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Umbilical arterial flow change during hemodialysis
Y Nakai1, J Nishio, S Nishimura
1Department of Obstetrics and Gynecology, School of Medicine, Osaka City University, Japan.
Journal of Perinatal Medicine
|May 22, 1998
Summary
Frequent hemodialysis during pregnancy maintained normal fetal growth. Umbilical artery resistance index changes during treatment suggest transient maternal hypovolemia, requiring further investigation in high-risk pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Nephrology
- Maternal-Fetal Medicine
Background:
- Hemodialysis in pregnancy presents unique challenges for maternal and fetal well-being.
- Maintaining adequate fetal growth and amniotic fluid volume is crucial during gestation.
Observation:
- A pregnant patient underwent hemodialysis thrice weekly from early gestation, with increased frequency to six times weekly at 30 weeks.
- Fetal growth and amniotic fluid volume remained normal throughout the pregnancy.
- Umbilical artery Doppler flow velocimetry showed a transient decrease in resistance index after 1.5 hours of hemodialysis, recovering by 3 hours.
Findings:
- The study observed a temporary reduction in umbilical artery resistance index during hemodialysis sessions.
- This physiological change is hypothesized to be a consequence of transient maternal hypovolemia.
- Despite these transient changes, the pregnancy resulted in a healthy neonate.
Implications:
- This case highlights the importance of careful monitoring of fetal well-being in pregnant patients undergoing hemodialysis.
- Understanding hemodynamic changes during treatment can inform clinical management strategies.
- Further research is needed to fully elucidate the effects of hemodialysis on feto-maternal circulation.