Surányi Andrea, Nyári Tibor, Keresztúri Attila, Pál Attila
Szegedi Tudományegyetem, Szent-Györgyi Albert Orvos- es Gyógyszerésztudományi Centrum, Altalános Orvostudományi Kar, Szülészeti es Nogyógyászati Klinika, Szeged.
Orv Hetil. 2006 Oct 15;147(41):1997-2002.
The object of this study was to investigate the fetal renal and middle cerebral arterial blood flows in patients with normal and hyperechogenic kidneys during the fetal period.
Study group consisted of 82 pregnancies with intrauterine growth retardation. Group included pregnant women from the third trimester. Hyperechogenic medullae were detected in 17 out of 82 pregnancies with intrauterine growth retardation.
Fetal renal hyperechogenicity appears to be an indicator of fetal arterial circulatory depression, correlated with pathological changes in the pulsatility index for the fetal renal arteries. The fetal renal arterial blood flow pulsatility index was significantly lower in hyperechogenic cases, while in the middle cerebral artery flow was in the normal range. This may also be an indication of subsequent intrauterine and neonatal complications, such as cesarean section because of fetal distress (47%), treatment in a neonatal intensive care unit (71%) or increased perinatal mortality (12%) in our cases.
Detailed ultrasound of renal parenchyma and Doppler examination of renal and middle cerebral arteries appear to be an useful method in the prenatal diagnosis of reduced renal perfusion and of intrauterine hypoxia so as to detect possible pathological fetal conditions in utero.
本研究的目的是调查胎儿期肾脏正常和回声增强的患者的胎儿肾和大脑中动脉血流情况。
研究组包括82例宫内生长受限的孕妇。该组包括孕晚期的孕妇。在82例宫内生长受限的孕妇中，有17例检测到髓质回声增强。
胎儿肾回声增强似乎是胎儿动脉循环抑制的一个指标，与胎儿肾动脉搏动指数的病理变化相关。回声增强病例中胎儿肾动脉血流搏动指数显著降低，而大脑中动脉血流在正常范围内。这也可能预示着随后的宫内和新生儿并发症，如因胎儿窘迫而行剖宫产（47%）、在新生儿重症监护病房接受治疗（71%）或在我们的病例中围产期死亡率增加（12%）。
肾脏实质的详细超声检查以及肾动脉和大脑中动脉的多普勒检查似乎是产前诊断肾灌注减少和宫内缺氧的有用方法，以便在子宫内检测可能的胎儿病理状况。
