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Oligohydramnios Doppler

Dawn S Hughes, Everett F Magann
The evaluation of amniotic fluid volume (AFV) is an established part of the antenatal surveillance of pregnancies at risk for an adverse pregnancy outcome. The two most commonly used ultrasound techniques to estimate AFV are the amniotic fluid index (AFI) and the single deepest pocket (SDP). Four studies have defined normal AFVs, and although their normal volumes have similarities, there are also differences primarily due to the statistical methodology used in each study. Dye-determined AFV correlates with ultrasound estimates for normal fluid volumes but correlates poorly for oligohydramnios and polyhydramnios...
September 16, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Rana Choudhary, Kavita Desai, Hetal Parekh, Kedar Ganla
Fetal growth restriction (FGR) and preeclampsia are the major causes of neonatal morbidity and mortality, which affect up to 8% of all pregnancies. The pathogenesis in FGR is an abnormal trophoblastic invasion leading to compromised uteroplacental circulation. However, in spite of this understanding and identification of high-risk patients, the management options are limited. There are some new studies which have demonstrated the role of sildenafil citrate in improving vasodilatation of small myometrial vessels and therefore improvement in amniotic fluid index, fetal weight, and even uterine and umbilical artery Doppler patterns...
2016: International Journal of Women's Health
Jerzy Stanek, Jacek Biesiada
This study aims to determine whether placental examination can be used to distinguish between pathologic fetal growth restriction (FGR) and constitutional fetal smallness. Data were extracted from a clinicoplacental database of high risk pregnancies during the period 1994-2013. These data were used to compare the 590 consecutive cases having birth weights below the 10th percentile with the 5201 remaining cases having gestational ages ≥20 weeks. The authors analyzed 20 clinical and 46 placental phenotypes using classical statistics, clustering analysis, and multidimensional scaling...
June 2016: Placenta
Mehmet Ozgur Akkurt, Iltac Akkurt, Metin Altay, Bora Coşkun, Salim Erkaya, Mekin Sezik
OBJECTIVE: To compare maternal ferritin levels across pregnancies with fetal growth restriction including SGA and IUGR compared to appropriate for gestational age (AGA). METHODS: Three groups were enrolled: AGA, SGA (birth weight below 10 th percentile for gestational age with no placental insufficiency findings), and IUGR (birth weight below 5th percentile for gestational age accompanied by abnormal umbilical artery Doppler waveforms and/or oligohydramnios). Maternal serum ferritin samples were obtained at gestational weeks 34 through 36, and delivery occurred at or beyond 36 weeks...
April 6, 2016: Journal of Maternal-fetal & Neonatal Medicine
Jerzy Stanek
To assess the usefulness and limitations of placental histology when morphological umbilical cord (UC) abnormality coexists with clinical UC compromise, 5634 consecutive placentas were divided into four groups and statistically compared: group 1-182 placentas from pregnancies with clinical features of UC compromise (variable decelerations, UC entanglement, prolapse, or true knot at delivery); group 2-1355 placentas with abnormal UC morphology or insertion; group 3-152 placentas with at least one phenotype from group 1 and one from group 2; group 4-3945 placentas with no clinical or morphological UC-related phenotypes (control group)...
June 2016: Virchows Archiv: An International Journal of Pathology
Sean Carter, Abhijit Dixit, Andrew Lunn, Anjum Deorukhkar, Martin Christian
A case is presented of a neonate born at 32 weeks of gestation with intra-uterine growth retardation. The renal scan performed at 31 weeks showed oligohydramnios but normal kidneys. The neonate was oliguric from birth and required early peritoneal dialysis. Her urine showed heavy proteinuria, and the plasma albumin was very low. Post-natal ultrasonography showed large bright kidneys with reduced corticomedullary differentiation but no dysplastia; arterial and venous flow was normal on Doppler ultrasound. The quiz discusses the differential diagnosis with particular reference to whether this picture represents acute kidney injury with expected improvement or chronic kidney disease...
February 18, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Bettina Paek, Melissa Dorn, Martin Walker
BACKGROUND: The diagnosis of twin-to-twin transfusion syndrome (TTTS) usually relies the presence of polyhydramnios in one sac with concomitant oligohydramnios in the other sac in a monochorionic diamniotic twin pregnancy. However, TTTS does not always show a linear progression and may present with cardiac compromise or critically abnormal Doppler velocimetry in either fetus before fluid measurements meet the typically used cutoff. OBJECTIVE: The aim of this study was to investigate the prevalence of atypical presentations of TTTS in a population undergoing laser fetoscopy...
July 2016: American Journal of Obstetrics and Gynecology
Oya Demirci, Selçuk Selçuk, Pınar Kumru, Mehmet Reşit Asoğlu, Didar Mahmutoğlu, Barış Boza, Gürcan Türkyılmaz, Zafer Bütün, Resul Arısoy, Bülent Tandoğan
OBJECTIVE: To determine the factors which affect the perinatal deaths in early and late fetal growth restriction (FGR) fetuses using threshold of estimated fetal weight (EFW) < 5(th) percentile. MATERIALS AND METHODS: This retrospective study included singleton 271 FGR fetuses, defined as an EFW < 5(th) percentile. All fetuses considered as growth restrictions were confirmed by birth weight. Fetuses with multiple pregnancy, congenital malformation, chromosomal abnormality, and premature rupture of membrane were excluded...
December 2015: Taiwanese Journal of Obstetrics & Gynecology
Keisuke Ishii, Masahiko Nakata, Seiji Wada, Takeshi Murakoshi, Haruhiko Sago
AIM: This study aimed to clarify the feasibility and perinatal outcomes of fetoscopic laser photocoagulation (FLP) for monochorionic twin gestation with selective intrauterine growth restriction (sIUGR) accompanied by both abnormal umbilical artery Doppler waveforms and isolated severe oligohydramnios of the sIUGR twin. METHODS: In this prospective clinical trial, which included 10 cases with absent or reversed end-diastolic flow in the umbilical artery and severe oligohydramnios of the sIUGR twin, the main outcomes investigated were the feasibility of FLP and the rate of severe FLP-related maternal complications...
November 2015: Journal of Obstetrics and Gynaecology Research
Siobhan Corcoran, Fionnuala Breathnach, Gerard Burke, Fionnuala McAuliffe, Michael Geary, Sean Daly, John Higgins, Alyson Hunter, John J Morrison, Shane Higgins, Rhona Mahony, Patrick Dicker, Elizabeth Tully, Fergal D Malone
OBJECTIVE: A 2-week ultrasound scanning schedule for monochorionic twins is endorsed widely. There is a lack of robust data to inform a schedule for the surveillance of dichorionic gestations. We aimed to determine how ultrasound scanning that is performed at 2- or 4-week intervals (or every 4 weeks before 32 weeks' gestation and every 2 weeks thereafter) may impact the prenatal detection of fetal growth restriction (FGR) and ultimately influence timing of delivery. STUDY DESIGN: In a consecutive cohort of 789 dichorionic twin pregnancies that were recruited prospectively for the multicenter Evaluation of Sonographic Predictors of Restricted Growth in Twins study, ultrasound determination of fetal growth and interrogation of umbilical and middle cerebral artery Doppler scans were performed every 2 weeks from 24 weeks' gestation until delivery...
October 2015: American Journal of Obstetrics and Gynecology
M Griffin, P T Seed, L Webster, J Myers, L MacKillop, N Simpson, D Anumba, A Khalil, M Denbow, A Sau, K Hinshaw, P von Dadelszen, S Benton, J Girling, C W G Redman, L C Chappell, A H Shennan
OBJECTIVES: To assess the diagnostic accuracy of placental growth factor (PlGF) and ultrasound parameters to predict delivery of a small-for-gestational-age (SGA) infant in women presenting with reduced symphysis-fundus height (SFH). METHODS: This was a multicenter prospective observational study recruiting 601 women with a singleton pregnancy and reduced SFH between 24 and 37 weeks' gestation across 11 sites in the UK and Canada. Plasma PlGF concentration < 5(th) centile, estimated fetal weight (EFW) < 10(th) centile, umbilical artery Doppler pulsatility index > 95(th) centile and oligohydramnios (amniotic fluid index < 5 cm) were compared as predictors for a SGA infant < 3(rd) customized birth-weight centile and adverse perinatal outcome...
August 2015: Ultrasound in Obstetrics & Gynecology
Cara Pessel, Audrey Merriam, Kavita Vani, Sara G Brubaker, Noelia Zork, Yuan Zhang, Lynn L Simpson, Cynthia Gyamfi-Bannerman, Russell Miller
OBJECTIVES: To determine whether isolated abnormal Doppler indices before 28 weeks predict adverse pregnancy outcomes in uncomplicated monochorionic diamniotic (MCDA) twins. METHODS: A retrospective cohort study of MCDA twin pregnancies receiving antenatal testing at a single center between 2007 and 2013 was conducted. Sonographic surveillance, including Doppler velocimetric studies of the umbilical artery, ductus venosus, and middle cerebral artery of each twin, was initiated by 28 weeks and repeated at least every 2 weeks...
April 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Nilgün Benzer, Aybike Tazegül Pekin, Setenay Arzu Yılmaz, Özlem Seçilmiş Kerimoğlu, Nasuh Utku Doğan, Çetin Çelik
AIM: Intermittent assessment of renal artery flow velocity waveforms during the early stages of pregnancy may help in predicting changes in amniotic fluid dynamics. The current study sought to determine the relation of renal artery and umbilical artery flow velocity waveforms with normal pregnancies and pregnancies complicated by either polyhydramnios or oligohydramnios. MATERIAL AND METHODS: Renal and umbilical artery Doppler values were evaluated at 22, 28 and 34 weeks' gestation in 300 low-risk pregnant women with singleton pregnancies...
April 2015: Journal of Obstetrics and Gynaecology Research
Gustavo Romero-Gutiérrez, José Herrera-Coria, Armando Saúl Ruiz-Treviño
BACKGROUND: Oligohydramnios is sometimes associated with poor perinatal outcome. Our aim was to determine the association of Doppler flowmetry with perinatal outcome in patients with oligohydramnios. METHODS: We carried out a prospective cross-sectional study that included 130 patients with pregnancy between 30 to 41 weeks of gestation; we compared the measurement of the resistance index in the umbilical artery by Doppler flowmetry and the measurement of amniotic fluid in patients with oligohydramnios...
September 2014: Revista Médica del Instituto Mexicano del Seguro Social
Suphang Chawengsettakul, Kusol Russameecharoen, Prapat Wanitpongpan
AIM: The aim of this study was to demonstrate the changes of right and left myocardial performance indices (MPI) in small-for-gestational age (SGA) fetuses during 28-40 weeks of gestation. MATERIAL AND METHODS: Singleton pregnant women during 28-40 weeks of gestation were enrolled. Estimated fetal weight was used to classify the subjects into appropriate-for-gestational age (AGA) and SGA groups. The Doppler indices of umbilical and middle cerebral arteries, including amniotic fluid index, were used to distinguish constitutional SGA (both normal Doppler indices and amniotic fluid index) from intrauterine growth restriction (IUGR) fetuses (abnormal Doppler indices and/or oligohydramnios)...
February 2015: Journal of Obstetrics and Gynaecology Research
Mj Griffin, Pt Seed, Lm Webster, H Tarft, Lc Chappell, Ah Shennan
: The SGA infant is at increased risk of short and long-term health complications. Identifying the SGA fetus remains challenging. Placental insufficiency contributes to pathogenesis and it has been proposed that markers of placental function such as PlGF may improve prediction. PELICAN FGR, a large multicentre, prospective observational study measuring PlGF in women with reduced symphysis fundal height (SFH), assessed the ability of PlGF and ultrasound parameters to predict delivery of an SGA infant. 592 women with singleton pregnancies and reduced SFH between 24-37 weeks' gestation across 11 sites in UK and Canada were analysed...
June 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
Richard M Benoit, Ahmet A Baschat
CLINICAL PROBLEM: Twin-to-twin transfusion syndrome (TTTS) increases perinatal morbidity and mortality for 10 to 15% of monochorionic (MC) gestations. PATHOPHYSIOLOGY: MC gestations are at risk due to the angioarchitecture of the shared placenta, with anastomoses of varying type, size, and quantity. TTTS results from progression of a chronic perfusion imbalance across unbalanced placental anastomoses, typically arising between 15 and 26 weeks gestation. The resulting abnormal fetal blood volume levels and compensatory physiological responses lead to an increased risk for fetal death, end-organ damage, and preterm birth...
August 2014: American Journal of Perinatology
Kerem D Seckin, Mahmut I Yeral, Mehmet F Karslı, Ismail B Gultekin
OBJECTIVE: To investigate the effects of long-lasting maternal fasting on fetal biometry, amniotic fluid volume, fetal Doppler parameters, and neonatal outcomes. METHODS: The present study, conducted at Solhan State Hospital, Bingol, Turkey, between July and August 2013 recruited 82 healthy and otherwise normal pregnant women with a gestational age of 29 weeks or more who were fasting for at least 20 days. The control group comprised 87 healthy non-fasting women matched for maternal age, parity, gestational age...
August 2014: International Journal of Gynaecology and Obstetrics
Kari M Horowitz, Deborah Feldman
INTRODUCTION: Fetal growth restriction is associated with intrauterine fetal demise, neonatal morbidity, and death. Late-term delivery is optimal for isolated fetal growth restriction without other risk factors. Fetal growth restriction alone is not an indication for cesarean delivery unless there is a nonreassuring fetal heart rate tracing. These patients may undergo induction of labor. We sought to identify risk factors that may predict primary cesarean delivery for nonreassuring fetal heart rate tracing in cases of induction of labor for fetal growth restriction...
May 2014: Obstetrics and Gynecology
Ernesto Castelazo-Morales, Diana Elena Monzalbo-Núñez, Miguel de Jesus López-Rioja, Santiago Castelazo-Alatorre
Preeclampsia is a multi systemic syndrome of variable severity, pregnancy specific, consequence of an abnormal vascular response to placentation, with increase in peripheral vascular resistance, stimulation of platelet aggregation, activation of the coagulation cascade, and endothelial dysfunction. In the majority of cases, it will present with gestational hypertension and proteinuria, after 20 weeks, nevertheless, in other cases, it has presented as an atypical form (with absence of hypertension and/or proteinuria) behaving like severe preeclampsia...
January 2014: Ginecología y Obstetricia de México
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