The left portal vein as an indicator of watershed in the fetal circulation: development during the second half of pregnancy and a suggested method of evaluation

Ultrasound Obstet Gynecol. 2007 Oct;30(5):757-64. doi: 10.1002/uog.5146.

Abstract

Objectives: The left portal vein represents a watershed area in the fetal circulation and the change of flow direction is a suggested marker of circulatory compromise. Our aim was to study the left portal vein of uncompromised human pregnancies and establish reference ranges.

Methods: One hundred and sixty low-risk pregnant women were recruited to a longitudinal study that included four to five Doppler measurements at monthly intervals during the second half of pregnancy.

Results: Based on 554 Doppler recordings we found time-averaged maximum flow velocities increasing from a mean of 10.6 cm/s to 14.2 cm/s during 21-31 weeks of gestation, remaining stable until 37 weeks and decreasing towards term. Intermittent flow reversal occurred during fetal respiratory movements, and continuous flow reversal was seen in 2/160 fetuses close to delivery.

Conclusions: We propose time-averaged maximum blood velocity measurement for quantification of the watershed phenomenon in the left portal branch, and have provided reference ranges for single observations and serial measurements.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Flow Velocity
  • Evaluation Studies as Topic
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Longitudinal Studies
  • Persistent Fetal Circulation Syndrome / diagnostic imaging*
  • Portal Vein / diagnostic imaging*
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimester, Second
  • Pregnancy Trimester, Third
  • Ultrasonography