Maternal Hepatic Vein Doppler Velocimetry During Uncomplicated Pregnancy and Pre-Eclampsia

Abstract

Changes of Doppler velocity measurements of distinct hepatic vein (HV) Doppler wave components were evaluated during uncomplicated pregnancy (UP) as a reference to measurements in pre-eclampsia (PE). Women with UP (n = 13) were submitted to standardised duplex scanning of HV at I I stages of pregnancy between 10 and 38 weeks. For each stage, mean +/- SD was calculated for HVA-, X-, V- and Y-peaks. Women with PE (n = 30) were evaluated once, and mean SD was calculated for pregnancies <32 weeks, 32-34(+6) weeks and >= 35 weeks. PE and UP values at corresponding gestational age were compared statistically using t-test. HVA-velocity measurements changed markedly from negative values in early uncomplicated pregnancy, converting around 21-24 weeks to positive values until term. Changes throughout gestation were less prominent for HV X-, V- and Y-velocities. HVA-velocity measurements were significantly lower in PE than in UP, the difference being more pronounced at 30 weeks (-3.59 +/- 3.41 vs. 6.12 +/- 3.43,p = 0.0001) than at 37 weeks (2.35 +/- 4.54 vs. 5.32 +/- 1.92,p = 0.04). Front our results, we conclude that HV Doppler velocimetry shows a gradual shift from central venous reversed flow during atrial contraction in uncomplicated early pregnancy to constantly forward moving flow until term. HV A-velocities are significantly lower in PE than in UP, the differences being more pronounced in late second trimester than near term. (E-mail: wilfried.gyselaers@zol.be) (C) 2009 World Federation for Ultrasound in Medicine & Biology.