Fetal renal artery impedance in pregnancies affected by preeclampsia

Ma’ayeh, Marwan; Krishnan, Vidhya; Gee, Stephen E.; Russo, Jessica; Shellhaas, Cynthia; Rood, Kara M.

doi:10.1515/jpm-2020-0024

Cited by 9 publications

(12 citation statements)

References 20 publications

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“…Physiologically, fetal renal arteries are high-resistance vessels. After birth, there is a rapid decrease in their resistance, with a simultaneous increase in blood flow through the kidneys [ 74 ]. Moreover, the glomerular filtration rate in the fetal kidneys begins to increase rapidly from 34 weeks of gestation [ 75 ].…”

Section: Consequences For Offspringmentioning

confidence: 99%

“…Moreover, the glomerular filtration rate in the fetal kidneys begins to increase rapidly from 34 weeks of gestation [ 75 ]. It is associated with an increase in urinary flow rate in the fetus [ 74 ]. During early renal development, the renin-angiotensin system is upregulated, which leads to the vasoconstriction of the renal arteries [ 76 ].…”

Section: Consequences For Offspringmentioning

confidence: 99%

“…There is also an increase in sympathetic tone in the renal vessels, as well as an increased sensitivity to adenosine in the fetus compared to that of the neonate, which results in an increase in the tone of the renal arteries. These vasoconstricting effects are counterbalanced by vasodilatory peptides including prostaglandins, nitric oxide (NO) and the Kallikrein–Kinin system [ 74 ]. Meanwhile, placental hypoxia in PE may result in dysfunction of the maternal vascular endothelium and the disturbance of the balance of vasoactive compounds [ 77 , 78 ].…”

Section: Consequences For Offspringmentioning

confidence: 99%

“…Levels of TxA2 and PC are measured indirectly using the levels of their stable metabolites thromboxane B2 (TXB2) and 6-keto-prostaglandin F1α (6KPG), respectively. The ratio of TXB2 / 6KPG in fetal umbilical cord blood in PE is lower compared to normal pregnancy, which suggests an increased relative concentration of PC [ 74 , 81 ]. In the adult population, it has been shown that abnormalities in renal artery resistance are associated with the progression of renal dysfunction in patients with chronic kidney disease [ 82 ].…”

Section: Consequences For Offspringmentioning

confidence: 99%

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Preeclampsia and Cardiovascular Risk for Offspring

Wojczakowski

Kimber-Trojnar

Dziwisz

et al. 2021

JCM

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There is growing evidence of long-term cardiovascular sequelae in children after in utero exposure to preeclampsia. Maternal hypertension and/or placental ischaemia during pregnancy increase the risk of hypertension, stroke, diabetes, and cardiovascular disease (CVD) in the offspring later in life. The mechanisms associated with CVD seem to be a combination of genetic, molecular, and environmental factors which can be defined as fetal and postnatal programming. The aim of this paper is to discuss the relationship between pregnancy complicated by preeclampsia and possibility of CVD in the offspring. Unfortunately, due to its multifactorial nature, a clear dependency mechanism between preeclampsia and CVD is difficult to establish.

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Section: Consequences For Offspringmentioning

confidence: 99%

Section: Consequences For Offspringmentioning

confidence: 99%

Section: Consequences For Offspringmentioning

confidence: 99%

Section: Consequences For Offspringmentioning

confidence: 99%

See 2 more Smart Citations

Preeclampsia and Cardiovascular Risk for Offspring

Wojczakowski

Kimber-Trojnar

Dziwisz

et al. 2021

JCM

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“…Similar studies conducted on preeclampsia and its association with renal artery Doppler showed mixed results. 22 The explanations given in these cases were increased thromboxane A2 and prostacyclin C There was also no significant difference noted in the mode of delivery with renal artery Doppler indices. With all these antenatal associations, the perinatal outcome evaluated in terms of NICU admissions can also be predicted with renal artery Doppler indices, and PI performed better than RI.…”

Section: Resultsmentioning

confidence: 79%

Performance of Fetal Renal Artery Doppler Compared with Umbilical Artery Doppler in Mild and Moderate Fetal Growth Restriction: An Observational Study in a Tertiary Care Hospital

Vasudeva¹,

Mundkur²,

Paladugu³

et al. 2021

International Journal of Infertility &Amp; Fetal Medicine

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Background Fetal growth restriction (FGR) and oligoamnios are one of the major reasons of preterm delivery and low birth weight contributing to almost two-third of neonatal mortality. Fetal kidney, in addition to placenta, acts in controlling and regulating physiology of the fetus. Doppler ultrasound has become a part of routine antenatal care in monitoring such high-risk pregnancies. However, renal artery was the least studied. Aim and objective To compare the relationship of perinatal outcomes with renal artery Doppler and umbilical artery Doppler indices. Materials and methods A prospective observational study carried out among women attending an antenatal clinic and who have undergone delivery in Department of Obstetrics and Gynecology, in a tertiary care hospital between August 2016 and May 2018. Regular ultrasonography was done at 28–31 weeks; they were followed up 4 weeks later and Doppler indices were noted. Results In the 394 patients studied, 13.1% were having FGR, 12.2% were oligoamnios, and 12.2% had preterm delivery. The p values of the pulsatility index and the resistivity index of the renal artery in FGR, oligoamnios, preterm delivery, and low birth weight were more significant than umbilical artery Doppler indices. Conclusion Renal artery Doppler indices were significantly more reliable in predicting adverse perinatal outcomes in cases of mild uteroplacental insufficiency. Additionally, renal artery Doppler indices were able to pick up these changes earlier than umbilical artery Doppler, hence a potential early indicator, and the pulsatility index being more specific and sensitive. Limitations Sample size of the study is limited with only mild cases of FGR. Larger studies are required. In addition, patients at a higher risk of FGR in comparison with low-risk cases should be studied with more sample size as this study did not show any significant association with comorbidities. How to cite this article Paladugu S, Mundkur A, Yedlapalli S, et al. Performance of Fetal Renal Artery Doppler Compared with Umbilical Artery Doppler in Mild and Moderate Fetal Growth Restriction: An Observational Study in a Tertiary Care Hospital. Int J Infertil Fetal Med 2020;11(1):1–4.

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Evaluation of Fetal Renal Artery Doppler Indices in Pregnancies Complicated with Preeclampsia

Kaya¹,

Kaya

2021

Gynecol Obstet Invest

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Objective: Preeclampsia, characterized by endothelial dysfunction, is associated with maternal and fetal Doppler alterations. This study aimed to evaluate fetal renal artery Doppler indices in pregnancies complicated with preeclampsia and compare them with normotensive pregnancies. Design: This cross-sectional study enrolled 46 pregnancies complicated with preeclampsia between weeks 24 and 37 of gestation as the study group and 48 normotensive pregnancies as the control group. Materials and Methods: The abdominal aorta, its bifurcation, and the renal arteries were visualized in the coronal view of the fetal abdomen using color Doppler. Renal artery Doppler indices were measured after arising from the abdominal aorta. The angle of insonation was ≤30° from the direction of blood flow, and the sample volume was 2 mm. Fetal renal artery pulsatility index, resistance index, systolic/diastolic ratio, and peak systolic velocity (PSV) were measured. All Doppler measurements were performed in the absence of fetal movements. Moreover, demographic characteristics and the perinatal outcome data of patients were recorded. Results: The values of fetal renal artery pulsatility and resistance indices were found to be significantly lower in the study group than those in the control group (p < 0.001 and p = 0.013, respectively). The fetal renal artery systolic/diastolic ratio and PSV values were also significantly lower in the study group compared with those in the control group (p = 0.007 and p < 0.001, respectively). Renal artery pulsatility and resistance indices were negatively correlated with mean arterial pressure (r = −0.381, p < 0.001 and r = −0.267, p = 0.009, respectively). The renal artery systolic/diastolic ratio was also significantly negatively correlated with the mean arterial pressure (r = −0.257, p = 0.013). Limitations: The main limitations of this study are its cross-sectional design and the small number of participants. Another limitation of the study is that preeclamptic pregnancies complicated with fetal growth restriction were not included. Conclusion: The observed decrease in fetal renal artery Doppler impedance may be caused by the unique response of the fetal renal artery to the factors involved in the etiopathogenesis of preeclampsia than other fetal peripheral vessels. These changes in fetal renal artery indices in pregnancies complicated with preeclampsia could be taken into account in the assessment of fetal health.

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Fetal renal artery impedance in pregnancies affected by preeclampsia

Cited by 9 publications

References 20 publications

Preeclampsia and Cardiovascular Risk for Offspring

Preeclampsia and Cardiovascular Risk for Offspring

Performance of Fetal Renal Artery Doppler Compared with Umbilical Artery Doppler in Mild and Moderate Fetal Growth Restriction: An Observational Study in a Tertiary Care Hospital

Evaluation of Fetal Renal Artery Doppler Indices in Pregnancies Complicated with Preeclampsia

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