# Color Doppler Ultrasonographic Evaluation of the Intrauterine Hepatic and Portal Venous System

## Authors

- Mehmet Akif Sarica ([ORCID](https://orcid.org/0000-0001-8472-3174)) — Department of Radiology, NCR Hospital, Gaziantep, Turkey
- Resat Kervancioglu ([ORCID](https://orcid.org/0000-0001-6207-0985)) — Department of Radiology, Gaziantep University School of Medicine, Gaziantep, Turkey

## Article information

- **Journal:** The Ulutas Medical Journal (Ulutas Med J), ISSN 2149-388X
- **Issue:** Volume 9, Issue 3 (2023), pages 185–192
- **Article type:** Original Article
- **Published online:** 2023-09-13
- **DOI:** [10.5455/umj.20230901100512](https://doi.org/10.5455/umj.20230901100512)
- **Licence:** [CC BY-NC 4.0](https://creativecommons.org/licenses/by-nc/4.0/)
- **Article page:** https://www.ulutasmedicaljournal.com/?mno=167893
- **PDF:** https://www.ulutasmedicaljournal.com/pdf/167893.pdf

## Abstract

Introduction: We aimed to determine the changes, varieties, and differences of the Doppler index of the umbilical, uterine and fetal middle cerebral artery (MCA) and umbilical vein (UV), ductus venosus (DV), inferior caval vein (ICV) of the normal pregnancies among the 18-37th weeks and the term to determine the normal values of our population. Materials and Methods: Umblical, uterine, and fetal MCA with UV, DV, and ICV Doppler examinations were performed following the routine obstetric ultrasonographic evaluation once throughout the pregnancy and at the delivery of 163 normal pregnant with no maternal or Fetal complications at 18-24 (66 patient), 25-30 (53 patients) and 31-37 weeks (44 patients). The Systole/Diastole (S/D) rate for the arteries and the ICV, preload index for the DV, and mean velocity for the UV were used as the Doppler indexes. All color Doppler ultrasonographic examinations were performed by only one operator using the Siemens Acuson Antares machine and the CH4-1 MHz convex probe. Results: During the following weeks of the pregnancy, the S/D Doppler index and DV preload index were found to be decreased. No significant changes were found for the UV mean velocity. Results were statistically evaluated. Conclusion: As a result, venous structures and arterial parameters should be evaluated during the obstetric color Doppler ultrasonographic examination. The evaluation of these structures can be important for the early diagnosis of the conditions such as intrauterine growth retardation and hypoxia.

## Keywords

Obstetric doppler; Umblical artery; Uterine artery; Fetal middle cerebral artery; Umblical vein; Ductus venosus; Inferior caval vein

## How to cite

Sarica MA, Kervancioglu R. Color Doppler Ultrasonographic Evaluation of the Intrauterine Hepatic and Portal Venous System. Ulutas Med J. 2023;9(3):185-192. doi:10.5455/umj.20230901100512

## References

1. Lees CC, Romero R, Stampalija T, et al. Clinical Opinion: The diagnosis and management of suspected fetal growth restriction: an evidence-based approach. Am J Obstet Gynecol. 2022;226(3):366-78. https://doi.org/10.1016/j.ajog.2021.11.1357
2. Audette MC, Kingdom JC. Screening for fetal growth restriction and placental insufficiency. Semin Fetal Neonatal Med. 2018;23(2):119-25. https://doi.org/10.1016/j.siny.2017.11.004
3. Pedroso MA, Palmer KR, Hodges RJ, Costa FDS, Rolnik DL. Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction. Rev Bras Ginecol Obstet. 2018;40(5):287-93. https://doi.org/10.1055/s-0038-1660777
4. Evangelista GCL, Viana AGA, Neves MM, Reis ECC. Resistivity and pulsatility indexes in feline kidney disease: a systematic review. Vet Radiol Ultrasound. 2022;63(3):306-18. https://doi.org/10.1111/vru.13102
5. Li X, Zhang J, Meng Y, et al. Transplant renal artery stenosis caused by the stretch of an artey branch: a case report and literature review. BMC Nephrol. 2018;19(1):56. https://doi.org/10.1186/s12882-018-0856-y
6. Ramirez-Gonzalez D, Poto A, Peinado B, Almela L, Navarro-Serna S, Ruiz S. Ultrasonography of Pregnancy in Murciano-Granadina Goat Breed: Fetal Growth Indices and Umbilical Artery Doppler Parameters. Animals (Basel). 2023;13(4). https://doi.org/10.3390/ani13040618
7. Adekanmi AJ, Roberts A, Morhason-Bello IO, Adeyinka AO. Utilization of Uterine and Umbilical Artery Doppler in the Second and Third Trimesters to Predict Adverse Pregnancy Outcomes: A Nigerian Experience. Womens Health Rep (New Rochelle). 2022;3(1):256-66. https://doi.org/10.1089/whr.2021.0058
8. Aslan A, Sancak S, Aslan M, et al. Diagnostic Value of Duplex Doppler Ultrasound Parameters in Papillary Thyroid Carcinoma. Acta Endocrinol (Buchar). 2018;14(1):43-8. https://doi.org/10.4183/aeb.2018.43
9. Kumagai G, Wada K, Kudo H, Asari T, Ichikawa N, Ishibashi Y. D-dimer monitoring combined with ultrasonography improves screening for asymptomatic venous thromboembolism in acute spinal cord injury. J Spinal Cord Med. 2020;43(3):353-7.
10. Schou KV, Ekelund CK, Jensen LN, et al. Short-Term Flow Changes in Monochorionic Survivor Twins after Ultrasound-Guided Umbilical Cord Occlusion. Fetal Diagn Ther. 2020;47(1): 45-53. https://doi.org/10.1159/000500021
11. Thompson RS, Trudinger BJ, Cook CM. Doppler ultrasound waveform indices: A/B ratio, pulsatility index and Pourcelot ratio. Br J Obstet Gynaecol. 1988;95(6):581-8. https://doi.org/10.1111/j.1471-0528.1988.tb09487.x
12. Şener T, Özalp S, Tekin B, Bayırlı R, Bal C. Is Fetal Umbilical Artery Systole/Diastolic Ratio Nomogram Different in Our Society? Journal of Clinical Obstetrics Gynecology. 1996;6(3): 208-11.
13. Matthews MJ, Stretanski MF. Ultrasound Therapy. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Michael Stretanski declares no relevant financial relationships with ineligible companies.2023.
14. Szymanski LM, Kogutt BK. Uterine Artery Doppler Velocimetry During Individually Prescribed Exercise in Pregnancy. Obstet Gynecol. 2018;132(4):1026-32. https://doi.org/10.1097/aog.0000000000002779
15. von Wowern E, Andersson J, Skarping ID, Howie MT, Olofsson P. Association between uterine artery Doppler blood flow changes and arterial wall elasticity in pregnant women. J Matern Fetal Neonatal Med. 2017;30(19):2309-14. https://doi.org/10.1080/14767058.2016.1247264
16. Pace S, Cerekja A, Stentella P, et al. Improvement of uterine artery Doppler velocimetry indices after metroplasty in arcuate uteri. Eur J Obstet Gynecol Reprod Biol. 2007;131(1):81-4. https://doi.org/10.1016/j.ejogrb.2006.02.011
17. Fadel BM, Pibarot P, Kazzi BE, et al. Spectral Doppler Interrogation of the Pulmonary Veins for the Diagnosis of Cardiac Disorders: A Comprehensive Review. J Am Soc Echocardiogr. 2021;34(3):223-36. https://doi.org/10.1016/j.echo.2020.09.012
18. Andelija S, Tafti D. Sonography Fetal Assessment, Protocols, and Interpretation. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Dawood Tafti declares no relevant financial relationships with ineligible companies.2023.
19. Minnella GP, Crupano FM, Syngelaki A, Zidere V, Akolekar R, Nicolaides KH. Diagnosis of major heart defects by routine first-trimester ultrasound examination: association with increased nuchal translucency, tricuspid regurgitation and abnormal flow in ductus venosus. Ultrasound Obstet Gynecol. 2020;55(5):637-44. https://doi.org/10.1002/uog.21956
20. Bahlmann F, Wellek S, Reinhardt I, Merz E, Steiner E, Welter C. Reference values of ductus venosus flow velocities and calculated waveform indices. Prenat Diagn. 2000;20(8):623-34. https://doi.org/10.1002/1097-0223(200008)20:8<623::aid-pd886>3.0.co;2-2
21. Govender V, Naidoo TD, Foolchand S. The pre-eclampsia, growth restriction, and ductus venosus doppler (GRADED) study: An observational study of early-onset fetal growth restriction and pre-eclampsia. Int J Gynaecol Obstet. 2023; 161(1):106-13. https://doi.org/10.1002/ijgo.14495