Ultrasonographic study and Doppler flow velocimetry of maternal kidneys and liver in low-risk pregnancy

Abstract

ObjectiveLongitudinal study with B-mode ultrasonography and Doppler ultrasonography of maternal kidneys and liver in low-risk pregnancy, to establish and quantify normality parameters, correlating them with physiological changes.Materials and MethodsTwenty-five pregnant women were assessed and selected to participate in the study, each of them undergoing four examinations at the first, second, third trimesters and postpartum.ResultsFindings during pregnancy were the following: increased renal volume, pyelocaliceal dilatation with incidence of 45.4% in the right kidney, and 9% in the left kidney; nephrolithiasis, 18.1% in the right kidney, 13.6% in the left kidney. With pyelocaliceal dilatation, mean values for resistivity index were: 0.68 for renal arteries; 0.66 for segmental arteries; 0.64 for interlobar arteries; 0.64 for arcuate arteries. Without pyelocaliceal dilatation, 0.67 for renal arteries; 0.64 for segmental arteries; 0.63 for interlobar arteries; and 0.61 for arcuate arteries. Portal vein flow velocities presented higher values in pregnancy, with mean value for maximum velocity of 28.9 cm/s, and 22.6 cm/s postpartum. The waveform pattern of the right hepatic vein presented changes persisting in the postpartum period in 31.8% of the patients. Cholelithiasis was observed in 18.1% of the patients.ConclusionAlterations in renal volume, pyelocaliceal dilatation, nephrolithiasis, cholelithiasis, changes in portal vein flow velocity, alterations in waveform pattern of the right hepatic vein, proved to be significant.

Sonographic Evaluation of Renal Dimensions and Volume in Normal Pregnancy in Bayelsa State, South-South, Nigeria

“…This increase in our study was however, not statistically significant (p > 0.05). This agrees with the findings from previous studies, where there was no statistical correlation between renal dimensions and increase in parity [2,6,11,12]. The reason for this is that the renal volume and dimensions return to normal after every pregnancy, and there is therefore, no additional increase in the size of the kidneys in subsequent pregnancies.…”

“…In this study, the renal volume and dimensions increased as parity increased. Various studies are in tandem with this finding [2,6,11,12]. This increase in our study was however, not statistically significant (p > 0.05).…”

Maternal Physiologic Renal Pelvis Dilatation in Pregnancy

“…More recently, in 1998, Faúndes et al 8 identified third‐trimester calyceal dilatation of greater than 5 mm in 53% of right and 20% of left kidneys, whereas Graif et al 11 identified “pyelectasis” of one or both kidneys of greater than 5 mm in 91 of 230 women (40%). A recent report by Daher et al 12 assessed multiple renal parameters in a small population of 25 women and reported a maximum calyceal measurement of greater than 5 mm in 45.4% on the right and 9.0% on the left. Anecdotally, the high incidence of dilatation in early reports may have been used to dismiss renal dilatation in symptomatic women as being physiologic.…”

Management of pregnancy in women with cirrhosis

“…Portal‐vein flow usually increases during pregnancy, although the impact of pregnancy on TIPSS function is unknown 21 . In women with previous TIPSS, regular (frequency unclear) ultrasound monitoring of the shunt during pregnancy is recommended.…”

“…Portal-vein flow usually increases during pregnancy, although the impact of pregnancy on TIPSS function is unknown. 21 In women with previous TIPSS, regular (frequency unclear) ultrasound monitoring of the shunt during pregnancy is recommended. A few case reports have described ongoing TIPSS patency during pregnancy, with possible increased flow velocity in the portal vein, stent and hepatic artery.…”