[Doppler ultrasound findings in hemodilution with hydroxyethyl starch in intrauterine fetal retardation].
The surveillance of IUGR is one of the main indications of Doppler ultrasound for use in obstetrics. The volume replacement with hydroxyethyl starch is an effective therapy against plasma volume contraction diagnosed by an increase of hematocrit above 38%, which is often combined with IUGR. 48 patients with those problems were treated with middle molecular hydroxyethyl starch for at least 10 days. Doppler ultrasound was used before, within and after therapy. 39 of 48 patients (81%) showed pathological Doppler results in at least one of the examined vessels (uterine artery, umbilical artery, fetal aorta and middle cerebral artery). There is a correlation between normalisation of Doppler results, decrease of hematocrit and increase of the fetal growth indicated by ultrasound or birth weight, respectively. This therapy seems to be useful if it starts between 28th and 34th week of pregnancy; if we find at most two vessels with pathological Doppler results; and if there is an improvement of the Doppler results within therapy. A poor effect is to be expected if therapy begins after 36 weeks of pregnancy, if no change in pathological Doppler results can be found, if fetal vessels show pathological Doppler results and if there is a "notching" in the uterine artery. The group of patients with intrauterine growth retardation can be specified by Doppler ultrasound, which may profit from volume replacement. Doppler examinations are helpful to fetal surveillance within this therapy.
Hübner
F
F
Frauenklinik, Stadtkrankenhaus Worms.
Sander
C
C
D000328:Adult; D001724:Birth Weight / Q000187:drug effects; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000628:therapy*; D005333:Fetus / Q000098:blood supply; D005865:Gestational Age; D006400:Hematocrit; D006438:Hemodilution; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange / Q000187:drug effects* / Q000502:physiology; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000628:therapy; D011247:Pregnancy; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal
D006895:Hydroxyethyl Starch Derivatives