The effect of intravascular blood transfusion on the flow velocity waveform of the portal venous system of the anemic fetus

R. L. D'Ancona, F. Rahman, T. Ozcan, J. A. Copel, Giancarlo Mari

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Abstract

Our objective was to assess flow velocity waveforms of the portal venous system of the anemic fetus prior to and immediately following intravascular transfusion. Color-guided pulsed Doppler was used to obtain flow velocity waveforms from the fetal portal vein in 14 anemic fetuses that were transfused in utero for rhesus alloimmunization. The portal vein velocity pattern was defined as continuous when no change in velocity during the cardiac cycle was noted. It was defined as pulsatile when a deflection of the wave was present. The flow velocity waveforms were quantified by using the ratio between the peak (highest, H) and the nadir (lowest, L) velocities (H/L ratio). Fourteen intravascular transfusions were performed. Gestational age ranged from 19.5 to 35 weeks (mean ± SD, 26.7 ± 5.3 weeks). The hematocrit ranged from 5.9 to 31.2% (mean ± SD, 20.3 ± 9%) prior to transfusion; after transfusion it was between 24.8 anzd 56.7% (mean ± SD, 42 ± 10.4%). In six cases (43%) the waveforms were pulsatile prior to transfusion; in the other eight (57%) they were continuous. The pulsatile pattern was present following transfusion in 13 cases (93%, p < 0.05). The mean of the H/L ratio was 1.3 ± 0.38 prior to transfusion and 2.0 ± 0.86 after transfusion (p < 0.05). Because the portal vein has continuous non-pulsatile flow in the normal fetus, the presence of pulsatility in the waves of six anemic fetuses (43%) may suggest portal hypertension. Compared to normal fetuses, there was an increased number of cases with pulsation, and even more so after transfusion. The pattern corresponds to findings in children with portal hypertension.

Original languageEnglish (US)
Pages (from-to)333-337
Number of pages5
JournalUltrasound in Obstetrics and Gynecology
Volume10
Issue number5
DOIs
StatePublished - Dec 1 1997

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Portal System
Blood Transfusion
Fetus
Portal Vein
Portal Hypertension
Hematocrit
Gestational Age
Color

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

Cite this

The effect of intravascular blood transfusion on the flow velocity waveform of the portal venous system of the anemic fetus. / D'Ancona, R. L.; Rahman, F.; Ozcan, T.; Copel, J. A.; Mari, Giancarlo.

In: Ultrasound in Obstetrics and Gynecology, Vol. 10, No. 5, 01.12.1997, p. 333-337.

Research output: Contribution to journalArticle

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