Abnormal fetal Renal Artery Doppler. Is It an Early Marker of fetal hypoxemia? | ||
| Benha Journal of Applied Sciences | ||
| Article 12, Volume 7, Issue 8, August 2022, Pages 91-98 PDF (782.76 K) | ||
| Document Type: Original Research Papers | ||
| DOI: 10.21608/bjas.2022.270099 | ||
| Authors | ||
| M K.El Manshy; A M.Elewa; M F.El Sherbeiny; M A.EL Sayed | ||
| Obstetrics and Gynecology,Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||
| Abstract | ||
| Background: The fetus receives its oxygen supply across the placenta, to which oxygen is delivered by maternal blood. The amount of oxygen delivered to the placental site is determined by the magnitude of blood flow and the oxygen content of uterine arterial blood. Intrauterine hypoxia is a significant clinical challenge in obstetrics that affects both the pregnant mother and fetus. Intrauterine hypoxia can occur in pregnant women living at high altitude and/or with cardiovascular disease. Fetal renal arterial resistance index decreases moderately during the third trimester of pregnancy, possibly related to the increased blood flow of the renal circulation. The aim of this work is to study fetal Renal Artery Doppler in normal and high risk pregnancy. The validity of abnormal renal artery doppler in late weeks of pregnancy as a marker of fetal hypoxia will be assessed in relation to umblical artery and MCA doppler indices. Methods: This was randomized prospective observational study was conducted at the Obstetrics and Gynecology Department, Benha University Hospital including 120 women attending the antenatal care clinic with pregnancy of more than 34 weeks of gestation referred after acquiring all the necessary formalities as pre‐ conception & prenatal tests as high-risk pregnancy or for routine ANC. The duration of the study had been from 6 to 12 months. Results: Women’s complication in Uncomplicated Group show that 9(27.3%) with no complication, 4(12.1%) had Oligohydramnios and 20(60.6%) had Small for gestational age fetus while in Complicated Group 37(42.5%) with no complication, 34(39.1%) had high blood pressure and 16(18.4%) had Small for gestational age fetus. There was statistically significant differences between groups where P<0.001. Women’s Renal Artery PI in Uncomplicated Group was ranged between 1.60 – 2.05 with mean±S.D. 1.804±0.150 while in Complicated Group was ranged between 1.60 – 2.05 with mean±S.D. 1.836±0.125. There was no statistically significant differences between groups where P=0.279. Women’s Renal Artery Vmax in Uncomplicated Group was ranged between 5.54 – 8.54 with mean±S.D. 7.046±0.888 while in Complicated Group was ranged between 5.52 – 8.54 with mean±S.D. 7.100±0.901. There was no statistically significant differences between groups where P=0.770. Women’s UMA PH in Uncomplicated Group was ranged between 6.20-9.90 with mean±S.D. 7.885±1.239 while in Complicated Group was ranged between 6-9.90 with mean±S.D. 7.905±1.182. There was no statistically significant differences between groups where P=0.885. Women’s Fetal Outcome (Apgar score) in Uncomplicated Group was ranged between 5-10 with mean±S.D. 7.61±1.802 while in Complicated Group was ranged between 5-10 with mean±S.D. 7.49±1.718. There was no statistically significant differences between groups where P=0.745. Conclusion: Reduction in the percentage of cardiac output directed towards the kidneys in cases of fetal hypoxemia leads to increased fetal renal artery pulsatility index with decreased renal perfusion. This decreased renal perfusion could be responsible for impaired nephrogensis and decreased kidney volume in fetuses with intrauterine growth restriction. | ||
| Keywords | ||
| Abnormal fetal Renal Artery Doppler; Early Marker; fetal hypoxemia | ||
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