Time Interval Measurements of the Ductus Venosus During the Early Second Trimester of Pregnancy: Reference Ranges and Clinical Application.

OBJECTIVES: The aims of this study were to construct reference ranges for the time interval parameters of the ductus venosus during the early second trimester of pregnancy and to demonstrate the clinical utility in various fetal disorders.

METHODS: The ductus venosus Doppler measurements of 331 healthy fetuses between 15 and 22 weeks' gestation were analyzed. The systolic time and diastolic time were subdivided into the systolic acceleration time, systolic deceleration time, diastolic acceleration time, and diastolic deceleration time. The median, 5th, and 95th regression lines for each variable were determined according to gestational age. The ductus venosus time interval parameters in cases of fetoplacental abnormalities were calculated and plotted against the reference ranges.

RESULTS: With advancing gestation, the systolic acceleration time and total systolic time increased significantly (P < .001). In contrast to the systolic phase, the diastolic deceleration time decreased significantly during the early second trimester of pregnancy (P = .023). The systolic deceleration time, diastolic acceleration time, and diastolic time were relatively constant. Fetuses with tricuspid insufficiency, twin-twin transfusion syndrome, intrauterine fetal growth restriction, and anemia had abnormal ductus venosus times with different patterns.

CONCLUSIONS: Predicted normal reference ranges for time interval variables in relation to gestational age were established. These could be helpful for assessing fetal cardiovascular function during the early second trimester of pregnancy.