Ductus venosus blood velocity in persistent pulmonary hypertension of the newborn
Drude Fugelsetha, Torvid Kiserudb, Knut Liestølc, Asbjørn Langsleta, Rolf Lindemanna
a Department of
Paediatrics Ullevål University Hospital
N-0407 Oslo Norway, b Department of Obstetrics and Gynaecology
Haukeland University Hospital
Bergen, c Department of Informatics
University of Oslo
Correspondence to: Dr Drude Fugelseth. Email: drude.fugelseth{at}ulleval.no
Accepted 30 December
1998
AIMS
To investigate
the ductus venosus flow velocity (DVFV) in infants with persistent
pulmonary hypertension of the newborn (PPHN); to evaluate the DVFV
pattern as a possible diagnostic supplement in neonates with PPHN and
other conditions with increased right atrial pressure.
METHODSDVFV
was studied in 16 neonates with PPHN on days 1-4 of postnatal life
using Doppler echocardiography. DVFV was compared with that in
mechanically ventilated neonates with increased intrathoracic pressure, but without signs of PPHN (n=11); with neonates with congenital heart defects resulting in right atrial pressure (n=6); and
with preterm neonates without PPHN (n=46); and healthy term neonates
(n=50).
RESULTSInfants
with PPHN and congenital heart defects with increased right atrial
pressure were regularly associated with an increased pulsatile pattern
and a reversed flow velocity in ductus venosus during atrial
contraction. A few short instances of reversed velocity were also noted
in normal neonates before the circulation had settled during the first
day after birth.
CONCLUSIONSA reversed
velocity in the ductus venosus during atrial contraction at this time
signifies that central venous pressure exceeds portal pressure. This
negative velocity deflection is easily recognised during Doppler
examination and can be recommended for diagnosing increased right
atrial pressure and PPHN.
Keywords: ductus venosus; persistent pulmonary hypertension of the newborn; echocardiography
© 1999 by Archives of Disease in Childhood
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