Blood flow velocity parameters in the ductus venosus in fetuses with congenital heart defects

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  • Authors: Yarygina T.A.1,2,3, Gasanova R.M.2,4, Shchegolev A.I.4, Gus A.I.3,4, Shmakov R.G.1,5
  • Affiliations:
    1. V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Russian Federation
    2. A.N. Bakulev National Medical Research Center of Cardiovascular Surgery, Ministry of Health of the Russian Federation
    3. Patrice Lumumba Peoples' Friendship University of Russia
    4. Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
    5. M.F. Vladimirsky Moscow Regional Research and Clinical Institute
  • Issue: No 9 (2025)
  • Pages: 98-108
  • Section: Original Articles
  • URL: https://journals.eco-vector.com/0300-9092/article/view/691941
  • DOI: https://doi.org/10.18565/aig.2025.214
  • ID: 691941

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Abstract

Objective: To investigate absolute flow velocity parameters in the ductus venosus of fetuses with congenital heart defects (CHD).

Materials and methods: In this cross-sectional study, we assessed the velocities of a-waves, S-waves, D-waves, and time-averaged maximum velocity (TAMX) in the ductus venosus of a total cohort of 171 fetuses with CHD, including 47 fetuses with right heart defects (subgroup 1) and 124 fetuses with other forms of defects (subgroup 2). A comparative analysis of the obtained indicators was conducted across three gestational intervals: 18–21 weeks (x1), 22–29 weeks (x2), and 30–40 weeks (x3) of pregnancy.

Results: The a-wave velocity below the 5th percentile was observed in 18.1%, 21.3%, and 16.9% of cases in the overall cohort and in subgroups 1 and 2, respectively. In the overall group and subgroup 2, there was a significant increase in the a-wave, S-wave, D-wave, and TAMX velocities in each subsequent gestational interval (p<0.001), consistent with the findings in the healthy population. In subgroup 1, there were no significant changes in a-wave velocity between gestational intervals (p>0.05), whereas increases in S-wave, D-wave, and TAMX values were recorded only between the first and third gestational intervals (x1–x3) (p=0.001). No differences were observed between the gestational intervals x1–x2 and x2–x3 (p>0.05). Comparative analysis of a-wave, S-wave, and D-wave velocities and TAMC did not reveal statistically significant differences between the study subgroups (p>0.05).

Conclusion: A decrease in the velocity of oxygenated blood flow to the fetal heart during the atrial contraction phase (a-wave) was observed in 16–21% of fetuses with cardiac pathology, indicating an increased risk of hypoxic complications. The lack of a physiological increase in flow velocities in the ductus venosus among fetuses with right heart defects underscores the need for additional antenatal monitoring in these patients.

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About the authors

Tamara A. Yarygina

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Russian Federation; A.N. Bakulev National Medical Research Center of Cardiovascular Surgery, Ministry of Health of the Russian Federation; Patrice Lumumba Peoples' Friendship University of Russia

Author for correspondence.
Email: tamarayarygina@gmail.com
ORCID iD: 0000-0001-6140-1930

PhD, Head of the Ultrasound Diagnostics Department, Researcher at the Perinatal Cardiology Center, Associated Professor at the Department of Ultrasound Diagnostics of the Faculty of Continuing Medical Education of the Medical Institute

Russian Federation, 101000, Moscow, Pokrovka str., 22a; 121552, Moscow, Roublyevskoe Shosse, 135; 127015, Russia, Moscow, Pistsovaya str., 10

Rena M. Gasanova

A.N. Bakulev National Medical Research Center of Cardiovascular Surgery, Ministry of Health of the Russian Federation; Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: rmgasanova@bakulev.ru
ORCID iD: 0000-0003-3318-1074

Dr. Med. Sci., Head of the Perinatal Cardiology Center, Physician of Ultrasound Diagnostics, Department of Ultrasound and Functional Diagnostics

Russian Federation, 121552, Moscow, Roublyevskoe Shosse, 135; 117997, Moscow, Ac. Oparin str., 4

Alexander I. Shchegolev

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: ashegolev@oparina4.ru
ORCID iD: 0000-0002-2111-1530

Dr. Med. Sci., Professor, Head of the 2nd Pathoanatomical Department

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Alexander I. Gus

Patrice Lumumba Peoples' Friendship University of Russia; Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: a_gus@oparina4.ru
ORCID iD: 0000-0003-1377-3128

Dr. Med. Sci., Professor, Chief Researcher at the Department of Ultrasound and Functional Diagnostics, Head of the Department of Ultrasound Diagnostics of the Faculty of Continuing Medical Education of the Medical Institute

Russian Federation, 117997, Moscow, Ac. Oparin str., 4; 127015, Russia, Moscow, Pistsovaya str., 10

Roman G. Shmakov

V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Russian Federation; M.F. Vladimirsky Moscow Regional Research and Clinical Institute

Email: mdshmakov@mail.ru
ORCID iD: 0000-0002-2206-1002

Dr. Med. Sci., Professor of the Russian Academy of Sciences, Director, Head of the Department of Obstetrics and Gynecology, Faculty of Advanced Medical Studies

Russian Federation, 101000, Moscow, Pokrovka str., 22a; Moscow

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2. Figure. Doppler spectrum of blood flow in the fetal ductus venosus with tricuspid valve dislocation (explanation in the text)

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