Low-resistance hepatic artery flow in first-trimester fetuses: an ominous sign
Article first published online: 23 MAR 2011
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 37, Issue 4, pages 438–443, April 2011
How to Cite
Bilardo, C. M., Timmerman, E., Robles De Medina, P. G. and Clur, S. A. (2011), Low-resistance hepatic artery flow in first-trimester fetuses: an ominous sign. Ultrasound Obstet Gynecol, 37: 438–443. doi: 10.1002/uog.7766
- Issue published online: 23 MAR 2011
- Article first published online: 23 MAR 2011
- Accepted manuscript online: 4 OCT 2010 07:55AM EST
- Manuscript Accepted: 2 AUG 2010
- fetal outcome;
- first trimester;
- genetic syndromes;
- hepatic artery;
- nuchal translucency
Low-resistance hepatic artery (HA) flow has been reported in severely growth-restricted fetuses. The same finding has been incidentally observed in first-trimester fetuses with enlarged nuchal translucency (NT). The aim of this study was to investigate HA flow in first-trimester fetuses.
Crown–rump length (CRL), NT, ductus venosus (DV) pulsatility index for veins (PIV) and HA pulsatility index (PI) were measured prospectively in fetuses at increased risk on first-trimester assessment for aneuploidy and in a control group of low-risk fetuses. Outcome of pregnancy was known in all cases. Independent sample t-test was used for intergroup comparison.
NT, DV-PIV and HA-PI were measured prospectively in 59 fetuses. Thirty-four had an enlarged NT and underwent karyotyping, which was abnormal in 16 cases (trisomy 21, n = 12; trisomy 18, n = 3; 47,XXY, n = 1). Two pregnancies were terminated in view of fetal anomalies. In three other infants an abnormality was confirmed after birth (Noonan syndrome, unspecified genetic syndrome and cardiac defect). The remaining 13 fetuses with enlarged NT and the 25 with normal NT had an uneventful pregnancy outcome. HA-PI was significantly and inversely correlated with NT and DV-PIV. Mean HA-PI was significantly lower in fetuses with adverse outcome (chromosomal anomalies 1.60; chromosomally normal fetuses with adverse outcome 1.66) than in controls (2.03).
Low-resistance HA flow can be observed in first-trimester fetuses and, based on its association with adverse outcome, it can be regarded as an ominous sign. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.