[Fetal renal ultrasound investigation in toxaemic pregnancies]

A relationship was sought between renal hyperechogenicity and the hypoxic state of fetuses.

120 pathological pregnancies were examined between the 28th and 36th weeks. The echogenicity of the fetal kidneys was examined with Combison 530 3D ultrasound equipment fitted with a 3-5 MHz transabdominal transducer. The serum kidney and liver functions and plasma electrolytes of the mothers were examined and blood was collected from the pulsating umbilical artery for determination of the same serum parameters. After delivery, the physical condition of the neonates was followed and their kidneys were examined with the same ultrasound equipment within the first 5 days.

There was a significant difference between the cases with fetal renal hyperechogenicity and without it for the pathological neonatal clinical outcome (chi-square test with Yates correction, p < 0.01). There were significantly more intrauterine retarded fetuses (6 cases, 40%) in cases with fetal renal hyperechogenicity, than in the control group (3 cases, 3%). The mode of delivery was caesarean section in 7 cases (46%) in group with fetal renal hyperechogenicity, while it were 6 cases (6%) in control group. The risk for pathological outcome is 6 times more in cases with fetal renal hyperechogenicity.

The results demonstrate that fetuses exhibiting renal hyperechogenicity in pathological pregnancies require particularly careful obstetric control and neonatological consultation. It is important that hyperechogenic cases be admitted to a perinatal intensive care unit. Fetal renal hyperechogenicity is considered to be associated with an enhanced risk of adverse perinatal outcome.