The controversial role of the ductus venosus in hypoxic human fetuses

Enrico Ferrazzi, Christoph Lees, Ganesh Acharya

Research output: Contribution to journalComment/debate

Abstract

The ductus venosus plays a critical role in circulatory adaptation to hypoxia in fetal growth restriction but the mechanisms still remain controversial. Increased shunting of blood through the ductus venosus under hypoxic conditions has been shown in animal and human studies. The hemodynamic laws governing the accelerated flow in this vessel suggest that any dilation at its isthmus, which increases the blood flow shunting to the heart, is associated with a low, absent or reversed a-wave and a high pulsatility index. Cardiac dysfunction associated with increased atrial pressure as well as reduced ventricular compliance might be predominant mechanisms determining the profile of ductus venosus velocity waveforms in severe fetal growth restriction with signs of hypoxic compromise. Understanding the pathophysiology of the ductus venosus will underpin translation of the hypotheses developed through biostatistics toward explaining with more confidence Doppler changes in the fetal circulation in predicting clinical outcomes.

Original languageEnglish
Pages (from-to)823-829
JournalActa Obstetricia et Gynecologica Scandinavica
Volume98
Issue number7
DOIs
Publication statusPublished - Jan 1 2019

Keywords

  • Doppler
  • ductus venosus
  • fetal growth restriction
  • fetal hypoxia
  • ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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