The left portal vein is the watershed of the fetal venous system
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Ö. Kilavuz
Abstract
Critical fetal organs are preferentially supplied with oxygenated blood from the umbilical vein (UV) by way of the ductus venosus (DV). Under normal conditions a significant part of UV-blood flows steadily forward through the left portal vein (LPV). Blood flow through the LPV could reverse, however, in cases of absent or reversed enddiastolic flow in the umbilical arteries. We tested when fetal blood flow reversal occurs by studying 28 cases with pathological flow in the umbilical artery. In the LPV we observed normal nonpulsatile forward flow in 9 cases, pulsatile forward flow in 10 cases, and reversed flow in 9 cases. Reverse flow in the LPV correlated significantly with an elevated resistance index of the umbilical arteries. This reversal could have major physiological implications: Deoxygenated blood may be added via the LPV to the blood shifted through the DV and ultimately reach critical fetal organs. In extremis there could be a waterhose effect, whereby more blood flows through the DV than the UV that supplies it. The LPV is thus the watershed of the venous circulation of the fetus.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
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- Mode of conception, placental morphology and perinatal outcome of twin gestations
- The effects of birth weight discordance and prematurity on twin neonatal outcome
- Esophageal atresia and tracheoesophageal fistula: the impact of prenatal suspicion on neonatal outcome in a tertiary care center
- Microbial invasion of the amniotic cavity at birth is associated with adverse short-term outcome of preterm infants
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- The effects of intramuscular administration of corticosteroids on the induction of parturition
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- Biovar diversity of Ureaplasma urealyticum in amniotic fluid: distribution, intrauterine inflammatory response and pregnancy outcomes
- Comparative study on the expression of cytokine – receptor genes in normal and preeclamptic human placentas using DNA microarrays
- Chorioangioma – new insights into a well-known problem I. Results of a clinical and morphological study of 136 cases
- Chorioangiomas – new insights into a well-known problem II. An immuno-histochemical investigation of 136 cases
- Impaired CD14-dependent and independent response of polymorphonuclear leukocytes in preterm infants
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