The changes in Doppler indices of fetal ductus venosus and umbilical artery after amnioinfusion for women with preterm premature rupture of membranes before 26 weeks' gestation.
OBJECTIVE
To investigate the changes in Doppler indices of the fetal ductus venosus (DV) and umbilical artery (UMA) after amnioinfusion in pregnant women with preterm premature rupture of membranes (pPROM). Pregnancies with pPROM and severe oligohydramnios cause sequelae in newborns and mothers.


METHODS
This cross-sectional study included a group of 25 patients with pPROM before 26 weeks' gestation. Color Doppler imaging was used to measure the impedance index and quantitative blood flow in the DV and systolic/diastolic ratio (S/D) of the UMA before and 30 minutes after the end of amnioinfusion. The following velocity parameters were measured: (1) DV peak systolic velocity; (2) DV time-averaged velocity; (3) DV maximum forward velocity during atrial contraction; (4) DV S/D; (5) DV pulsatility index (PI); (6) DV Pourcelots resistance index (RI); (7) fetal heart rate; and (8) UMA S/D.


RESULTS
Twenty-one of the 25 patients underwent a total of 27 amnioinfusions. The mean PI and RI of the DV, and S/D of the DV and UMA decreased significantly after amnioinfusion (PI, 0.75 +/- 0.24 vs. 0.60 +/- 0.18, p = 0.009; RI, 0.60 +/- 0.15 vs. 0.50 +/- 0.13; DV S/D, 3.07 +/- 1.81 vs. 2.13 +/- 0.66, p = 0.008; UMA S/D, 3.58 +/- 0.87 vs. 2.88 +/- 0.62, p = 0.001).


CONCLUSIONS
Amnioinfusion increases the space for the fetuses and reduces the impedance of the fetoplacental circulation. Improvements in DV and UMA flow may benefit fetuses suffering severe oligohydramnios in mid-pregnancy.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
Te-Yao
TY
Hsu
Jenn-Jeih
JJ
Hsu
Hung-Chun
HC
Fu
Chia-Yu
CY
Ou
Chih-Chang
CC
Tsai
Bi-Hua
BH
Cheng
Fu-Min
FM
Fang
Hui-Fen
HF
Kao
Chun-Yuh
CY
Yang
Wen Lin
WL
Tsai
Chuen Chu
CC
Sung
Men-Yi
MY
Tsai
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D003430:Cross-Sectional Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D016104:Oligohydramnios / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011247:Pregnancy; D011673:Pulsatile Flow; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000502:physiology; D014471:Umbilical Veins / Q000000981:diagnostic imaging* / Q000502:physiology; D055815:Young Adult