Hemodynamics of Arterial and Venous Circulation in the Intrauterine Fetal Evaluation
Branka Cancarevic Djajic, Rade Vilendecic, Vesna Ecim-Zlojutro, Nenad Lucic, Dragica Draganovic, Sasa Savic
Acta Inform Med. 2012; 20(4): 249-253
Introduction: The purpose of each antenatal control focuses on the detection and prevention of hypoxic-ischemic injury and fetal death (1))using modern biophysical tests and Doppler parameters. Goal: This study examines the correlation of changes in arterial compared to venous hemodynamics of the fetus and is determined by the most sensitive and most specific Doppler parameter in the assessment of intrauterine fetal status. Material and Methods: The study was conducted as prospective and included 119 pregnant women. All subjects underwent NST (nonstres test), and Doppler measurements of blood flow in the umbilical artery (Aum), fetal aorta (Ao) and the central cerebral artery (MCA). In case of borderline and pathological arterial flow was measured through the ductus venozus (DV) and umbilical vein (VU). At birth to the child was determined umbilical artery blood pH and Apgar score (AS) in the first minute. Based on the clinical condition of the newborn and outcome was calculated perinatal morbidity and mortality. Results: In all cases with a pathological arterial flow, which is verified during measurement also the pathological venous flow and confirmed fetal acidemia at birth and low Apgar scores? In this group, the two neonates died in the first week. Conclusion: There is a justification for the analysis of venous flow in the event borderline and pathologic findings in fetal arterial system. It has been proven that the cerebroumbilical (C/U) index is most effective parameter in predicting changes in the venous system and this the most sensitive Doppler parameter in predicting fetal acidosis and the most specific Doppler flow through the central cerebral artery.