Maternal Hepatic Vein Doppler Velocimetry During Uncomplicated Pregnancy and Pre-Eclampsia

Abstract 

Changes of Doppler velocity measurements of distinct hepatic vein (HV) Doppler wave components were evaluated during uncomplicated pregnancy (UP) as a reference to measurements in pre-eclampsia (PE). Women with UP (n = 13) were submitted to standardised duplex scanning of HV at 11 stages of pregnancy between 10 and 38 weeks. For each stage, mean ± SD was calculated for HV A-, X-, V- and Y-peaks. Women with PE (n = 30) were evaluated once, and mean ± SD was calculated for pregnancies <32 weeks, 32–34⁺⁶ weeks and ≥35 weeks. PE and UP values at corresponding gestational age were compared statistically using t-test. HV A-velocity measurements changed markedly from negative values in early uncomplicated pregnancy, converting around 22–24 weeks to positive values until term. Changes throughout gestation were less prominent for HV X-, V- and Y-velocities. HV A-velocity measurements were significantly lower in PE than in UP, the difference being more pronounced at 30 weeks (–3.59 ± 3.41 vs. 6.12 ± 3.43, p = 0.0001) than at 37 weeks (2.35 ± 4.54 vs. 5.32 ± 1.92, p = 0.04). From our results, we conclude that HV Doppler velocimetry shows a gradual shift from central venous reversed flow during atrial contraction in uncomplicated early pregnancy to constantly forward moving flow until term. HV A-velocities are significantly lower in PE than in UP, the differences being more pronounced in late second trimester than near term. (Email: wilfried.gyselaers@zol.be)

Key Words: Maternal venous hemodynamics, Hepatic veins, Gestational physiology, Pre-eclampsia, Doppler