Application of Doppler flow parameters of the ductus venosus in fetus during the second trimester in evaluating the prognosis of fetal growth restriction

Objective To investigate the clinical application of Doppler flow parameters of the ductus venosus in fetus during the second trimester in evaluating the prognosis of fetal growth restriction.Methods There were a control group(422 normal fetuses)and a study group(200 fetuses with FGR).We measured and analyzed Doppler flow parameters of the ductus venosus in fetuses of the two groups,and the ultrasound findings were observed and recorded.We measured Doppler flow parameter RI of the umbilical artery and the middle cerebral artery in fetuses of the study group.200 fetuses were grouped into five groups according to Doppler flow parameters of the ductus venosus and the umbilical artery refer to the control group.Doppler flow parameters of the ductus venosus and the the umbilical artery and the ultrasound findings were analysed in each group.All these fetuses were followed up until the end of pregnancy and the pregnancy outcomes were recorded.Results Doppler flow parameters of the ductus venosus in 422 normal fetuses in control group were measured:Peak S:(59.02±16.32)cm/s,wave A:(32.87±11.27)cm/s,RI:0.45±0.09,PI:0.53±0.13,and S/D:1.87±0.34.200 fetuses in study group were divided into five groups based on Doppler flow parameters of the ductus venosus and the umbilical artery 114 cases appeared as Peak S was lower than that in control group(P 0.05),and wave D was lower but RI,PI and S/D were higher than that in control group(P 0.05);2 16 fetuses appeared as Peak S and wave D were lower but RI,PI and S/D were higher than that in control group(P 0.05).The umbilical artery was absent enddiastolic flow or RI of the umbilical artery and RI of the middle cerebral artery ratio greater than 1.0;3 9 cases appeared with absent or reversed wave A and the umbilical artery was absent or reversed end-diastolic flow.Among them,7fetuses there induced labor,and others were donor-twins of TTTS,whose donor-twins were dead and the recipient-twins were delivered at term with normal weight;4 Among 29 cases whose blood flow spectrum of the ductus venosus was normal but which of umbilical artery was abnormal;5 Among 132 cases whose blood flow spectrum of the ductus venosus and the umbilical artery were both normal.Conclusion The intrauterine oxygen condition and right heart function can be reflected by measuring and analyzing Doppler flow parameters of the ductus venosus in fetuses of FGR during the second trimester.When the fetus appears with absent or reversed wave A and the umbilical artery is absent or reversed end-diastolic flow,pregnancy outcome will be adverse probably.So Doppler flow parameter of the ductus venosus in fetus during the second trimester is one of the important indicator in evaluating the intact survival rate of fetal growth restriction.