'Reverse Flow in Ductus Venosus' - 12 week scan at FMC

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I am posting this in the hope that someone may have been in a similar position and can help me understand the implications of my 12 week scan - apologies for the long post.

I have just been for a 12 week scan at the Foetal Medicine Centre where one of the markers they check is the Ductus Venosus flow. My baby's flow is reverse flow. This can be an indicator of Downs. We were told that 80% of Downs babies have this condition bu that 3% of 'chromosomally normal' babies also have reverse flow. Once combined with my age, blood results or other markers (nuchal fold, nasal bone) we were given a very low risk of Downs, Edwards and Patau.

DH is very happy with these results but I can't stop worrying about what this reverse flow means outside of the context of the Nuchal scan. The sonographer said we could do nothing more than wait for the 20 week scan and focused on my low chromosomal defect risk.

Now I am home I am worried about what might await us at the 20 week scan as reverse flow can be indicative of heart defects. This has just caused the most ENORMOUS row between me and DH. He can only see the facts: in the context of the 12 week scan this anomaly has been cancelled out to by other good indicators to give an overall low risk whereas I, worrier that I am, can only think about why the anomaly is there at all.

I know there is nothing I can do but wait for the 20 week scan and google (bad bad idea) but I was hoping someone else further on down the line might have had this experience that they could share.

Hi Nem5, Im doing my antenatal at UCH too (27 weeks now). I went for a heart scan at 16 weeks and the sonographer wasnt happy at all because he believed it was very early.

Thanks . Did this mean you had to go back again ?

No, the sonographer went ahead and performed the scan. Luckly everything was ok. at 20 weeks scan they had a good look at the heart and again nothing wrong with it. Stay positive, it will be the same with you!!

Just wanted to update the thread and say that after a 1 in 9 risk of downs (had a CVS so this was ruled out at 12 weeks) and reverse ductus venosus diagnosed, I had a perfectly healthy baby boy 4 weeks ago. Wanted to post as I know how frightening it is when you don't get good news at a scan and if it reassures one person then it's worth it. Good luck to everyone.

I just want to add to the thread that I had a scan at 16 weeks and all is well with baby, babys heart and no reverse flow visable. All normal.

I have just been pointed over here having started a thread because we saw on our scan report that the songrapher had put that there was reverse flow through the ductus venosus.

I haven't been referred for a heart scan. First of all the sonographer said he would organise one for me at 16 weeks (because high risk for DS) and then later on when he gave me his report, he said that he wouldn't refer me because the nuchal was under 3 (though he said it was high at 2.85) so the plan would be to have the 20 week scan as usual and then if anything was spotted, I'd be sent for a cardiac scan then.

He didn't actually mention the reverse flow - I noticed it on the report and then looked it up. I wondered if he wasn't very confident in his result or if it wasn't a big deal in his book...

Hi there
I posted a while back at 13 weeks. I now have 2 weeks left (being induced on the 29th Oct due to cholestasis).
I never did get any clear answers on the reverse flow which was picked up at a private clinic as they refused to check for it at my NHS hospital, so i have spent the whole pregnancy wondering and worrying. On a good note tho the baby has passed all the routine scans with flying colours, has always measured spot on for dates and the heart, valves, chamber checks have all come back A1. They always put 'positive flow' after checking the cord too, but is this the same thing?
Anyway i will check back after having the baby, which is a little girl and let you all know the outcome. My gut feeling is that she isn't Downs, but i can't know that for sure.

Helene

Hello! Back in March on my 12 weeks scan my baby had reverse flow. Obviously I was REALLY scared and then somebody directed me to this thread. I just want to say that 2 weeks ago I gave birth to a healthy baby boy:) I enquired about the reverse flow and the doctors told me: it's one of those things...

Hello all. New to this forum. We've just had a 12 week scan done by UCH in London and had some not very good news. We're hoping you can shed more light on this and if we should worry about this? The information after the scan/bloodtest are as follows:

Fetal anatomy:
Skull = normal
Brain = normal
Heart = normal limited
Stomach = visible left-sided
Abdomen = normal

Additional markers for risk assessment:
Nasal bone = present
Tricuspid flow = normal
Ductus venosus = reverse flow (a-wave)

Estimated risk for Trisomy at 11-14 weeks gestation:
Background risk Trisomy 21 = 1:776
Background risk Trisomy 13/18 = 1:6430
Adjusted risk Trisomy 21 = 1:6071
Adjusted risk Trisomy 13/18 = 1:4804

Comments:

Verbal consent obtained for scan. The risk for Down's syndrome (assessed by a combination of nuchal translucency, nasal bone, fetal blood flow and serum biochemistry) was low (less than 1 in 150). There is abnormal flow in the fetal ductus venosus. Since everything else looked normal, this is unlikely to be important amd it resolves spontaneously in more than 95% of the cases. However we will carry out a detailed fetal scan including echocardiography at 20 weeks. The mother is aware that ultrasound alone cannot exclude all genetic syndromes or chromosomal abnormalities.

Decision:
Rescan at 20 weeks for anomaly and cardiac scan.

As you can imagine, we're getting really worried about this. The doctor said that these things can pass in about 2 weeks and we shouldn't get worried. We're lucky as we have another scan next week at a different hospital so they may shed more light or give a totally different opinion who knows. All I know is that we never had this issue with our first child Evie and this is really worrying :(

If anyone can reassure us that would be great.

Kind regards,

Matt + Lu

I can reply more later but that looks really good and not bad at all! Apparently reverse flow at the '12 week scan' is neither here nor there really but is one of those soft markers that when there are lots of others can give you a higher risk. We had that at our scan along with other soft markers so i did lots of reading on it and if that was all there was, I wouldn't have been worried at all. Honestly.

There is a charity called 'antenatal results and choices' ARC that you can phone and chat to and they will talk it all through with you. They are brilliant.

Hi,

We've just had our 12 week, 3 day scan and been told that our baby has a reverse flow of the ductus venous. There are no other indicators of down's syndrom: nuchal, and nasal development are good, as are limbs and heart rate, blood pressure. Baby was moving around and all seemed normal and healthy otherwise. Our chance of downs was given at 1:476.

We've read a lot of this thread and understand the general consensus, but nevertheless, have a few questions that we need nailing down, and wonder if anyone can help us out.

1. Are the chances of down's syndrome lowered because other key developmental features seem present and normal?

2. If so, am I right in thinking that the main concern is a heart defect? Surely as a CVS carries a 1% risk of a miscarriage, and can't tell us about the heart, it doesn't seem like the right thing to do. Does anyone have any views on this?

3. What causes reverse flow? Tried google but there's no definitive answer (if there even exists such a thing in medical terms).

4. If the worst does happen once, be it down's syndrome or heart defects, does that mean that there's an increased chance of it happening again?

5. Are there other syndromes/illnesses/conditions associated with reverse flow?

6. I know the ductus venous closes post-natal, but if the flow persists for the full term, will it definitely cause problems in the baby? Does this pose health risks for mum as well?

7. A 16 week scan with cardio seems to be the best option, would you agree?

We really appreciate the instant perspective on the subject that this thread has provided us with, and thank everyone else that has commented and made an anxious and daunting experience a little easier to comprehend.

Wishing everyone well

B&G

This is my first time posting on this thread and I don't know a huge amount about reverse flow on DV, but I have experience of CVS and other markers of Down syndrome on antenatal screening tests.

bbgn, in response to some of your questions, if reverse flow is the only marker that showed up on your scan and the most important markers (nasal bone and nuchal) are all ok, then the chances are that everything will be fine and that you will have a healthy baby. It seems that the reversed DV flow in isolation is quite common and it's only a worry when combined with other risk factors.

The CVS only detects chromosomal problems, so if I had the results you were given, I wouldn't bother with the CVS. If there is a heart problem (which is very unlikely given your results), the CVS won't be able to detect it.

To be on the safe side, I think the best way forward is to have a fetal echo of the baby's heart at 20 weeks, but the chances are that everything will be fine.

With regard to it happening again if there is a problem, I really think you're getting ahead of yourself. In isolation, the DV problem seems to have very little clinical significance.

Try not to worry, and good luck.

xx

HI, I am writing from Poland so reality here is quite different. I had my 12 weeks scan and the DV also came out reverse , all the other markers were ok and the risk for Trisomnia 21 was counted as 1:4511. The doctor did not include reverse flow in DV in the count for some reason but he was very concerned with it. He sent me for another scan to some world-famous specialist (whom I heard to eb very rude but still great doctor) (tomorrow), so it is just 2 days after the first scan. Did anybody have two scans in such a short period of time? Would it show anything else? Could it possibly mean my doctor was not sure of his readings? Should I do any other check-ups-CVS , AMNIO? I read that you all had to wait for the 16week or 20 weeks scan and then the doctors could say anything.
I admit I am panicking. I lost my first baby so since day one I am pretty much scared and not really enjoying that time. Sometimes I wish it was 50's when women walked completely free of DV, NT, CRL or everything else.

Hi all,
Just wanted to post that we too were told our baby had reverse flow in the DV at my 12 weeks scan at UCH in December last year. I had no other markers and my Downs Risk was low, but I was very upset and worried about the reverse flow.
Reading all the positive outcomes on this thread really helped to reassure me, so I wanted to let anyone reading this know that we had my 20 week scan and a cardiogram at the Fetal Medicine Unit last week and all was well.
I asked the doctor about the reverse flow and he said that it was very easy to misread and that if he (a fetal cardiac specialist) had done the first scan, he probably could have got a reading without the reverse flow! So there you are.
It's a difficult one to deal with, because there's so little info on it (none of my baby books even mention the DV, let alone reverse flow), so it's easy to work yourself up.
I think the best thing to do is sit tight and then let the experts have a look and from what I've seen on this forum and my own experience, in most cases everything seems to resolve itself.
Thinking of you all and wishing everyone healthy babies.

Hi - was just on mumsnet and remembered this thread, thought I'd pop by and update. For anyone who has had the diagnosis of reverse flow in the ductus venosus now it is worth trawling through all the messages as you will see some experiences right through which can be reassuring. Unfortunately can't write for long as have my gorgeous (healthy) 16 month boy using me as a climbing frame and am ignoring a mountain of housework!
I would just like to echo what others have said in that this diagnosis alone seems to have little clinical significance and so many positive outcomes. Wishing you all all the best.

Hello....I'm from Canada, and I just had my first trimester screening done too, and I too had abnormal flow from ductus venosus, with all other markers being normal. Like all of you...I am freaking out!!! My overall screen came back negative, with my risk for chromosomal abnormalities being low. I now have to wait for the 18 week echo with a cardiologist to determine heart functioning. In Canada, they have only been testing the dv for one year....is there anybody out there who can give me anymore reassurance, or anyone from Canada who has been through this as well?

Thanks

Hi, I just wanted to add a comment as I found this thread really helpful. We were told at the FMC at the end of our 12w scan (just as I was getting up to go) that the baby had the reverse flow thing. We got all the stats (throwing in words like Downs and heart defects) and were told it was probably fine but we were still offered a CVS (which we declined). I was about 1 in 1000 for Downs and I didn't have any of the other markers.

I went home feeling flat, was very quiet that evening and the next day stayed in bed. My excitement about being pregnant definitely decreased. I was more concerned about a heart problem than Downs.

Fortunately I then found this thread which was really helpful and made me realise that I didn't want to or need to spend the next 8 weeks miserable and worrying. I took the view that it probably would be ok and my husband wasn't worried and I put it (almost) to the back of my mind.

We had our 20w scan today - back at the FMC. They checked the heart thoroughly and everything was fine. Hugely relieved tonight and feel like I can spend the next 20 weeks being properly happy and excited.

We go to the FMC because it is so nice there, the staff are pleasant, you know they will do a "proper" job and you don't have to wait 3hrs in a grotty NHS waiting room for a stressed sonographer to see you at the end of their busy shift. However you have to remember that the FMC is into the latest bestest technology and tests and with a "proper" job you may get more information than you want or need. But if you don't have any other Downs markers then please take the reverse flow results with a pinch of salt - the NHS don't even bother with it, it can fix itself and at 20w they don't even look at it. Try not to worry! Easier said than done but hopefully this thread will help you too.

Hello there
I had meant to up date you earlier but time has run away with me!
I posted with a Downs risk of 1:5 after a scan highlighted a reverse flow. Not helped by the fact I was 45, (i am now 46) Well i can announce that i had a gorgeous little girl on the 1st of November by C-section (she was breach) and
she is absolutely perfect in every way :-) She is now 7 months and the light of our lives.
All that worry and stress for nothing! Thank you so much to everyone here for all of your support!
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Helene

Sorry that link didn't work, try this
www.facebook.com/photo.php?fbid=10150345502121040&set=a.10150345501411040.425164.534711039&type=1&theater
Helene

Hello ladies so lovely to hear positive stories at last, my sister had her 13 week scan today @ kings and discovered a reverse flow ductus venosus, she is 26 so still at low risk however in general her risks have increased slightly. Everything else all ok yet now has awkward job of waiting for 22 weeks of which she must return to kings, as well as having local scan at 20 wks.
She is so so terrified & upset, fingers crossed.

Joining old thread as seems most appropriate -
Just wondering if anyone else has experienced similar recently and what the advice or outcome was?
thanks!

Hello everyone - would be really grateful if anyone out there could offer some support or reassurance?

First of all, I'm not pregnant myself, just very, very worried about my daughter and her husband. She has had a difficult first pregnancy right from the start - spotting then some horrendous bleeding with clots, through weeks 4 - 8. However, we paid for some private scans at week 8 to assess situation as she couldn't get an NHS scan until next day after a particularly horrendous bleed. At that scan, foetus observed, moving beautifully and heart beat and CRL all ok for gestational age. Also noted was an empty sac sitting in uterus, which also showed some suspicion of a bicornuate uterus (very, very mild). So, just beginning to relax, after 4 weeks of no more bleeding, and her triple screen (at 12 weeks) has been horribly skewed by her bloods and also her age (34). (PAPP-a only 0.3 and HCG 4.8). NT good at 1.00mm. Risk for T21 was 1:15, so of course very upsetting. They didn't have CVS because of raised risk of miscarriage (some clots still there). So, another private scan to assess soft markers: Nasal bone present, Regurgitation OK. NT ok. (1.4) BUT - reverse flow present. Oh dear. Risk of T21 now increased to 1:7, as uterine arteries checked and although one slightly raised, other ok. (So not likely to be placental issues, which is another potential cause of this blood result patterning)

I am just wondering whether anyone else has seen research about why this blood result patterning might have been skewed:
An empty sac = ? vanishing twin (not spotted at NHS 12 week scan, just the private one at 10 weeks)?
Gilbert's Syndrome, which my daughter has, (elevated bilirubin intefering with assay)?
Mostly vegetarian diet intefering with assay?
Presence of blood in uterus?
I had P.E.T with elder daughter (could be familial poor placental function)?

Or are we clutching at straws? The risk is as it is of course - as everyone knows, if you are the 1 in whatever 'x' is, you are still the one - and until amnio next week we will just have to wait. But waiting and wondering is awful. (And I feel so guilty as I suggested the additional private scan as I though it would reduce the risk!)

where did you have the scan and where will the amnio take place? At the FMC?