Department of Obstetrics and Gynecology, Clinics Hospital, University of São Paulo, São Paulo, Brazil.
Statistician at the Department of Obstetrics and Gynecology, Clinics Hospital, University of São Paulo, São Paulo, Brazil.
Prenat Diagn. 2017 Aug;37(8):837-842. doi: 10.1002/pd.5099. Epub 2017 Jul 19.
To identify the correlation between the renal vascularization index (VI), the flow index (FI) and the vascularization and flow index (VFI) and placental and fetal hemodynamics in fetuses with growth restriction.
Bidimensional ultrasound and three-dimensional power Doppler with the VOCAL technique were used to determine the renal vascular indexes and fetal and placental hemodynamics in fetuses below the 10th percentile for fetal weight. Partial correlation analysis (controlled for renal depth and gestational age) was performed. The fetuses were divided into four groups according to their hemodynamic picture, and renal indexes were compared between the groups.
Eighty-one fetuses were evaluated. VI, FI and VFI showed negative correlation with the ductus venosus pulsatility index. VI and VFI showed positive correlations with the amniotic fluid index. The group of fetuses with the worst hemodynamic picture (abnormal umbilical artery, middle cerebral artery and ductus venosus pulsatility indexes) showed significantly lower VI and VFI than the group with no changes in these pulsatility indexes.
Renal vascularization indexes were inversely correlated with ductus venosus pulsatility indexes and were diminished in fetuses showing hemodynamic compromise. These changes might be related to postnatal renal impairment. © 2017 John Wiley & Sons, Ltd.
探讨胎儿生长受限（FGR）胎儿肾血管化指数（VI）、血流指数（FI）和血管化及血流指数（VFI）与胎盘及胎儿血流动力学之间的相关性。
采用二维超声及三维能量多普勒联合 VOCAL 技术检测胎儿体重低于第 10 百分位数的胎儿的肾血管指数及胎儿和胎盘血流动力学参数。进行偏相关分析（控制肾深度和孕龄）。根据血流动力学图像将胎儿分为四组，比较各组间的肾指数。
共 81 例胎儿进行了评估。VI、FI 和 VFI 与静脉导管搏动指数呈负相关。VI 和 VFI 与羊水指数呈正相关。血流动力学图像最差的胎儿组（脐动脉、大脑中动脉和静脉导管搏动指数异常）的 VI 和 VFI 明显低于这些搏动指数无变化的胎儿组。
肾血管化指数与静脉导管搏动指数呈负相关，在血流动力学受损的胎儿中降低。这些变化可能与出生后肾功能损害有关。© 2017 约翰威立父子公司
