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

[Toppy]

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.

Thank you all - so good to know that there are peops out there who are so happy to respond! Scans were done at JRH (Oxford) and at Beard's Mill Clinic, newyearposter.

Keep trying to look at big picture, and stay positive for my daughter, but scary odds - hard to strike a balance of not minimising the risk with breezy - 82% chance taht all will be well. Additionalyy, I think the private scans look at risk related to 'now', whereas NHS work on 'term risk'? (i.e. becasue more DS babies die pre-term then they adjust the irsk for term, which makes it lower?

Sorry about all the typos in previous post!

reason I ask is that if you wanted to go to London, Prof Nicolaides sees patients on Wednesdays (I believe - you would have to call and check) and he performs amnios. He might be the best person to see and to answer all of your questions. You might be able to get an appointment for this Weds., although if the amnio is next week he would most likely suggest that anyway..google him if you haven't already come across him.

should have specified - at the Fetal Medical Centre on Harley St.

I'm sorry I can't answer your questions myself but hopefully have pointed you in the direction of someone who can! So sorry you and your daughter are going through this.

Thank you newyearposter. I do know of Prof Nicolaides: the Beards Mill doctor we've seen, (Victoria Heath), has worked with him for many years, so we have been very much helped by her extensive knowledge and incredible support at the two scans performed by her. I think that although we have all the cold stats, I am looking at anecdotal comfort /support really. i.e. looking for people who not only have (had) the same risk but the same patterning with the astronomically high HCG (off the scale almost, even for a Downs bell curve) And whether anyone has similar unknowns - for instance the bilirubin link, the 1st trimester bleeding, the potential vanishing twin, and this one soft marker too. And whether the fact that the absence of three of the more significant soft markers is more important than the blood patterns and the one soft marker in making the 1 out of 7 more likely to be 'you'.

I know I am very much trying to over- analyse (!) But I feel very helpless and my scientifically trained brain just wants to delve deeper and deeper to find some 'ahh! there is something we can hang on to!' My way of coping I think.

However, what will be will be, so I'm also trying to use Buddhist philosophy with meta, and 'Let it be'. My one aim is to remain strong to support my daughter and hubby at this awful time of waiting, and then through the next stages if we don't get an all-clear. Letting them know that whatever the outcome we will be there for them through their decision making with whatever they need, with (of course) non-judgemental and unbiased loving support, and absolutely no 'advice' or input unless they request it.

Phew - that's all a bit heavy for this early in the morning isn't it?!

In case anyone picks up this thread - my daughter had her amnio on Tuesday 17th and the rapid results were back just over 24 hours later. No chromosomal abnormalities! (Well not T21, which was the high risk one or T18, T13).

Incidentally, the consultant performing the amnio said 'Well, with such a good NT this will not be Down's'.....sort of confirms my internet searching on anecdotal evidence!

I thought I'd add my story as I have found this thread so helpful during the last 8 weeks.
At my 12 week scan, I was told I was 'high risk' for Downs, due to reverse flow in the ductus venosus. My nuchal was 2.3 (highish end of normal), and I also had low Papp A.
Obviously I was very worried and opted to have a CVS. This came back clear for chromosomal abnormalities, but I was left with this heart issue.
I have now had 2 heart scans, and both are showing completely normal. The reverse flow had fixed itself by 16 weeks, and I've just had a further one (22 weeks preg) to check for any sign of heart abnormalities but there are none.
I hope that anyone else who gets this diagnosis at 12 weeks can get comfort from this thread.

Thank u toppy, bex, lissy, blue and every1 here who reduced my tension and stress about my problem.... I thought I'm the only one reported with these problems... You ppl gave me just a lill bit of relaxation now....

I will detail in short.... If u ppl can help me, pls do....

My name is sathya... I'm from India(Bangalore)... Now starting with the topic, I did my double marker test in my 12th week till that everything was normal... But wen my double marker report came, Dr called me and my husband to discuss abt the issue thr... She told us Trisomy 21 came positive with down syndrome risk of 1:119 , and she asked me to take and come the NT- NB scan from an experienced speciality doctor for scanning and she herself gave me the address of the scanning centre and Dr...... (srinivasa scanning centre Bangalore - shankarapuram)

I did my NT scanning wen I was exactly 13 weeks... In the NT-NB scan Dr gave me a report with

    Nasal bone not yet ossified and ductus venosus 'A' wave reversal

And at the end of scanning he told not to worry now, we will wait for another 2 weeks and do aminocenthesis test for any chromosomal abnormalities since trisomy 21 came positive.... Bcoz aminocenthesis can be done only at 16th week....

    This is happened till now and I'm 13 weeks 3 days... I was searching full google to get any positive hope for me to get lill bit of relaxation and I finally found this site and the comments regarding this topic was very helpfull to me.... Thank u all for ur help till now and  for future helpfull comments....  

Even now we didn't tell our parents and anyone that I'm pregnant yet, our family is living in chennai and since we r living separately we thought of giving them a surprise and telling them after 3 months... But exactly wen I'm at the end of the 3rd month all these started and we ourself were worried and we don't want to tell them a happy news with these symptoms, they will be scared. We r more worried bcoz of no one to support r pray for us....

Pls, u friends pray for us to get all these problems solved and get a healthy baby.... Thanks in advance...

Hello everyone, what a mine of information this thread is! So good to find lots of info about ductus venosus reverse flow all together as it's so hard to find anything elsewhere.

I have recently had a scan at the FMC which showed reverse flow ductus venosus. I also had slightly high NT measurement (2.7mm at 12 weeks) and quite low beta-HCG and Papp-A results (0.4 and 0.3 I think). But heart and everything else looked fine, they got a really good look at the heart.

Altogether that puts me at high risk (1:42) for Edwards and Patau and high-ish risk for Downs (1:175).

NHS did not give me a risk factor for Edwards and Patau but said 1:104 for Downs. They said I should have a detailed heart scan at 21 weeks, this was because of the NT and bloods not because of ductus venosus.

I have had a CVS and am awaiting the results - will update the thread when I get them and also when I have the detailed heart scan.

Best of luck Sathy I hope your amnio shows good results. As this thread shows, the nasal bone and ductus venosus can both resolve themselves so I hope this happens for you.

thanks a lot for ur good words minipie.... im in my 15 plus week... only on 16 plus week amino will be done itseems...next week i got appointment for amino..i hope everything turns good and the result should be the best.... nasal bone should be grown fully and ductus venosus reverse flow should be turned to normal flow and no other problems should raise hereafter.... im praying for my baby's normal growth and normal delivery.... thanks for ur prayers and support everyone here.....

Hi everyone, I'm in my 27th week now.... I got my fish result normal and waiting for my amino result, didn't get yet....

Reverse flow and nasal bone came to know normal in the previous scan which I took 4weeks back...

Hope everything goes good throughout my pregnancy and delivery....

Thanks for all of ur prayers....

Hi all,

Glad i found this thread. Am 36 & first time pregnant. its now 12 weeks 2 days. Biochemical markers ( Beta hCG & PAPP-A ) are normal. Underwent scan today, NT is 1.8 & Nasal bone present, but there is a reversal of flow in Ductus venosus. I was extremely worried, but feeling reassured after reading the above posts ( Thanks to Toppy & Others ). I wont worry much based on the experience here & wait for 16 week scan. But was just wondering if any one had bad outcome after isolated DV flow reversal & failed to post or not felt like posting here. Hope i dont sound pessimist, but on googling most scientific studies in past have showed significant numbers having bad outcome. It was all gloomy today untill i came across this thread.

Hi Sathya , hope your delivery went on well. I am also from bangalore, but working & residing in Kuwait. There are no good feto-maternal specialist here. Hence going to bangalore next month. It would be great if u could tell me about the good feto-maternal centres in bangalore. Is Srinivasa scanning centre the best one ? kindly reply.

Hi all, my post on here and have to say this thread has been useful and reassuring.
As a father to be I'm naturally just as concerned, our 12 week scan a UCLH came back as reverse flow. The sonographer didn't have much to say other than 'don't worry' - as my fiancé sat there in tears. We've been referred to a cardiologist on Friday, the speed of that had us worried. But reading this we're staying positive.
Thank you, fingers crossed and ill let you know we get on - hopefully we can then try to assure others :)

Hello everyone. I'm Kati from Hungary. I know it's a very old thread, but it has given me a lot of hope when I needed it, so here's my story. Doctor detected reverse flow in DV at the 12 week scan (nasal bone WAS there, and NT was 1.6mm, so very good). It was confirmed by another one in a bigger city, so no doubt about it. Nobody said anything about what it actually meant. My Downs risk came back 1:14000 after the scan and the blood results at 12weeks, but they didn't count the abnormal DV flow, of course. We were sent to have a genetic counselling session - still not much was said about this. The doctor there only said that of all cases apparently about 80% of the babies born was healthy. (Which would have meant a 1:5 risk...) We were advised to have a detailed heart scan at week 18-20. We had it, and everything was FINE! We also had a non-invasive blood test which can screen chromosomal abnormalities from the fetus's and the mother's DNA, and this time the risk for Downs came back as 1:67.000.000. Which was REALLY reassuring. I'm not sure if anyone reads this thread any more, but I'll give an update once my (2nd) little boy is born. (First one was born without us even thinking about all the things that could go wrong, at week 39, natural birth, and he's "fit as a fiddle").

Hi Mums and mums to be! Just had my 12 weeks scan at FMC and we were told there was a positive tricuspid regurgitation. All the other markers are good and the risk is 1:1239. I am not so worried about the Down syndrome, but concerned about the implications of having a positive tricuspid regurgitation. We were told not to worry but a cardiac scan at 20 weeks was recommended. Could you please share your thoughts if you know more about having a positive regurgitation or have experienced something similar? Does it indicate a future heart problem? Should I be worries?

Hi I'm in exactly the same situation as you! Went for my 13+ week scan and harmony came back 1:10000 but nuchal 2.5 thickness and reverse flow /tricuspid regurgitation. He said it may resolve itself but I should follow up with a cardiac scan at 20 wks. Really worried

Hello Everyone! I can't believe that this thread is from 2009! I'm from Portugal and yesterday I had my 12 week scan. Everything went fine, NT 2.0mm, nasal bones present, chemical analysis great. In the end the risk dor Down's was 1:16000.

The only problem was that in the end of the ultrasound our Dr. said that he detected a reverse flow in DV. He said that it was a minor marker for Down's but recommended a fetal ecocardiogram at 20 weeks and "not to worry because it must go away".

Of course we are really worried. This thread was great to give me some hope but I can't help thinking about heart defects. There is so few information about this in the internet. They always look at this problem as complementary to the other markers..

If someone have more information and final outcomes about this please post. It's important not to forget this thread. It will help a lot of mums.

I will keep you updated for the next weeks. Thank You!

Hi everyone! Like SofFer, I'm from Portugal, and today was the day of my 13 week scan. Everything went ok (NT 2.0, nasal bones present...) and I'm waiting for chemical analysis result.

But... I also heard about the reverse flow in DV. She said that it may be nothing but she reccomended a fetal ecocardiogram after 20 weeks scan.

I'm also looking for any extra information. SofFer do you have news?

ThankYou!

Hi mums!

For now I still don't have a lot of information to share. After my scan I saw my doctor and we talked about the relevance of the inverted DV.

She told me that all the cases she had seen, always went well and babies have born perfectly healthy! In most cases, DV comes back to normal before the 20 week scan.

Now I'm almost 16 weeks pregnant and I have a fetal ecocardiogram booked for my 18 week (is still early but if there was something really serious they are already capable to detect at this stage).

I'll return here in a few weeks to share more news! Thanks!

Hello Everyone,

Yesterday was the day of my fetal ecocardiogram. It went perfect. Everything was perfectly fine and there wasn't any problem in my baby's heart! :)

The doctor was great and told me that the inverted DV by itself rarely represents a problem in the heart.

Hope that this thread continues to help a lot of mums like me! Good luck for all!

Hi it's me the original poster just 'popping back' after nearly 8 years to say NOTHING ever came of that reverse flow as comfort for anyone that comes across this thread going forward.

In hindsight it was very worrying but extremely minor. Technology is such these days that tiny little things can be picked up that the sonographer feels they should pass on to you but in all likelihood will never affect a successful outcome.

Hi everyone.
I'm from Russia and am currently facing exactly the same issue. Had my 12 week scan 2 days ago and everything was fine (NT 1.8, nasal bone 2.0) except this reverse flow thing. The doctor immediately told me that was the least important of the 3 markers and could mean either chromosomal abnormalities or a heart defect. She also said, that if the blood tests are fine, I won't have to worry about the former but will have to tell the sonographer who performs the 20 week scan about the reverse flow. She did reassure me, though, that there's an 80% chance of a good outcome.
Naturally, I could not resist googling immediately and I did a search in Russian, which did not give me much comfort. There are forums where women share similar worries but hardly ever return to write about the outcomes. I was so lucky to have found this thread on the very day of my scan and I've been reading it for 3 days. It has given me tremendous reassuarance! I am so grateful to all of you ladies who kept coming back and updating the information, and kept this thread alive. I can actually go back to enjoying my pregnancy. The last thing I would want to do now is get into my head and disconnect from my baby, when it needs me to be present and calm.
Sending the warmest wishes and immense gratitude to you all!
I will definitely return to tell all the future moms out there how everything goes.

The blood test was excellent, showing very low risks of chromosomal abnormalities. My doctor recommended an additional scan at 16 weeks, which I had 5 days ago. Everything seemed fine. When I asked whether the reverse flow was gone, the sonographer said it cannot 'be gone' simply because they (I don't remember clearly) either don't see that thing or do not evaluate it after 14 weeks. She said it's meaningful only between 10 and 14 weeks. So far the heart looks fine and the heartbeat is clear and regular. But I have to wait till 20 weeks for them to be able to have a proper look.
I was also referred to a geneticist, but the appointment is not until the end of the week. I was told though that she'll most likely refer me to an additional blood screen performed between 16 and 18 weeks to completely rule out any possibility of chromosomal abnormalies.
Incidentally, they told me it's a boy! I feel so much better after this recent scan and have finally decided to tell the family.
I'll be back again at 20 weeks with another update.

Please start your own thread for this rather than dragging up a years old one