Application Of Doppler Flow Parameters Of The Ductus Venosus In Fetus During The Second Trimester In Evaluating The Prognosis Of Fetal Growth Restriction

OBJECTIVE: To investigate the clinical application of Doppler flow parameters ofthe ductus venosus in fetus during the second trimester in evaluating the prognosis of fetalgrowth restriction.MATERIALS AND METHODS: There were a control group(422normal fetuses)and a study group(200fetuses with FGR). We measured and analyzed growth and Dopplerflow parameters of the ductus venosus in fetuses of the two groups, and the ultrasoundfindings were observed and recorded. We measured Doppler flow parameter RI of theumbilical artery and the middle cerebral artery in fetuses of the study group with PhilipsiU22color Doppler system.200fetuses were grouped into five groups according toDoppler flow parameters of the ductus venosus and the umbilical artery refer to the controlgroup. Doppler flow parameters of the ductus venosus and the the umbilical artery andthe ultrasound findings were analysed in each group. All these fetuses were followed upuntil the end of pregnancy and the pregnancy outcomes were recorded..RESULTS: Doppler flow parameters of the ductus venosus in422normal fetuses incontrol group were measured: Peak S：59.02±16.32（cm/s），wave A：32.87±11.27（cm/s）， RI：0.45±0.09，PI：0.53±0.13，and S/D：1.87±0.34. Blood flow spectrumof the ductus venosus in39fetuses(19.50％) of study group were abnormal. Among them,25cases revealed abnormal umbilical artery waveform.200fetuses in study group weredivided into five groups based on Doppler flow parameters of the ductus venosus and theumbilical artery1)14cases appeared as Peak S：55.10±15.81（cm/s），wave A：13.95±4.86（cm/s）， RI：0.75±0.05，PI：1.13±0.08，S/D：4.13±0.86。Peak S was lowerthan that in control group（P>0.05）,and wave D was lower but RI、PI and S/D were higherthan that in control group（P<0.05）.The Doppler flow parameters of the umbilical artery were normal. Among them,3fetuses with heart malformation were induced abortion,4neonatuses were FGR, and7fetuses （50%）were delivered at term with normal weight;2)16fetuses appeared as Peak S：38.16±7.28（cm/s），wave A：8.74±2.19（cm/s）， RI：0.78±0.04，PI：1.21±0.08，S/D：4.63±1.51. Peak S and wave D were lower but RI、PI and S/D were higher than that in control group（P<0.05）. The umbilical artery wasabsent end-diastolic flow or RI of the umbilical artery and RI of the middle cerebral arteryratio greater than1.0. Among them,3fetuses with structure abnormalities andhypamnion were induced abortion,6neonatuses were FGR, and7fetuses（43.75％） weredelivered at term with normal weight；3)9cases appeared with absent or reversed wave Aand the umbilical artery was absent or reversed end-diastolic flow. Among them,7fetuseswere induced labor, and others were donor-twins of TTTS, whose donor-twins were deadand the recipient-twins were delivered at term with normal weight.4） Among29caseswhose blood flow spectrum of the ductus venosus was normal but which of umbilicalartery was abnormal,11neonatuses were FGR,1fetuses with short limbswas dead in the course of delivery,and18cases(62.07％)were delivered at term withnormal weight.5） Among132cases whose blood flow spectrum of the ductus venosusand the umbilical artery were both normal,36neonatuses were FGR, and96cases（72.73%）were delivered at term with normal weight.CONCLUTIONS: The intrauterine oxygen condition and right heart function can bereflected by measuring and analyzing Doppler flow parameters of the ductus venosus infetuses of FGR during the second trimester. When the fetus appears with absent or reversedwave A and the umbilical artery is absent or reversed end-diastolic flow, pregnancyoutcome will be adverse probably. So Doppler flow parameter of the ductus venosus infetus during the second trimester is one of the important indicator in evaluating the intactsurvival rate of fetal growth restriction.