Uterine Artery Doppler Velocimetry in Patients with Idiopathic Hydramnios

Abstract

Objective: To evaluate the role of overdistended uterus on the uterine artery (UA) blood flow velocimetry by comparing UA Doppler in patients with idiopathic hydramnios to patients with normal amniotic fluid (AF) volume. Methods: Pulsatility index (PI) of both UAs was determined prospectively between 26 and 41 weeks of gestation in 72 consecutive pregnant women with singleton pregnancies and idiopathic hydramnios and in 72 pregnant women with normal AF volume. Hydramnios was defined as an AF index (AFI) above 24 cm. A normal amount of AF was defined as an AFI of 6–24 cm. Patients with known fetal structural or chromosomal anomalies and those with diabetes mellitus were excluded. Results: No significant differences were observed between the groups with regard to maternal age, gravidity, and gestational age at examination. Gestational age at delivery and accordingly birth weight were significantly lower in patients with hydramnios compared to those with a normal AFI (34.9 ± 2.1 vs. 39.1 ± 1.2, p < 0.001; 2,508 ± 399 vs. 2,995 ± 420, p < 0.001, respectively). No significant differences were noted between right UA PI (0.73 ± 0.3 in the hydramnios group vs. 0.71 ± 0.2 in the control group; p = 0.091) and left UA PI (0.91 ± 0.3 in the hydramnios group vs. 0.84 ± 0.3 in the control group; p = 0.131) of both groups. Conclusion: UA velocimetry in patients with idiopathic hydramnios was not significantly different from those with a normal AF volume.

Clinical Relevance of Sonographically Estimated Amniotic Fluid Volume: Polyhydramnios

“…69 However, there does not appear to be a substantial effect of polyhydramnios on maternal uterine blood flow. In a study by Hershkovitz et al, 70 uterine artery Doppler velocimetric findings in patients with idiopathic hydramnios, defined in their study as patients with an AFI greater than 24 cm and without known fetal structural or chromosomal anomalies or diabetes, was not significantly different from those with a normal AFV, defined as an AFI between 6 and 24 cm. Doppler velocity studies such as umbilical artery Doppler are often used as a reflection of uteroplacental blood flow and resistance within the placenta as part of antepartum surveillance in the setting of IUGR.…”

Clinical Relevance of Sonographically Estimated Amniotic Fluid Volume

“…However, there does not appear to be a substantial effect of polyhydramnios on maternal uterine blood flow. In a study by Hershkovitz et al, 70 uterine artery Doppler velocimetric findings in patients with idiopathic hydramnios, defined in their study as patients with an AFI greater than 24 cm and without known fetal structural or chromosomal anomalies or diabetes, was not significantly different from those with a normal AFV, defined as an AFI between 6 and 24 cm. Doppler velocity studies such as umbilical artery Doppler are often used as a reflection of uteroplacental blood flow and resistance within the placenta as part of antepartum surveillance in the setting of IUGR.…”

Idiopathic polyhydramnios and pregnancy outcome: systematic review and meta‐analysis

“…This is a possible etiology for the increased risk of fetal demise in these pregnancies. However, in a study of umbilical artery Doppler flow, Hershkovitz et al 32 . found no difference between patients with polyhydramnios and those with normal AFV.…”

“…This is a possible etiology for the increased risk of fetal demise in these pregnancies. However, in a study of umbilical artery Doppler flow, Hershkovitz et al 32 found no difference between patients with polyhydramnios and those with normal AFV. Until further studies are performed, antenatal fetal surveillance could be considered to assess fetal wellbeing in pregnancies complicated by idiopathic polyhydramnios, but should be evaluated on an individual basis and with counseling and shared decision-making between provider and patient.…”