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. Design: 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. Copyright (C) 2003 S. Karger AG, Basel.