Correlation of Ultrasound Umbilical Venous Blood Flow in Normal Pregnancy with Gestational Age and Foetal Weight
Journal of Advances in Medical and Pharmaceutical Sciences,
Background: Umbilical venous (UV) blood flow is a direct and physiological measurement of vascular placental function.
Objectives: To correlate UV blood flow with gestational age (GA) and foetal weight (FW) in a cohort of normal pregnant Nigerian women.
Materials and Methods: 2,247 women with normal singleton pregnancy between 20 – 40 weeks were included in this study, which was conducted between May 2020 – October 2022, in Bayelsa State, South-South Nigeria. The women had ultrasound assessment of UV blood flow and foetal biometric parameters and weight. Data was analysed using SPSS version 25, associations between categorical variables and between categorical and continuous variables were assessed using chi square and t-test, respectively, with p-value <0.05 considered statistically significant. Correlation analysis was done, and presented in tables and charts.
Results: There was a strong linear correlation between UV blood flow volume and GA (correlation coefficient, ɼ= 0.95; p=0.001), FW (ɼ=0.81; p=0.001), foetal biparietal diameter (BPD) (ɼ=0.88; P=0.001) and abdominal circumference (AC) (ɼ=0.75; P=0.001). Conversely, UV blood flow volume/FW showed a strong inverse relationship with FW (ɼ=- 0.73; p = 0.001), and a weak inverse relationship with GA (ɼ=- 0.36; p = 0.001).
Conclusion: UV blood flow increases with advancing gestation and FW. The increase in UV blood flow in later gestation is however surpassed by the increase in FW, resulting in a reduction in UV blood flow volume per unit FW in the third trimester. The linear increase in UV blood flow volume with foetal BPD and AC suggests that these three parameters could be used in combination to estimate both GA and FW.
- UV blood flow
- gestational age
- foetal weight
How to Cite
Gill RW, Kossoff G, Warren PS, Garrett WJ. Umbilical venous flow in normal and complicated pregnancy. Ultrasound Med Biol. 1984;10(3):349–63.
Al-Bayati MM, Majeed WI, Makki AT. The relationship between umbilical venous blood flow & fetal weight in the last trimester. Iraqi J Med Sci. 2009;7(4):4–10.
Link G, Clark KE, Lang U. Umbilical blood flow during pregnancy: evidence for decreasing placental perfusion. Am J Obstet Gynecol. 2007;196(5):489.e1-7.
Gill RW, Trudinger BJ, Garrett WJ, Kossoff G, Warren PS. Fetal umbilical venous flow measured in utero by pulsed Doppler and B-mode ultrasound. I. Normal pregnancies. Am J Obstet Gynecol. 1981;139(6):720–5.
Künzel W, Jovanovic V, Grüssner S. Blood flow in the umbilical vein and artery in pregnancy. Geburtshilfe Frauenheilkd. 1991;51(7):513–22.
Espinoza J, Romero R, Kim YM, Kusanovic JP, Hassan S, Erez O, et al. Normal and abnormal transformation of the spiral arteries during pregnancy. J Perinat Med. 2006;34(6):447–58.
Hecher K, Campbell S, Doyle P, Harrington K, Nicolaides K. Assessment of Fetal Compromise by Doppler Ultrasound Investigation of the Fetal Circulation. Circulation. 1995;91(1):129–38.
Bolarinwa OA. Sample size estimation for health and social science researchers: The principles and considerations for different study designs. Niger Postgrad Med J. 2020;27(2):67–75.
LaMorte WW. Sample Size for One Sample, Continuous Outcome. Boston University School of Public Health.
Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. Estimation of fetal weight with the use of head, body, and femur measurements--a prospective study. Am. J. Obstet. Gynecol. 1985;151(3): 333–7.
Barbera A, Galan HL, Ferrazzi E, Rigano S, Józwik M, Battaglia FC, et al. Relationship of umbilical vein blood flow to growth parameters in the human fetus. Am. J. Obstet. Gynecol. 1999;181(1):174–9.
Boito S, Struijk PC, Ursem NTC, Stijnen TH, Wladimiroff JW. Umbilical venous volume flow in the normally developing and growth-restricted human fetus: Umbilical venous volume flow. Ultrasound Obstet Gynecol. 2002;19(4):344–9.
El behery MM, Nouh AA, Alanwar AM, Diab AE. Effect of umbilical vein blood flow on perinatal outcome of fetuses with lean and/or hypo-coiled umbilical cord. Arch Gynecol Obstet. 2011;283(1):53–8.
Di Naro E, Ghezzi F, Raio L, Franchi M, D’Addario V, Lanzillotti G, et al. Umbilical vein blood flow in fetuses with normal and lean umbilical cord: Umbilical vein blood flow profile. Ultrasound Obstet Gynecol. 2001;17(3):224–8.
Cruz-Lemini M, Valenzuela-Alcaraz B, Figueras F, Sitges M, Gómez O, Martínez JM, et al. Comparison of Two Different Ultrasound Systems for the Evaluation of Tissue Doppler Velocities in Fetuses. Fetal Diagn Ther. 2016;40(1):35–40.
Lees C, Albaiges G, Deane C, Parra M, Nicolaides KH. Assessment of umbilical arterial and venous flow using color Doppler: Umbilical arterial and venous flow. Ultrasound Obstet Gynecol. 1999;14(4):250–5.
Sutton MSJ, Theard MA, Bhatia SJS, Plappert T, Saltzman DH, Doubilet P. Changes in Placental Blood Flow in the Normal Human Fetus with Gestational Age. Pediatr Res. 1990;28(4):383–7.
Arduini D, Rizzo G, Romanini C. Changes of pulsatility index from fetal vessels preceding the onset of late decelerations in growth-retarded fetuses. Obstet Gynecol. 1992;79(4):605–10.
Figueras F, Fernández S, Hernández-Andrade E, Gratacós E. Umbilical venous blood flow measurement: accuracy and reproducibility. Ultrasound Obstet Gynecol. 2008;32(4):587–91.
Costa-Santos C, Bernardes J, Ayres-de-Campos D, Costa A, Costa C. The limits of agreement and the intraclass correlation coefficient may be inconsistent in the interpretation of agreement. J Clin Epidemiol. 2011;64(3):264–9.
Fernandez S, Figueras F, Gomez O, Martinez JM, Eixarch E, Comas M, et al. Intra- and interobserver reliability of umbilical vein blood flow. Prenat Diagn. 2008;28(11):999–1003.
Abstract View: 73 times
PDF Download: 23 times