What is the definition of pulsatile umbilical venous flow in twin-twin transfusion syndrome?

Zoi Russell, Rubén A. Quintero, Eftichia V. Kontopoulos

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective: The aim of the study was to derive an objective definition of pulsatile umbilical venous flow (PUVF). Study Design: Pulsed Doppler waveform analysis of the umbilical vein was performed in stages III and IV twin-twin transfusion syndrome (TTTS) patients. In patients with PUVF, the umbilical vein maximum (Vmax) and the umbilical vein minimum velocity (Vmin) and the resistance index for the umbilical vein (UVRI) = (100 × [Vmax - Vmin]/Vmax) were assessed. Results: PUVF was noted in 130 of 226 stages III and IV TTTS patients. Digital images were available for analysis in 65 of 130 patients (50%). The minimum UVRI associated with PUVF was 16% for stages III and IV TTTS. There was a trend for increasing UVRI with stage (P = .052). Stage IV patients were more likely to have an UVRI greater than 30% (P = .02). Conclusion: PUVF can be defined as an UVRI greater than 15%. A scale definition of PUVF may further facilitate assessment of the degree of fetal hemodynamic compromise.

Original languageEnglish (US)
Pages (from-to)634.e1-634.e4
JournalAmerican journal of obstetrics and gynecology
Issue number6
StatePublished - Dec 2008


  • fetus
  • pulsatile
  • pulsatility
  • Quintero staging
  • resistance index
  • twin-twin transfusion syndrome
  • umbilical vein

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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