Cerebral Venous Engorgement in Hydrops Fetalis

Abstract

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