Journal of Ultrasound in Medicine, Vol 6, Issue 12 679-684, Copyright © 1987 by American Institute of Ultrasound in Medicine
Doppler blood flow velocity waveforms in alpha-thalassemia hydrops fetalis
J. S. Woo, S. T. Liang, R. L. Lo and F. Y. Chan
Department of Obstetrics and Gynecology, University of Hong Kong.
Doppler shift blood flow velocity-time waveforms in the umbilical arteries
(UA), aorta (A), and inferior vena cava (IVC) in eight fetuses with
alpha-thalassemia (alpha-thal) hydrops fetalis were described. The UA
waveforms in these fetuses with anemia in utero depicted a hyperdynamic
circulatory state with a relative increase in acceleration slope, more
linear decline from maximum systole to end diastole, and reduced spectral
broadening. The aortic waveforms similarly displayed distorted systolic
peaks, flow turbulence, and greatly elevated diastolic frequencies.
Reversal of end diastolic flow in the IVC also indicated cardiac
decompensation in these fetuses. Progressive changes in these waveforms
were apparent in two fetuses that had serial evaluation. In another four
fetuses in which alpha-thal major was diagnosed in the second trimester by
DNA analysis and had Doppler evaluation before termination of pregnancy,
consistent changes in the UA, A, and IVC waveforms were not observed. This
study confirms the potential usefulness of Doppler spectral waveforms in
depicting altered hemodynamic changes in the fetus and in the evaluation of
hydrops fetalis. Doppler ultrasound examination can be included as part of
the routine workup of hydrops fetalis.
