Clinic Value Of Flow Velocity Waveform Of Fetal Pulmonary Vein By Prenatal Ultrasound In Fetuses With Cardiac Anomalies

Purpose: To investigate the change rules of fetal pulmonary venous flow waveformin normal fetuses. To investigate the diagnosis value of the changes of fetal pulmonaryvenous flow waveform in fetal cardiac anomalies.Methods:390singleton pregnant fetuses were selected, who were undergoneprenatalutrasonographic screening and had regular prenatalexaminations in our hospital fromJanuary,2013to May,2014. Among these fetuses, there were a control group (295normalfetuses) and a abnormal group (95fetuses with cardiac anomalies). We examined the fetalstructure and measured the fetal growth and the fetal pulmonary venous blood flowwaveform in the two groups with Philips iE33color Doppler system. The ultrasoundfindings were observed and recorded. The pulmonary venous blood flow parameters (S, A,D, Vmean, VTI, S/D, PI, PVI) were measured. Characteristics of normal fetal left and rightpulmonary venous blood flow waveform were observed. The correlation of eachpulmonary venous blood flow parameter with the gestational age was analyzed and theparameters were compared in the control group. The change rules of abnormal shape offetal pulmonary venous blood flowwave were observed. The relationship of the changerules with cardiac anomalies was analyzed.Results: All of the295normal fetal pulmonary venous blood flow waveform containS, D, A. The pattern of left and right pulmonary vein blood flow waveform were similar.Most of them, S/D is greater than1, including250left pulmonary vein (84.7%) and251right pulmonary vein (84.7%); a small number of them, S/D is less than1, including36leftpulmonary vein (12.2%) and36right pulmonary vein (12.2%); rare of them, S/D is equalto1, including9left pulmonary vein (3.1%) and8right pulmonary vein (2.7%). Most of them, A wave is antegrade, including284left pulmonary vein (96.3%) and282rightpulmonary vein (95.6%); rare of them, A wave is absent, including11left pulmonary vein(3.7%) and13right pulmonary vein (4.4%); and none of them, A wave is reversed. Thereis a positive correlation between S, D, A, Vmean, VTI with the gestational ages. S/D, PI, PVIhave no significant effect with the gestational age.In the abnormal group,26fetal pulmonary venous blood flow waveform changed:12fetuses with A wave absent (7fetuses with LSOL,3fetuses with RSOL and2fetuses withSD),10fetuses with A wave reverse (5fetuses with LSOL,1fetuses with RSOL,1fetuseswith SD and3fetuses with CTD), and4fetuses with abnormal pulmonary venous bloodflow waveform were observed a continuous waveform change (4fetuses with TAPVC).Conclusions: When A wave of fetal pulmonary venous blood flow waveform ismissing or reverse, fetal cardiac abnormalities should be considered. We suggest them todo fetal echocardiographic examination further. When the fetal pulmonary venous bloodflow waveform changes with a continuous waveform change, we should consider whetherthe futus has anomalous pulmonary venous connection. Observing and measuring fetalpulmonary venous flow waveform has clinic value in fetal cardiac anomalies and should beused as a examination indicator.