The Predictive Values of Ductus Venosus Pulsatility Index and ''A Wave'' for Chromosomal Abnormalities

Abstract

Objective: To establish a reference range for fetal ductus venosus pulsatility index for veins (DV PIV) and investigate the efficacy of the abnormal ductus venosus (DV) Doppler assessment to diagnose the chromosomal abnormalities of the fetus during first-trimester screening. Material and Methods: We retrospectively evaluated a total of 3,243 singleton pregnancies at 11+0 to 13+6 weeks of gestation in a 12-year period and assigned the patients into 2 groups to compare the efficacy of DV PIV in predicting chromosome abnormalities. The first group consisted of pregnancies involving fetuses with chromosomal abnormalities and the second group consisted of uncomplicated singleton fetuses with available DV Doppler measurements. We determined a cut-off value for DV PIV measurements to predict chromosomal abnormalities, and analyzed the relationship between chromosome abnormalities, and abnormal DV Doppler measurements. Results: A total of 644 fetuses (104 fetuses with an abnormal karyotype (pregnancies involving fetuses with chromosomal abnormalities) and 540 fetuses phenotypically normal or euploid in neonates after birth (pregnancies with normal fetuses) met the study criteria. The 5th and 95th percentiles of DV PIV were 0.78 and 1.21 in pregnancies with normal fetuses. We calculated with 63.6% sensitivity and 60.3% specificity, (95% confidence interval 0.72-0.83) for DV PIV to diagnose chromosomal abnormalities. Abnormal DV blood flow was related to all trisomies. The lowest DV PIV was observed in cases with trisomy 21, while the highest DV PIV values were found in cases with trisomy 18 and 13 in the abnormal karyotype group. Conclusion: Routinely monitoring DIV PIV as a first-trimester screening tool may be beneficial to predict fetal chromosomal abnormalities.