Abstract
In recent years evaluation of the venous system has become a compulsory part of the haemodynamic assessment of the fetus, but the underlying mechanisms of our Doppler recordings are still incompletely understood. The present chapter is not intended to solve all that, but rather to address important hemodynamic issues from a clinical point of view to help clinicians use and interpret venous Doppler recordings. For the interested reader more extensive discussions of blood flow dynamics are available in the literature [1–5]
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References
Nichols WW, O’Rourke MF (1998) McDonald’s blood flow in arteries. Theoretical, experimental and clinical principles. Arnold, London, p 564
Burns PN (1995) Hemodynamics. In: Taylor KJW, Burns PN, Wells PNT (eds) Clinical applications of Doppler ultrasound. Raven Press, New York, pp 35–44
Fung YC (1984) Biodynamics. Springer, Berlin Heidelberg New York
Fung YC (1984) Biomechanics. Springer, Berlin Heidelberg New York
Fung YC (1993) Biomechanics. Springer, Berlin Heidelberg New York
Pennati G, Bellotti M, Gasperi C de, Rognoni G (2004) Spatial velocity profile changes along the cord in normal human fetuses: can these affect Doppler measurements of venous umbilical blood flow? Ultrasound Obstet Gynecol 23:131–137
Gill RW (1979) Pulsed Doppler with B-mode imaging for quantitative blood flow measurement. Ultrasound Med Biol 5:223–235
Eik-Nes SH, Maršál K, Brubakk AO, Ulstein M (1980) Ultrasonic measurements of human fetal blood flow in aorta and umbilical vein: Influence of fetal breathing movements. In: Kurjak A (ed) Recent advances in ultrasound diagnosis. Proceedings of the International Symposium on Recent Advances in Ultrasound Diagnosis, vol 2. Excerpta Medica, Amsterdam, pp 233–240
Jouppila P, Kirkinen P, Puukka R (1986) Correlation between umbilical vein blood flow and umbilical blood viscosity in normal and complicated pregnancies. Arch Gynecol 237:191–197
Kiserud T, Eik-Nes SH, Blaas H-G, Hellevik LR, Simensen B (1994) Ductus venosus blood velocity and the umbilical circulation in the seriously growth retarded fetus. Ultrasound Obstet Gynecol 4:109–114
Tchirikov M, Rybakowski C, Hünecke B, Schröder HJ (1998) Blood flow through the ductus venosus in singleton and multifetal pregnancies and in fetuses with intrauterine growth retardation. Am J Obstet Gynecol 178: 943–949
Kiserud T, Rasmussen S, Skulstad SM (2000) Blood flow and degree of shunting through the ductus venosus in the human fetus. Am J Obstet Gynecol 182:147–153
Bellotti M, Pennati G, Gasperi C de, Battaglia FC, Ferrazzi E (2000) Role of ductus venosus in distribution of umbilical flow in human fetuses during second half of pregnancy. Am J Physiol 279:H1256–1263
Barbera A, Galan HL, Ferrazzi E, Rigano S, Józwik M, Pardi G (1999) Relationship of umbilical vein blood flow to growth parameters in the human fetus. Am J Obstet Gynecol 181:174–179
Pennati G, Redaelli A, Bellotti M, Ferrazzi E (1996) Computational analysis of the ductus venosus fluid dynamics based on Doppler measurements. Ultrasound Med Biol 22:1017–1029
Pennati G, Bellotti M, Ferrazzi E, Bozzo M, Pardi G, Fumero R (1998) Blood flow through the ductus venosus in human fetuses: calculation using Doppler velocimetry and computational findings. Ultrasound Med Biol 24: 477–487
Kiserud T, Hellevik LR, Hanson MA (1998) The blood velocity profile in the ductus venosus inlet expressed by the mean/maximum velocity ratio. Ultrasound Med Biol 24:1301–1306
Reuss ML, Rudolph AM, Dae MW (1983) Phasic blood flow patterns in the superior and inferior venae cavae and umbilical vein of fetal sheep. Am J Obstet Gynecol 145:70–76
Hasaart TH, de Haan J (1986) Phasic blood flow patterns in the common umbilical vein of fetal sheep during umbilical cord occlusion and the influence of autonomic nervous system blockade. J Perinat Med 14:1926
Reed KL, Appleton CP, Anderson CF, Shenker L, Sahn DJ (1990) Doppler studies of vena cava flows in human fetuses; insights into normal and abnormal cardiac physiology. Circulation 81:498–505
Kanzaki T, Chiba Y (1990) Evaluation of the preload condition of the fetus by inferior vena caval blood flow pattern. Fetal Diagn Ther 5:168–174
Kiserud T, Jauniaux E, West D, Ozturk O, Hanson MA (2001) Circulatory responses to acute maternal hyperoxaemia and hypoxaemia assessed non-invasively by ultrasound in fetal sheep at 0.3–0.5 gestation. Br J Obstet Gynaecol 108:359–364
Gudmundsson S, Gunnarsson G, Hökegård K-H, Ingmarsson J, Kjellmer I (1999) Venous Doppler velocimetry in relationship to central venous pressure and heart rate during hypoxia in ovine fetus. J Perinat Med 27: 81–90
Huhta JC (1997) Deciphering the hieroglyphics of venous Doppler velocities. Ultrasound Obstet Gynecol 9: 300–301
Kiserud T (1997) In a different vein: the ductus venosus could yield much valuable information. Ultrasound Obstet Gynecol 9:369–372
Kiserud T (2001) The ductus venosus. Semin Perinatol 25:11–20
Kiserud T (2003) The fetal venous circulation. Fetal Maternal Med Rev 14:57–97
Kiserud T (2003) Venous flow in IUGR and cardiac decompensation. In: Yagel S, Gembruch U, Silverman N (eds) Fetal cardiology. Dunitz, London, pp 541–551
Kiserud T, Crowe C, Hanson M (1998) Ductus venosus agenesis prevents transmission of central venous pulsation to the umbilical vein in the fetal sheep. Ultrasound Obstet Gynecol 11:190–194
Kiserud T (1999) Hemodynamics of the ductus venosus. Eur J Obstet Gynecol Reprod Biol 84:139–147
Kiserud T (2000) Fetal venous circulation: an update on hemodynamics. J Perinat Med 28:90–96
Pennati G, Bellotti M, Ferrazzi E, Rigano S, Garberi A (1997) Hemodynamic changes across the human ductus venosus: a comparison between clinical findings and mathematical calculations. Ultrasound Obstet Gynecol 9: 383–391
Hellevik LR, Kiserud T, Irgens F, Ytrehus T, Eik-Nes SH (1998) Simulation of pressure drop and energy dissipation for blood flow in a human fetal bifurcation. ASME J Biomech Eng 120:455–462
Hellevik LR, Stergiopulos N, Kiserud T, Rabben SI, Eik-Nes SH, Irgens F (2000) A mathematical model of umbilical venous pulsation. J Biomech 33:1123–1130
Hellevik LR (1999) Wave propagation and pressure drop in precordial veins. Department of Applied Mechanics, Thermodynamics and Fluid Dynamics. Norwegian University of Science and Technology, Trondheim
Acharya G, Kiserud T (1999) Ductus venosus blood velocity and diameter pulsationare more prominent at the outlet than at the inlet. Eur J Obstet Gynecol Reprod Biol 84:149–154
Hellevik LR, Kiserud T, Irgens F, Stergiopulos N, Hanson M (1998) Mechanical properties of the fetal ductus venosus and umbilical vein. Heart Vessels 13:175–180
Hellevik LR, Segers P, Stergiopulos N et al. (1999) Mechanism of pulmonary venous pressure and flow waves. Heart Vessels 14:67–71
Bellotti M, Pennati G, Pardi G, Fumero R (1998) Dilatation of the ductus venosus in human fetuses: ultrasonographic evidence and mathematical modeling. Am J Physiol 275 (Heart Circ Physiol 4):H1759–H1767
Kiserud T, Ozaki T, Nishina H, Rodeck C, Hanson MA (2000) Effect of NO, phenylephrine and hypoxemia on the ductus venosus diameter in the fetal sheep. Am J Physiol 279:H1166–H1171
Kiserud T, Eik-Nes SH, Hellevik LR, Blaas H-G (1992) Ductus venosus: a longitudinal doppler velocimetric study of the human fetus. J Matern Fetal Invest 2:5–11
Kilavuz Ö, Vetter K (1998) The umbilcal ring: the first rapid in the fetoplacental venous system. J Perinat Med 26:120–122
Skulstad SM, Rasmussen S, Iversen O-E, Kiserud T (2001) The development of high venous velocity at the fetal umbilical ring during gestational weeks 11–19. Br J Obstet Gynaecol 108:248–253
Skulstad SM, Kiserud T, Rasmussen S (2002) Degree of fetal umbilical venous constriction at the abdominal wall in a low risk population at 20–40 weeks of gestation. Prenat Diagn 22:1022–1027
Skulstad SM, Kiserud T, Rasmussen S (2004) The effect of vascular constriction on umbilical venous pulsation. Ultrasound Obstet Gynecol 23:126–130
Nakai Y, Imanaka M, Nishio J, Ogita S (1997) Umbilical venous pulsation associated with hypercoiled cord in growth-retarded fetuses. Gynecol Obstet Invest 43:6–7
Mari G, Uerpairojkit B, Copel JA (1995) Abdominal venous system in the normal fetus. Obstet Gynecol 86:729–733
van Splunder IP, Huisman TWA, Stijnen T, Wladimiroff JW (1994) Presence of pulsationand reproducibility of waveform recording in the umbilical and left portal vein in normal pregnancies. Ultrasound Obstet Gynecol 4: 49–53
Kiserud T, Kilavuz Ö, Hellevik LR (2003) Venous pulsation in the left portal branch: the effect of pulse and flow direction. Ultrasound Obstet Gynecol 21:359–364
Parker KH, Jones CJH (1990) Forward and backward running waves in the arteries: analysis using the method of characteristics. ASME J Biomech Eng 112:322–326
Schröder HJ, Tchirikov M, Rybakowski C (2002) Pressure pulses and flow velocity in central veins of anesthetized sheep fetus. Am J Physiol Heart Circ Physiol 284:H1205–H1211
Lingman G, Laurin J, Maršál K, Persson P-H (1986) Circulatory changes in fetuses with imminent asphyxia. Biol Neonate 49:66–73
Gudmundsson S, Huhta JC, Wood DC, Tulzer G, Cohen AW, Weiner S (1991) Venous Doppler ultrasonography in the fetus with nonimmune hydrops. Am J Obstet Gynecol 164:33–37
Nakai Y, Miyazaki Y, Matsuoka Y, Matsumoto M, Imanaka M, Ogita S (1992) Pulsatile umbilical venous flow and its clinical significance. Br J Obstet Gynaecol 99:977–980
Kiserud T, Rasmussen S (2001) Ultrasound assessment of the fetal foramen ovale. Ultrasound Obstet Gynecol 17:119–124
Rizzo G, Arduini D, Romanini C (1992) Umbilical vein pulsation: a physiological finding in early gestation. Am J Obstet Gynecol 167:675–677
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Kiserud, T. (2005). Venous Hemodynamics. In: Maulik, D. (eds) Doppler Ultrasound in Obstetrics and Gynecology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28903-8_5
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DOI: https://doi.org/10.1007/3-540-28903-8_5
Publisher Name: Springer, Berlin, Heidelberg
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