fetal coronary blood flow
- Fetal surveillance
- Intrauterine growth retardation
- Tricuspid insufficiency
- Triphasic umbilical venous pulsation
ASJC Scopus subject areas
- Obstetrics and Gynecology
- Radiology Nuclear Medicine and imaging
- Reproductive Medicine
- Acoustics and Ultrasonics
- Radiological and Ultrasound Technology
Cite this
Triphasic umbilical venous blood flow with prolonged survival in severe intrauterine growth retardation : A case report. / Baschat, Ahmet; Gembruch, U.
In: Ultrasound in Obstetrics and Gynecology, Vol. 8, No. 3, 09.1996, p. 201-205.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Triphasic umbilical venous blood flow with prolonged survival in severe intrauterine growth retardation
T2 - A case report
AU - Baschat, Ahmet
AU - Gembruch, U.
PY - 1996/9
Y1 - 1996/9
N2 - We report a case of a singleton pregnancy with severe intrauterine growth retardation diagnosed at 24 + 0 weeks' gestation. Pulsed wave Doppler sonography revealed unilateral elevation of the pulsatility index with a diastolic notch in one uterine artery in association with reversed end-diastolic flow in the umbilical artery. From 24 + 3 weeks onwards there were pathological indices in the descending aorta, inferior vena cava and ductus venosus, with biphasic pulsatile flow in the umbilical vein, while indices in the middle cerebral artery were normal. Coronary blood flow was demonstrated in both coronary arteries with the use of color-coded and pulsed wave Doppler sonography. The clinical course was marked by minimal growth and persistence of pathological venous indices. At 29 + 3 weeks' gestation the venous flow pattern in the umbilical vein was noted to be triphasic pulsatile. At this time there was cardiac dilatation with tricuspid and mitral insufficiency. The parents did not want active management and intrauterine fetal death was diagnosed at 30 + 4 weeks' gestation. This case illustrates the fact that prolonged intrauterine survival, despite highly pathological Doppler indices in the venous and arterial circulation, is possible, indicating the extreme adaptability of some fetuses with early onset intrauterine growth retardation.
AB - We report a case of a singleton pregnancy with severe intrauterine growth retardation diagnosed at 24 + 0 weeks' gestation. Pulsed wave Doppler sonography revealed unilateral elevation of the pulsatility index with a diastolic notch in one uterine artery in association with reversed end-diastolic flow in the umbilical artery. From 24 + 3 weeks onwards there were pathological indices in the descending aorta, inferior vena cava and ductus venosus, with biphasic pulsatile flow in the umbilical vein, while indices in the middle cerebral artery were normal. Coronary blood flow was demonstrated in both coronary arteries with the use of color-coded and pulsed wave Doppler sonography. The clinical course was marked by minimal growth and persistence of pathological venous indices. At 29 + 3 weeks' gestation the venous flow pattern in the umbilical vein was noted to be triphasic pulsatile. At this time there was cardiac dilatation with tricuspid and mitral insufficiency. The parents did not want active management and intrauterine fetal death was diagnosed at 30 + 4 weeks' gestation. This case illustrates the fact that prolonged intrauterine survival, despite highly pathological Doppler indices in the venous and arterial circulation, is possible, indicating the extreme adaptability of some fetuses with early onset intrauterine growth retardation.
KW - Doppler sonography
KW - Fetal coronary blood flow
KW - Fetal surveillance
KW - Intrauterine growth retardation
KW - Tricuspid insufficiency
KW - Triphasic umbilical venous pulsation
UR - http://www.scopus.com/inward/record.url?scp=0030229245&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030229245&partnerID=8YFLogxK
M3 - Article
C2 - 8915091
AN - SCOPUS:0030229245
VL - 8
SP - 201
EP - 205
JO - Ultrasound in Obstetrics and Gynecology
JF - Ultrasound in Obstetrics and Gynecology
SN - 0960-7692
IS - 3
ER -