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Re: [medicalimaging] Fetal umbilical vein doppler - NOT Fetal breathing - UKFrom: Dr. Fazeel (fazeel@abt.wol.net.pk)Fri Apr 4 10:42:33 2003
Thanks, Please send pics of some "true fetal breathing effects on umbilical artery and vein doppler" thanks fazeel -------Original Message------- From: medicalimaging@yahoogroups.com Date: Friday, April 04, 2003 12:48:27 AM To: medicalimaging@yahoogroups.com Subject: [medicalimaging] Fetal umbilical vein doppler - NOT Fetal breathing - UK Dear Fazeel, What do you mean by "now I am"? Do you mean to say you think you saw fetal breathing effect on that Umb V waveform? Poor You. And, poor Latha and Rochita too. Tell you something. All you have to do is place a sample volume on the next case and when you get Umb Art and Umb V spectrum, ask her to breath ( Not very deep in which case your sample volume will get displaced too much). Just moderate breathing Ok? Now you will see the slow undulation on the Umb V FVW, "exactly" like the one you posted. The KEY Fazeel, is the chnages you will see in the Umb Art FVW during the same time. A slow progressive dip and climb (of sytolic peaks) spread over 3,4 or 5 waves. This happens because of a mild displacement of probe( and consequent change in insonation angle) as her abdomen rises and falls. Its an artefact. Ther is no real change in the velocities during maternal breathing. ON THE CONTRARY, during fetal breathing you will see a more rapid Umb V undulation AND,( repeat AND), the Umb artery will show a CLASSIC pattern. A change in almost every alternate beat. I will try to search my files and post to you a picture of the effects on Umb V and A FVW during fetal breathing. I only hope that the Hard disk crash I had not so long ago had affected it. ...Udayakumar -- --- "Dr. Fazeel" <fazeel@abt.wol.net.pk> wrote: > Let's see what our guru Udaya says ? i wasn't sure > in the begining when i > saw this, but now i am. > fazeel > > -------Original Message------- > > From: medicalimaging@yahoogroups.com > Date: Wednesday, April 02, 2003 12:36:45 AM > To: medicalimaging@yahoogroups.com > Subject: Re: [medicalimaging] Re: Fetal umbilical > vein doppler - Fetal > breathing - Fazeel > > Umbilical venous waveforms by Doppler ultrasound are > seen normally during > fetal breathing movements. Each waveform extends two > to four fetal cardiac > cycles > So this is exactly what Fazeel demonstrated > ..right? > Rochita > Latha Natarajan <nattu@bgl.vsnl.net.in> wrote: > Am J Obstet Gynecol 2000 Apr;182(4):835-38; > discussion 738-40Related > Articles, Links > > > Changes in umbilical venous velocities with > physiologic perturbations. > > Reed KL, Anderson CF. > > Department of Obstetrics and Gynecology, Arizona > Health Sciences Center, > Tucson 85724, USA. > > OBJECTIVE: The purpose of this study was to > determine the direction of > transmission of umbilical venous Doppler flow > velocity changes in human > fetuses. STUDY DESIGN: Strip chart recordings of > simultaneously measured > umbilical arterial and venous velocities were > examined at two sites in the > umbilical cord, one near the fetus (proximal) and > one near the placenta > (distal). Fetuses with venous pulsations or > breathing episodes were included > At both locations time from venous pulsation to > arterial systole was > measured in fetuses with venous pulsations and > duration of phase delay > between arterial diastolic velocity minimum and > venous velocity minimum was > measured in fetuses with breathing episodes. > RESULTS: In 21 fetuses with > venous pulsations the pulsations occurred earlier in > the cardiac cycle at > proximal sites (0.12 +/- 0.04 second before systole) > and later at distal > sites (0.02 +/- 0.04 second before systole;P <.001). > Phase delays in venous > velocities in the 5 fetuses with breathing episodes > were also longer at > distal sites than at proximal sites (P <.011). > CONCLUSION: Changes in > umbilical venous velocities occurred earlier at > sites that were closer to > the fetus. These findings suggest that changes in > umbilical venous > velocities originate in the fetal venous system and > are transmitted to, > rather than from, the placenta. > > J Clin Ultrasound 1995 Nov-Dec;23(9):551-3Related > Articles, Links > > Assessment of fetal breathing movements using three > different ultrasound > modalities. > > Bruner JP, Coggins T. > > Department of Obstetrics and Gynecology, Vanderbilt > University Medical > Center, Nashville, Tennessee 37232-2519, USA. > > Twenty-five consecutive women in the third trimester > of pregnancy were > studied to determine the presence or absence of > fetal breathing movements > using three different ultrasound imaging techniques. > Using real-time B-mode > observation of the fetal trunk as the standard, > image-directed pulsed wave > Doppler insonation of the umbilical vein confirmed > the presence of breathing > movements with a sensitivity of 100% > and the absence of breathing movements with a > specificity of 100%. The > sensitivity and specificity of color Doppler imaging > of the fetal naso- and > oropharynx for the presence or absence of fetal > breathing movements were 96% > and 100%, respectively. In the current study, the > detection of fetal > breathing movements by three different ultrasound > modalities was virtually > interchangeable. > > PMID: 8537477 [PubMed - indexed for MEDLINE] > > Am J Perinatol 1995 May;12(3):217-9Related Articles, > Links > > Umbilical venous Doppler waveform without fetal > breathing: its significance. > > Mitra SC. > > Department of Obstetrics and Gynecology, Jamaica > Hospital, New York 11418, > USA. > > . During Doppler study of gross intrauterine growth > retardation (IUGR) and > twin to twin transfusion cases, single or double > peaked umbilical venous > waveforms were detected with each fetal cardiac > cycle. Umbilical arterial > Doppler study detected minimal, absent, or reverse > diastolic flow. In these > fetuses, the ratio of right and left ventricular > diameters at the > atrioventricular valve level was increased, and > pulse-wave and color Doppler > study showed tricuspid regurgitation. This tricuspid > regurgitation caused > reverse flow in the umbilical vein from the right > atrium and inferior vena > cava and produced characteristic venous waveforms. > These umbilical waveforms > were associated with gross IUGR or cardiac failure > of the fetuses with > perinatal morbidity and mortality. > > Am J Obstet Gynecol 1990 Dec;163(6 Pt > 1):1792-6Related Articles, Links > > Variation and correlation in human fetal umbilical > Doppler velocities with > fetal breathing: evidence of the cardiac-placental > connection. > > Indik JH, Reed KL. > > Department of Obstetrics and Gynecology, Arizona > Health Sciences Center, > Tucson 85724. > > Doppler velocity waveforms in the human fetal > umbilical vein and artery were > analyzed during episodes of fetal breathing. Heart > rate, systolic and > diastolic velocities were measured from the > umbilical artery waveform. > Diastolic velocity varied the most with a mean (+/- > SD) coefficient of > variation of 16.0% +/- 5.0%. The coefficient of > variation of systolic > velocity was 7.8% +/- 2.4% and of heart rate was > 5.0% +/- 1.8%. We also > found that umbilical arterial flow was related to > umbilical venous flow, > implying an interdependence between fetal > cardiovascular blood flow and > placental blood flow. During breathing, venous flow > varies because of > changes in intrathoracic pressure in the fetus. This > variation in umbilical > venous velocity may affect the umbilical arterial > diastolic velocity through > alterations in placental filling, and may affect the > umbilical arterial > systolic velocity through alterations in ventricular > filling, which by the > Frank-Starling mechanism changes stroke volume. The > interdependency of > umbilical venous and umbilical arterial blood flow > velocities must be > considered in the interpretation of the significance > of umbilical artery > Doppler velocity measurements. > === message truncated === visit http://in.tv.yahoo.com Yahoo! Groups Sponsor ADVERTISEMENT Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.
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