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Fetal renal pulsed Doppler waveform in prolonged pregnancies
J C Veille1, M Penry, E Mueller-Heubach
1Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157.
Objective:
Our purpose was to determine Doppler waveforms of the fetal human renal artery in prolonged pregnancy in the presence or absence of oligohydramnios.
Study Design:
Fifty patients at or after 40 weeks were studied. Ultrasonography was performed to determine the amniotic fluid index by the four-quadrants technique. Two groups of patients were obtained on the basis of the amniotic fluid index. Group 1 had an amniotic fluid index > 5 (normal) (n = 33); group 2 had amniotic fluid index < or = 5 (oligohydramnios) (n = 17). Umbilical artery and fetal renal pulsed Doppler waveforms were determined and analyzed. The fetal renal artery systolic-to-diastolic ratio of the two groups was compared.
Results:
Fetuses with a low amniotic fluid index had a significantly higher ratio. A significant negative correlation coefficient between amniotic fluid index and fetal renal systolic/diastolic ratio was found (r = -0.435 and p < 0.01).
Conclusions:
In prolonged pregnancies there is a significant relationship between the amniotic fluid index and the fetal renal systolic/diastolic ratio. In pregnancies associated with oligohydramnios the systolic/diastolic ratio is significantly higher than in those with normal amniotic fluid volume. These data suggest that intrarenal flow in prolonged pregnancies complicated with oligohydramnios is significantly different.