الفهرس 
DOPPLER ULTRASOUNDOnly 14 pages are availabe for public view
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Abstract
Doppler ultrasound has been used to measure the blood flow velocity in vessels during the cardiac cycle in the fetoplacental, uteroplacental circulation and has been focused on arteries for the evaluation of downstream distribution of cardiac output (Gembruch et al., 2003).
Ductus venosus flow plays a fundamental role in fetal hemodynamics, and In utero, it allows approximately 20 to 30% of the umbilical venous blood to bypass the liver and rapidly reach the central circulation and help maintain a stable flow of blood towards the brain, heart and adrenal glands (Kiserud et al., 2000).
The Ductus venosus acts as the first partition determining the proportion of umbilical venous blood that is diverted to the heart and the typical Ductus venosus waveform includes a peak during ventricular systole, a second peak during ventricular diastole and a nadir during the atrial contraction in late diastole (Kiserud, 2005).
This study was a prospective observational study that included 30 high-risk pregnancies admitted at obstetric department for follow up until delivery, held to find out if Ductus venosus Doppler velocimetry might give earlier indication of fetal hypoxemia than does Umbilical artery and middle cerebral artery blood velocity, this study was carried out at Ain Shams University Maternity hospital.
We selected patient with high risk pregnancies with Singleton fetus with normal anatomy, Suspected Intra-uterine growth restriction, Oligohydraminos, Placental vascular dysfunction documented by abnormal umbilical artery pulsatility index by local reference ranges, pre eclampsia complicated by Placental insufficiency.
We excluded fetus with major congenital malformation as indicted by ultrasound examination, multiple gestations, patient who were planned for emergency termination.
All patients subjected to, history and physical examination taking to confirm inclusion and exclusion criteria.
We used a Machine sonoAce 8000 SE (Medison Digital GAIA) ultrasound machine with Doppler to assess fetal biometry for assessment of Gestational age, fetal weight estimation, and amniotic fluid index measurement.
Doppler ultrasound was performed and the mean pulsatility index (P I), Resistance index (R I) and systolic/diastolic ratio (S/D) of three consecutive flow velocity waveforms was calculated.
We found 9 cases of them with abnormal Ductus venosus pattern with flow shape A, B, C and after labor we found Neonatal admissions to neonatal intensive care unit due to hypoxia.
In order of statistical description we divided the cases into 2 group (hypoxic and non hypoxic group) according to Apgar score was less than 7 at five minute or PH less than 7.25 (acidosis) or neonatal admissions to neonatal intensive care unit according to (Hofstatter et al., 1996).
On comparing the diagnostic ability of DV RI and MCA S/D, DV RI showed the highest diagnostic ability 88% and MCA S/D is 82%.