Fetal renal artery flow and renal echogenicity in the chronically hypoxic state |
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Authors: | A Surányi K Streitman A Pál T Nyári C Retz J M Foidart J P Schaaps L Kovács |
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Institution: | 1. Department of Pediatrics, Albert Szent-Gy?rgyi Medical University, Korányi f. 14–16, 6725 Szeged, Hungary e-mail:SURANYI@pedia.szote.u-szeged.hu Tel.: +36-62-310565, Fax: +36-62-544559, Hungary 2. Department of Obstetrics and Gynecology, Albert Szent-Gy?rgyi Medical University, Szeged, Hungary, Hungary 3. Department of Medical Informatics, Albert Szent-Gy?rgyi Medical University, Szeged, Hungary, Hungary 4. Department of Obstetrics and Gynecology, University of Liége, C.H.R. de la Citadelle, Liége, Belgium, Belgium
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Abstract: | The object of this study was to investigate the fetal renal arterial blood flow in normal and hyperechogenic kidneys during
the third trimester of gestation. The pregnancies screened were all chronically hypoxic. Depending on the etiology of the
intrauterine chronic hypoxia, the cases were divided into two study groups. Group I comprised 120 pregnant women with pregnancy-associated
hypertension and/or proteinuria. Group II consisted of 87 pregnancies with intrauterine growth retardation. Both study groups
included pregnant women from the third trimester. Hyperechogenic renal medullae were detected in 15 out of 120 cases with
pregnancy-associated hypertension and/or proteinuria, and in 22 fetuses of the 87 pregnancies involving intrauterine growth
retardation. Fetal renal hyperechogenicity appears to be an indicator of fetal arterial circulatory depression, correlated
with pathological changes in the resistance index for the fetal renal arteries. The fetal renal arterial blood flow resistance
index was significantly lower in hyperechogenic cases. This may also be an in utero indication of subsequent intrauterine
and neonatal complications, such as cesarean section because of fetal distress (43%), treatment in a neonatal intensive care
unit (51%) or increased perinatal mortality (5.4%, as compared with 0.8–1.0% in the normal population). Detailed ultrasound
and Doppler examinations of renal parenchyma and arteries appear to be useful methods in the prenatal diagnosis of reduced
renal perfusion and of intrauterine hypoxia to detect possible pathological fetal conditions in utero.
Received: 2 September 1998 / Revised: 5 May 1999 / Accepted: 7 May 1999 |
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Keywords: | Fetus Renal hyperechogenicity Renal artery Ultrasound Vascular resistance |
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