Prenatal ultrasonographic assessment of the ductus arteriosus: A review

OBJECTIVE: To review current data pertaining to prenatal ultrasonography of the ductus venosus. DATA SOURCES: We identified English-language studies regarding prenatal ultrasonography and the fetal ductus venosus. The studies were obtained from a MEDLINE search for the period 1966 through March 1996. Additional sources were identified through cross-referencing. METHODS OF STUDY SELECTION: We reviewed all published reports, case studies, and articles regarding ultrasonographic morphology, physiology, and pathophysiology of the fetal ductus venosus. TABULATION, INTEGRATION, AND RESULTS: Knowledge of the function of the fetal ductus venosus in both normal and abnormal fetal conditions is increased by prenatal ultrasonographic data. Altered ductus venosus hemodynamics may be noted in various medical conditions that include fetal growth restriction, twin-twin transfusion, invasive diagnostic procedures (chorionic villus sampling and fetal blood sampling), fetal anemia and transfusion, complex cardiac structural anomalies, and cardiac arrhythmias. CONCLUSION: Blood flow velocity in the fetal ductus venosus reflects the pressure gradient between the umbilical vein and the cardiac atria. Knowledge of pathophysiologic hemodynamic changes of blood flow in this vessel obtainable by prenatal ultrasonography in conjunction with fetal disease may assist diagnosis and management.