Extrakardiale Doppler-Untersuchungen bei fetalen Herzfehlern

There have been few studies using Doppler measurements (umbilical artery, middle cerebral artery, ductus venosus) in fetuses with isolated heart disease. As a consequence of their hemodynamics, some specific cardiac lesions show significant alterations in fetal blood flow compared to controls. An increased pulsatility of the umbilical artery has occasionally been observed in those fetuses with the most severe obstructive lesions and reverse perfusion via the ductus arteriosus. In contrast to fetuses with intrauterine growth restriction and brain sparing following general redistribution, those with hypoplastic left heart or complete transposition of the great arteries may have isolated cerebral vasodilatation with decreased pulsatility of the middle cerebral artery as an adaptive local response to moderate hypoxia. An increased pulsatility of the ductus venosus has been described, especially in right heart lesions with increased right-atrial pressure, usually without being associated with cardiac compromise.