Cerebral Venous Engorgement in Hydrops Fetalis.

A 34-year-old gravida was diagnosed with hydrops fetalis, hydrothorax with cardiac compression, hygroma, ascites, and subcutaneous edema at 20 weeks of gestation. The peak systolic umbilical artery and middle cerebral artery velocities were 30 cm/sec and 28 cm/sec, respectively. The umbilical vein demonstrated a lowamplitude blunted waveform. The cerebral venous sinuses were imaged by color Doppler ultrasonographic at low Nyquist limits in transverse planes at the level of cisterna magna (1). The tentorial venous sinuses (not visualized routinely) and confluences of sinuses were both prominent (Figure 1A). Pulsed-wave Doppler interrogation at the confluence demonstrated a low-amplitude blunted pulsatile waveform composed of a systolic component and a forward early diastolic component (Figure 1B).