Doppler assessment of maternal central venous hemodynamics in uncomplicated pregnancy: a comprehensive review

Doppler studies on haemodynamics of the cardiovascular system and intra-abdominal organ perfusion in non-pregnant individuals are usually performed by cardiologists and radiologists. Specialists in Maternal-Fetal Medicine are also familiar with cardiovascular Doppler sonography, however, they mostly focus on the fetal (Malcus, 2004) or uteroplacental circulation (Abramowicz and Sheiner, 2008; Papageorghiou and Leslie, 2007; Cnossen et al., 2008). Recently, several studies have been reported using Doppler assessment to explore the dynamics of the maternal venous compartment, illustrating its feasibility and reproducibility (Karabulut et al., 2003; Bateman et al., 2004; Roobottom et al., 1995; Gyselaers et al., 2009b; Gyselaers et al., 2008; Gyselaers et al., 2009a). These studies have shown that the venous compartment is also subject to maternal cardiovascular adaptation during uneventful pregnancy (Gyselaers et al., 2009b; Gyselaers et al., 2009a). In gestational diseases , such as preeclampsia, some of the observations show promising results with respect to detecting maternal cardiovascular maladaptation (Gyselaers et al., 2009b; Gyselaers et al., 2009a) and predicting the development of subsequent disease (Gyselaers and Mesens, 2009). Therefore, the maternal venous compartment is a new area to be explored in obstetric ultrasound imaging (Gyselaers, 2008), in order to link Doppler observations to known features of gestational (patho)physiology (Gyselaers et al., 2009b; Gyselaers et al., 2009a) and to the information obtained from other techniques (Carty et al., 2008). This paper offers a comprehensive review on Doppler assessment of the maternal venous compartment during uncomplicated pregnancy.