PFM.67 Can fetal renal artery Dopplers predict perinatal outcome in fetal growth restriction?

Abstract

Severe intra-uterine growth restriction (IUGR) is significantly associated with intra-uterine and perinatal morbidity and mortality. There are no reliable screening tools and currently, monitoring is with Doppler ultrasound after the diagnosis has been made. The vessels interrogated to decide optimal timing of delivery include the umbilical artery and middle cerebral artery, and ductus venosus which have significant limitations as predictive tools for perinatal outcome. Changes in fetal renal artery Dopplers may accurately reflect renal function which is vital to fetal wellbeing and amniotic fluid production. Fetal renal artery Dopplers may therefore be an important intermediary to screen for and predict fetal compromise prior to changes in other fetal blood vessels. A Doppler blood flow examination is an integral part of the routine second trimester check to demonstrate fetal kidneys. This was extended to include measurements in the IUGR clinic in pregnancies prior to 23 completed weeks gestation. Correlation was sought with perinatal outcome measures including birth weight, Apgar scores, cord gases, requirement for resuscitation and NICU admission and comparisons against local normative charts. The results are presented Conclusion Potential was demonstrated for clinical use. Further research is needed.

Comparative evaluation of fetal renal artery hemodynamics in normohydramnios, idiopathic oligohydramnios and polyhydramnios in third trimester pregnancy

“…We found limited studies evaluating renal Doppler indices predicting neonatal ICU admissions. One similar study conducted showed potential correlation between RA indices and perinatal outcome [27]. Another study showed early detection of hypoxic fetuses using RA hemodynamics in patients with gestational diabetes mellitus [28].…”