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

Doppler studies on hemodynamics of the cardiovascular system and intra-abdominal organ perfusion in non-pregnant individuals are usualy performed by cardiologists and radiologists. Specialists in Maternal-Fetal Medicine are also familiar with cardiovascular Doppler sonography, however they mostly focus on the fetal 1;2 or uteroplacental circulation 3-5. Recently, several reports have been published on Doppler assessment of the maternal venous compartment, illustrating its feasibility and repeatability 6-11. These studies have shown that the venous compartment is also subject to maternal cardiovascular adaptation during uncomplicated pregnancy 9;11. In gestational diseases, such as preeclampsia, some of the observations show promising results with respect to the evaluation of maternal cardiovascular maladaptation 9;11 and prediction of subsequent disease 12. Therefore, the maternal venous compartment is a new area to be explored in obstetric ultrasound imaging 13, in order to link Doppler observations to known features of gestational cardiovascular (patho)physiology 14-16 and to the information obtained from other parameters 17. This paper offers a comprehensive review on Doppler assessment of the maternal venous compartment during uncomplicated pregnancy.