Prenatal diagnosis of the hemodynamics of fetal renal disease by color Doppler ultrasound.
OBJECTIVE
Hemodynamic analysis of the fetal renal artery elucidated the function of the renal glomerulus and renal tubule in normal growth fetus and was weighed against fetal renal disease.


METHODS
The subjects were fetuses from pregnant women who gave informed consent. There were 6 cases of polycystic kidney, 4 cases of hydronephrosis and 33 cases of fetuses presenting with normal growth. A longitudinal study was performed for normal growth fetuses. Using maximum systolic velocity (V(max)), pulsatility index (PI) and resistance index (RI), the blood flow was measured initially at 20-24 weeks of pregnancy and every 4 weeks thereafter. The measurement was performed 5 times in total. Also, for fetal renal disease, the measurement was performed using the same indexes.


RESULTS
In 2 cases of polycystic kidney, which led to death due to postpartum afunctional kidney, V(max) indicated the lower level of less than mean -1.5 SD. In 1 case of single hydronephrosis, the single afunctional kidney was observed postpartum due to blood flow disruption. In 7 cases of normal renal function after birth, it indicated the lower level in some gestational ages but was generally in the normal range.


CONCLUSIONS
Using indexes to evaluate the glomerulus and renal tubule of fetal renal disease, mean -1.5 SD of V(max) can be considered to be the lower limit in the normal range and expected to be an important factor for the final outcome.
Iura
T
T
Department of Obstetrics and Gynecology, Kanazawa Medical University, Uchinada, Ishikawa, Japan. popiura@kanazawa-med.ac.jp
Makinoda
S
S
Miyazaki
S
S
Fujita
S
S
Inoue
H
H
Hirosaki
N
N
Imafuku
N
N
D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000151:congenital* / Q000000981:diagnostic imaging*; D008297:Male; D007690:Polycystic Kidney Diseases / Q000000981:diagnostic imaging; D011247:Pregnancy; D012077:Renal Artery / Q000000981:diagnostic imaging; D012079:Renal Circulation; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods*