Hemodynamics analysis of fetal intra-abdominal umbilical vein varix using computational fluid dynamics with Doppler ultrasound

Hemodynamics analysis of fetal intra-abdominal umbilical vein varix using computational fluid dynamics with Doppler ultrasound | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Hemodynamics analysis of fetal intra-abdominal umbilical vein varix using computational fluid dynamics with Doppler ultrasound Xue Song, Shiyue Zhang, Mingrui Li, YanYan Hu, Jingying Wang, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6619972/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Fetal intra-abdominal umbilical vein varix (FIUVV) is a rare but potentially risky fetal umbilical cord (UC) vascular anomaly closely related to adverse pregnancy outcomes. Clinically, the diagnosis of FIUVV primarily relies on Doppler ultrasound. Unfortunately, it is challenging to provide detailed FIUVV hemodynamics, while current in silico computational fluid dynamics (CFD) can provide these details with necessary ultrasound data. Therefore, this study uses CFD to simulate blood flow in four different geometric FIUVV models based on clinical Doppler ultrasound data. The varix region exhibited marked velocity deceleration, with a reduction of approximately 16-48% compared to the normal umbilical vein (UV) model. In addition, a large low-velocity region forms near the UV wall, where the slow-moving blood flow generates recirculating flow under the influence of the reverse pressure gradient. The pressure within the varicose region remains nearly equal to that at its entrance, while a distinct pressure gradient emerges near the exit of the varicose segment. Within the venous dilatation region, wall shear stress (WSS) decreased to 6% of that in the normal UV model. The downstream end of the varix region, the contraction of vessel diameter and velocity recovery lead to a sharp increase in WSS, with peak WSS reaching three times the normal value in the elongated fusiform and bilobed fusiform umbilical vein varix models. These results predispose to endothelial dysfunction and thrombogenesis and subsequently may impair fetal growth and development. These results underscore the critical role of CFD in elucidating FIUVV pathophysiology, particularly in quantifying thrombosis-prone low-shear zones and endothelial stress hotspots. The methodology provides novel insights into stratifying hemodynamic risks and optimizing prenatal monitoring protocols. Biological sciences/Physiology Health sciences/Cardiology Physical sciences/Engineering Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6619972","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":474707121,"identity":"7fee1222-fcf8-4dfe-9354-e189ae472e91","order_by":0,"name":"Xue Song","email":"","orcid":"","institution":"Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Xue","middleName":"","lastName":"Song","suffix":""},{"id":474707122,"identity":"3501b9df-0b0b-442f-829b-61cdb3628bd3","order_by":1,"name":"Shiyue Zhang","email":"","orcid":"","institution":"Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Shiyue","middleName":"","lastName":"Zhang","suffix":""},{"id":474707123,"identity":"a9a81313-b40a-4392-9bc8-c433c1b6fd5a","order_by":2,"name":"Mingrui Li","email":"","orcid":"","institution":"Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Mingrui","middleName":"","lastName":"Li","suffix":""},{"id":474707124,"identity":"d4173ef6-fa10-4c23-bcf4-e5adb979160f","order_by":3,"name":"YanYan Hu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAArElEQVRIiWNgGAWjYFACHgaGDwzMIJYB8VoYZ5CshZmHJC0GN3KPSdv8sU5sYG/eJsFQc4cYLXlp0rlt6YkNPMfKJBiOPSNGS46ZdG7D4cQGiRwzCcaGw0RqsfgD1CL/hhQtDGwgW3iI1CJ55o2xZW9bunEbT1qxRcIxIrTwHc8xvPHjj7VsP/vhjTc+1BChReFCAoTBBiISCGtgYJDvP0CMslEwCkbBKBjRAAAnqzf6sXerfwAAAABJRU5ErkJggg==","orcid":"","institution":"Qilu Hospital of Shandong University","correspondingAuthor":true,"prefix":"","firstName":"YanYan","middleName":"","lastName":"Hu","suffix":""},{"id":474707125,"identity":"c7f45390-6c8d-41ab-bae6-37805486c076","order_by":4,"name":"Jingying Wang","email":"","orcid":"","institution":"Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Jingying","middleName":"","lastName":"Wang","suffix":""},{"id":474707126,"identity":"b14a2130-f13e-45e4-8bc3-54d0ddb6d021","order_by":5,"name":"Ke Sun","email":"","orcid":"","institution":"Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Ke","middleName":"","lastName":"Sun","suffix":""}],"badges":[],"createdAt":"2025-05-08 11:08:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6619972/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6619972/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86800254,"identity":"58a5cf1a-f3d6-4c8f-90c3-ec6b8d836954","added_by":"auto","created_at":"2025-07-15 16:46:50","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":8308664,"visible":true,"origin":"","legend":"","description":"","filename":"HemodynamicsanalysisoffetalintraabdominalumbilicalveinvarixusingcomputationalfluiddynamicswithDopplerultrasound2.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6619972/v1_covered_d16ab1a2-1e49-4b7d-9258-c5b34a851e32.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Hemodynamics analysis of fetal intra-abdominal umbilical vein varix using computational fluid dynamics with Doppler ultrasound","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-6619972/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6619972/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Fetal intra-abdominal umbilical vein varix (FIUVV) is a rare but potentially risky fetal umbilical cord (UC) vascular anomaly closely related to adverse pregnancy outcomes. Clinically, the diagnosis of FIUVV primarily relies on Doppler ultrasound. Unfortunately, it is challenging to provide detailed FIUVV hemodynamics, while current in silico computational fluid dynamics (CFD) can provide these details with necessary ultrasound data. Therefore, this study uses CFD to simulate blood flow in four different geometric FIUVV models based on clinical Doppler ultrasound data. The varix region exhibited marked velocity deceleration, with a reduction of approximately 16-48% compared to the normal umbilical vein (UV) model. In addition, a large low-velocity region forms near the UV wall, where the slow-moving blood flow generates recirculating flow under the influence of the reverse pressure gradient. The pressure within the varicose region remains nearly equal to that at its entrance, while a distinct pressure gradient emerges near the exit of the varicose segment. Within the venous dilatation region, wall shear stress (WSS) decreased to 6% of that in the normal UV model. The downstream end of the varix region, the contraction of vessel diameter and velocity recovery lead to a sharp increase in WSS, with peak WSS reaching three times the normal value in the elongated fusiform and bilobed fusiform umbilical vein varix models. These results predispose to endothelial dysfunction and thrombogenesis and subsequently may impair fetal growth and development. These results underscore the critical role of CFD in elucidating FIUVV pathophysiology, particularly in quantifying thrombosis-prone low-shear zones and endothelial stress hotspots. 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