By Kypros H. Nicolaides, G. Rizzo
This finished scientific textbook on Doppler overview of placental and fetal circulate presents the root wanted for the theoretical portion of the certificates of Competence in placental and fetal Doppler provided by way of the overseas Society of Ultrasound in Obstetrics and Gynecology and the overseas Society of Perinatal medication. Following introductory chapters on Doppler ultrasound ideas, perform, safeguard and technique, the publication covers Doppler reviews within the complete variety of components appropriate to placental and fetal circulation.
Key features:
*Explains Doppler review of placental and fetal circulation
*Provides the foundation of studying for a certificates of competence in placental and fetal Doppler
*Contains introductory fabric on Doppler ultrasound ideas, perform, safeguard and strategies comprises bibliographic references and index
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Extra info for Placental and fetal doppler
Example text
PV and TPV are the most commonly used indices. The former is influenced by several factors, including valve size, myocardial contractility and afterload24,30,31, while the latter is believed to be secondary to the mean arterial pressure36. Coronary blood flow Coronary blood flow may be visualized with the use of high-resolution ultrasound equipment and color Doppler echocardiography. In normal fetuses, both right and left coronary arteries may be identified after 31 weeks of gestation under optimal conditions of fetal imaging37.
In normal fetuses, both right and left coronary arteries may be identified after 31 weeks of gestation under optimal conditions of fetal imaging37. In compromised fetuses, these vessels may be identified at an earlier gestational age, probably due to an increased coronary blood flow37. Pulmonary vessels Velocity waveforms may be recorded from the right and left pulmonary arteries or from peripheral vessels within the lung38–41. vp 18 August 2004 14:08:11 Color profile: Generic CMYK printer profile Composite Default screen METHODOLOGY OF DOPPLER ASSESSMENT Figure 14 Flow velocity waveform from the pulmonary artery at 32 weeks of gestation according to the site of sampling and there is a progressive increase in the diastolic component in the more distal vessels40,41 (Figure 14).
Ductal PV increases linearly with gestation and its values represent the highest velocity in the fetal circulation occurring in normal conditions while the PI is constant42,43. 9, are considered to be an expression of ductal constriction42. vp 18 August 2004 14:08:14 Color profile: Generic CMYK printer profile Composite Default screen METHODOLOGY OF DOPPLER ASSESSMENT Figure 15 Sagittal view of the fetal thorax and abdomen showing the ductus venosus (top). Transverse section of the fetal abdomen showing the ductus venosus originating from the umbilical vein (bottom, left) and transverse oblique view demonstrating the aliasing effect (bottom, right) FETAL VENOUS FLOW Anatomy The fetal liver with its venous vasculature – umbilical and portal veins, ductus venosus and hepatic veins – and the inferior vena cava are the main areas of interest in the investigation of venous blood return to the fetal heart.