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a Department of
Paediatrics, Ullevål University Hospital, N-0407
Oslo, Norway, b Department of Informatics, c Department of Obstetrics and Gynaecology
Haukeland University Hospital Bergen
Norway
Correspondence to: Dr Drude Fugelseth.
Accepted 31 January
1997
AIM
To assess ultrasonographically the flow
pattern and the time of postnatal closure of ductus venosus related to
the other fetal shunts.
METHODS
Fifty healthy, term neonates were studied
from day 1 up to day 18 using a VingMed CFM 800A ultrasound scanner.
RESULTS
Ductus arteriosus was closed in 94% of
the infants before day 3. Ductus venosus, however, was closed in only
12% at the same time, in 76% before day 7, and in all infants before
day 18. A closed ductus venosus or ductus arteriosus did not show signs of reopening. Pulsed and colour Doppler flow could be detected across
the foramen ovale in all infants during the sequential investigation.
At day 1, when the pulmonary vascular resistance was still high, a
reversed Doppler flow velocity signal was seen in ductus venosus in 10 infants (20%) and a bidirectional flow in ductus arteriosus in 26 (52%). Closure of the ductus venosus was not significantly correlated
with closure of the ductus arteriosus nor related to sex nor weight loss.
CONCLUSIONS
The time of closure of the ductus
venosus evaluated by ultrasonography is much later than that of
the ductus arteriosus. The flow pattern in ductus venosus reflects the
portocaval pressure gradient and the pressure on the right side of the
heart and in the pulmonary arteries. Both the flow pattern in the
ductus venosus as well as that in the ductus arteriosus may be an
indication of compromised neonatal haemodynamics.
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