o_1977r8vv9vk1ts2ms0kd8pksa.pdf

a Contents XIX
Clinical Applications in Fetal Cardiac
Abnormalities .................... 437
Ventriculocoronary Connections
in the Human Fetus ............. 437
Coronary Arteriovenous Fistula
in the Human Fetus ............. 438
Idiopathic Arterial Calcification
in the Human Fetus ............. 438
Critical Aortic Stenosis ............ 439
Persistent Left Superior Vena Cava ... 439
References ...................... 439
30 Doppler Interrogation
of the Umbilical Venous Flow ....... 443
Enrico Ferrazzi, Serena Rigano
Introduction ..................... 443
Fetal Flow Volume Measurements in the
Era of Digital Computing and Imaging .. 443
Sources of Inaccuracies ........... 443
Source of Accuracy .............. 444
Volume Flow Values and Problems
of Standardization ............... 444
Comparison Between Non-Invasive
Doppler Volume Flow Values and
Traditional Experimental Studies ..... 445
From Umbilical Flow Volume Measurements
to Fetal Pathophysiology ....... 445
The Relationship of Umbilical Vein
Blood Flow to Growth Parameters
in the Human Fetus ............. 445
Umbilical Vein Blood Flow and Abnormal
Fetal Growth ............... 445
Diagnostic Usage of Umbilical Vein
Blood Flow in Growth-Restricted
Fetuses ...................... 446
Redistribution of Umbilical Flow
in Fetal Liver .................... 447
References ...................... 448
31 Doppler Examination of the Fetal
Pulmonary Venous Circulation ....... 451
Rabih Chaoui, Franka Lenz, Kai-Sven Heling
Introduction ..................... 451
Visualization of Pulmonary Veins Using
Real-Time and Color Doppler Ultrasound . 451
Pulsed Doppler Ultrasound of Lung Veins 453
Physiologic Conditions ........... 453
Abnormal Patterns of Flow Velocity
Waveforms .................... 455
Other Fields of Interest Assessing
Pulmonary Vein Doppler .......... 456
Malformations of Pulmonary Veins and
Their Diagnosis ................... 457
Embryology in Summary .......... 457
Anomalies of the Pulmonary Venous
Connections ................... 458
Prenatal Diagnosis of Anomalous
Pulmonary Venous Connection ...... 458
References ...................... 462
32 Introduction to Fetal Doppler
Echocardiography ................ 465
Dev Maulik
Introduction ..................... 465
Choice of Equipment for Doppler
Echocardiography ................. 465
General Considerations ........... 465
Ultrasound System .............. 466
Preparation for Echocardiographic
Examination ..................... 466
Method of Fetal Doppler Echocardiography
.................... 467
Preliminary Examination .......... 467
General Approach to Fetal Cardiac Imaging
......................... 467
Spectral Doppler Sonographic Examination
......................... 471
Color Doppler Flow Mapping ....... 472
Spectral and Color Doppler M-Mode
Echocardiography ............... 473
Tissue Doppler Echocardiography .... 474
Doppler Depiction of Fetal Cardiac
Circulation ...................... 475
Atrial Flow .................... 476
Interatrial Flow ................. 477
Tricuspid and Mitral Flow .......... 477
Pulmonary and Aortic Outflows ..... 479
Doppler Echocardiography During Early
Pregnancy .................... 480
Determination of Fetal Cardiac Output .. 480
Cardiac Output: Normative Data ..... 481
Right Heart Versus Left Heart
Dominance ................... 482
Limitations of Cardiac Output
Measurement .................. 482
Summary ....................... 482
References .................... 482
33 Doppler Echocardiography for Managing
Congenital Cardiac Disease ......... 485
Dev Maulik
Introduction ..................... 485
Risk Factors and Indications for Fetal
Cardiac Evaluation ................ 485
Benefits of Fetal Echocardiographic
Assessment ..................... 486