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First trimester severe ductus venosus flow abnormalities in isolation or combination with other markers of aneuploidy and fetal anomalies

  • Marcin Wiechec EMAIL logo , Agnieszka Nocun , Anna Matyszkiewicz , Ewa Wiercinska and Emilia Latała
Published/Copyright: January 20, 2015
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 44 Issue 2

Abstract

Background: Altered flow in ductus venosus (DV) may be caused by the changes in preload or afterload. Its association with aneuploidy and congenital heart defects (CHDs) was widely described.

Objectives: The aim of this study was to examine the incidence of a reversed a-wave in DV flow (revDV) and the absence of DV (noDV), their coincidences with other markers of aneuploidy or fetal abnormalities in a mixed-risk population.

Methods: The study group covered women who underwent an ultrasound scan between 11+0 and 13+6 weeks’ gestation.

Applied inclusion criteria: Singleton pregnancies with known pregnancy outcome and a crown-rump length of 45–84 mm.

Results: A total of 5811 cases, including 137 aneuploidies, met the inclusion criteria: 35 subjects of noDV, 189 of revDV and 5587 of normal DV flow. The incidence of noDV in euploidy was 0.47%, and in aneuploidy 5.8%. The incidence of revDV in euploidy was 2.46%, and in aneuploidy 35.7%. Among aneuploidy, the highest prevalence of noDV was found in monosomy 45X. revDV showed the highest prevalence in trisomy 18. Isolated noDV was only found in euploidy. Isolated revDV subjects were only observed in euploidy and trisomy 21. Any combination of revDV with additional markers showed high incidence in major trisomies. Extracardiac anatomy and abnormal cardiac findings showed a higher prevalence in noDV and revDV cases.

Conclusions: The presence of noDV might be useful in suspicion of monosomy X among cases with increased nuchal translucency, as well as in differentiating them from other aneuploidies. The combinations of aneuploidy markers with revDV are strong indicators of aneuploidy. revDV alone is a poor screening tool for aneuploidy and euploidy with CHD.

Keywords: Chromosomal aberrations; ductus venosus; first trimester
Corresponding author: Marcin Wiechec, MD, Chair of Gynecology and Obstetrics, Jagiellonian University, 23 Kopernika Street, Krakow 31-501, Poland, E-mail:

Acknowledgments

We would like to acknowledge Anna Grzeszczak, MA, from Prof. Josef Tischner Complex of High Schools and Vocational Education in Limanowa, Poland, for her valuable input in language corrections of the original manuscript.

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2014-10-19
Accepted: 2014-12-3
Published Online: 2015-1-20
Published in Print: 2016-3-1

©2016 by De Gruyter

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Current topics on ultrasound in perinatology
  4. Recommendation and Guidelines for Perinatal Practice
  5. Ultrasound in Africa: what can really be done?
  6. 3D/4D sonography – any safety problem
  7. Controversial ultrasound findings in mid trimester pregnancy. Evidence based approach
  8. Academy’s Corner
  9. Sonoembryology by 3D HDlive silhouette ultrasound – what is added by the “see-through fashion”?
  10. Original articles – Obstetrics
  11. How effective is ultrasound-based screening for trisomy 18 without the addition of biochemistry at the time of late first trimester?
  12. Single center experience in selective feticide in high-order multiple pregnancy: clinical and ethical issues
  13. Diagnostic accuracy of cervical elastography in predicting labor induction success: a systematic review and meta-analysis
  14. Birth weight-related percentiles of brain ventricular system as a tool for assessment of posthemorrhagic hydrocephalus and ventricular enlargement
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  16. Original articles – Fetus
  17. Nonimmune fetal ascites: identification of ultrasound findings predictive of perinatal death
  18. First trimester severe ductus venosus flow abnormalities in isolation or combination with other markers of aneuploidy and fetal anomalies
  19. Evaluation of the adequacy of reference charts for the accurate identification of fetuses with bone length below the 5th percentile
  20. Does ethnicity have an effect on fetal behavior? A comparison of Asian and Caucasian populations
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  22. Fetal nasal bone length in the second trimester: comparison between population groups from different ethnic origins
  23. Pregnancy outcome and long-term follow-up of fetuses with isolated increased NT: a retrospective cohort study
  24. Effect of antenatal betamethasone administration on Doppler velocimetry of fetal and uteroplacental vessels: a prospective study
  25. Opinion paper
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  27. Congress Calendar
  28. Congress Calendar
https://doi.org/10.1515/jpm-2014-0323
Keywords for this article
Chromosomal aberrations; ductus venosus; first trimester

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Current topics on ultrasound in perinatology
  4. Recommendation and Guidelines for Perinatal Practice
  5. Ultrasound in Africa: what can really be done?
  6. 3D/4D sonography – any safety problem
  7. Controversial ultrasound findings in mid trimester pregnancy. Evidence based approach
  8. Academy’s Corner
  9. Sonoembryology by 3D HDlive silhouette ultrasound – what is added by the “see-through fashion”?
  10. Original articles – Obstetrics
  11. How effective is ultrasound-based screening for trisomy 18 without the addition of biochemistry at the time of late first trimester?
  12. Single center experience in selective feticide in high-order multiple pregnancy: clinical and ethical issues
  13. Diagnostic accuracy of cervical elastography in predicting labor induction success: a systematic review and meta-analysis
  14. Birth weight-related percentiles of brain ventricular system as a tool for assessment of posthemorrhagic hydrocephalus and ventricular enlargement
  15. First trimester erythropoietin (EPO) serum concentration as a potential marker for abnormal placentation disorders. Reference values for erythropoietin (EPO) concentration at 11–13+6 weeks of gestation
  16. Original articles – Fetus
  17. Nonimmune fetal ascites: identification of ultrasound findings predictive of perinatal death
  18. First trimester severe ductus venosus flow abnormalities in isolation or combination with other markers of aneuploidy and fetal anomalies
  19. Evaluation of the adequacy of reference charts for the accurate identification of fetuses with bone length below the 5th percentile
  20. Does ethnicity have an effect on fetal behavior? A comparison of Asian and Caucasian populations
  21. Accuracy of ultrasound in estimating fetal weight and growth discordancy in triplet pregnancies
  22. Fetal nasal bone length in the second trimester: comparison between population groups from different ethnic origins
  23. Pregnancy outcome and long-term follow-up of fetuses with isolated increased NT: a retrospective cohort study
  24. Effect of antenatal betamethasone administration on Doppler velocimetry of fetal and uteroplacental vessels: a prospective study
  25. Opinion paper
  26. Fetal cerebro-placental ratio and adverse perinatal outcome: systematic review and meta-analysis of the association and diagnostic performance
  27. Congress Calendar
  28. Congress Calendar
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