[Fetal enlarged flaccid intestinal loops and pathologic Doppler findings--criteria for fetal distress].

In pregnancies with signs of placental insufficiency relatively often flaccid and enlarged intestinal convolutions were detected, which differed markedly from hyperperistaltically distended convolutions as in the case of bowel obstructions. In order to show a correlation between placental insufficiency i.e. a deficiency in supply--and the typical flaccid bowels, we performed a prospective study on 258 pregnant women with placental insufficiency and a control group of 151 normal pregnancies. The examinations were performed with a color duplex system. As criterium we registered detection of flaccid bowel convolutions-characterized by rich echoes-which could be well distinguished from the bowel which appears as homogeneous. It could also be well differentiated from the mostly echo-free aspect of obstructed bowels, associated by hyperperistaltics. Flaccid and enlarged bowel convolutions were found in 67 patients in the collective with placental insufficiency (26%) and in 8 patients in the control group (5%). In all fetuses the aorta as well as the carotic artery were examined by Doppler sonography. In the group with placental insufficiency markedly increased values were noted from the resistance index (RI) in the aorta as compared to the controls. The values in the carotis, however, were lower. This must be considered as a sign for a higher degree of centralization in these fetuses with supply deficiency. In those fetuses with enlarged bowel convolutions the doppler parameters were even more pathologic. Their post partal condition was also clearly worse. In 28 fetuses of this group in almost all cases no diastolic flow could be detected in the arteria mesenterica superior, whereas such a flow was found in all other cases.(ABSTRACT TRUNCATED AT 250 WORDS)