P02.08: Increased hepatic artery flow in first early-second trimester fetuses with enlarged nuchal translucency
An increased hepatic artery (HA) flow has been described in 2nd trimester compromised growth retarded fetuses. A similar increase in HA artery flow was coincidentally observed in 1st trimester fetuses referred to our FMU in view of an increased nuchal translucency (NT). Aim of this study was to systematically investigate possible trends in HA flow in 1st-early 2nd strimester fetuses and its relationship to outcome.
1st-early 2nd trimester fetuses referred in view of an enlarged NT or for 1st trimester risk assessment were included. In all cases CRL, NT, ductus venosus (DV) PIV, HA PI and pregnancy outcome were known.
50 fetuses fulfilled the criteria. NT was enlarged (>P95) in 35. DVPIV was abnormal in 41(>p95 neg/rev a wave). There were 18 trisomy 21, 3 trisomy 18, 1 trisomy 13. In 28 fetuses the karyotype was normal. In 4 the pregnancy was terminated due to hydrops or structural anomalies and in one Noonan syndrome was diagnosed in infancy. The outcome was normal in 22 fetuses.
NT and HAPI and DVPIV and HAPI were significantly correlated in the whole group (r = − 0, 48; − 0, 49, respectively p < 0,001. DVPIV was significantly(p < 0,001) higher and HAPI significantly lower in fetuses with adverse outcome(AO) [median and ranges DVPIV Normal outcome: 1,4 (0,79–2,78); Adverse outcome: 2,5 (1,5–3,50)] [median and renges HAPI Normal outcome: 1,8 (1,20–2,9); Adverse outcome: 1,4 (1,25–2)].
In fetuses with enlarged NT and adverse outcome there is a trend for an increased flow in the hepatic artery. The pathophysiological background of this observation and its clinical implications deserve further investigation.