Cardiac Doppler flow velocities in human fetuses

Cardiac Doppler flow velocity studies were performed in normal human fetuses between 18 and 40 weeks of gestation. Two-dimensional linear array and sector scanning techniques were used for the initial evaluation of the fetuses, which included a standard ultrasound examination to determine normal anatomy and estimated gestational age and weight. Fetal cardiac ultrasound examination was then performed, with four-chamber, short-axis/great vessel, long-axis/left ventricular outflow tract, and aortic arch views obtained. Pulsed echo Doppler instrumentation was used to obtain flow velocity measurements through the tricuspid, pulmonary outflow, mitral, and aortic outflow regions. Calculation of transvalve volume flow for mitral and tricuspid valves was performed by combining the valve anulus sizes and calculated mean temporal velocities for the valves. Maximal flow velocities were greater through the tricuspid (mean maximal velocity 51 ± 1.2 [SE] cm/sec) than through the mitral (47 ± 1.1 cm/sec; p<.05) valve regions, with a wide range of scatter for results between fetuses but less than 6% average variation in the individual fetuses during gestation. For 18 fetuses, right heart dimensions and volume flows (mean 307 + 30 ml/kg/min) were greater than left heart dimensions and volume flows (232 ± 25 ml/kg/min). Doppler echocardiography may prove to be useful as an adjunct to imaging echocardiography for evaluation of fetal cardiac anatomy and function.