Taiwanese Journal of Obstetrics and Gynecology
Volume 48, Issue 3 , Pages 268-272, September 2009

The Changes in Doppler Indices of Fetal Ductus Venosus and Umbilical Artery After Amnioinfusion for Women With Preterm Premature Rupture of Membranes Before 26 Weeks' Gestation

  • Te-Yao Hsu

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
    • ,
  • Jenn-Jeih Hsu

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei Medical Center, Chang Gung University College of Medicine, Chang Gung University, Taipei, Taiwan
    • ,
  • Hung-Chun Fu

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
    • ,
  • Chia-Yu Ou

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
    • ,
  • Chih-Chang Tsai

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
    • ,
  • Bi-Hua Cheng

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
    • ,
  • Fu-Min Fang

      Affiliations

    • Department of Radiotherapy, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
    • ,
  • Hui-Fen Kao

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
    • ,
  • Chun-Yuh Yang

      Affiliations

    • School of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Wen Lin Tsai

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
    • ,
  • Chuen Chu Sung

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
    • ,
  • Men-Yi Tsai

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Men-Yi Tsai, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan

Accepted 6 July 2009.

Article Outline

Summary 

Objective

To investigate the changes in Doppler indices of the fetal ductus venosus (DV) and umbilical artery (UMA) after amnioinfusion in pregnant women with preterm premature rupture of membranes (pPROM). Pregnancies with pPROM and severe oligohydramnios cause sequelae in newborns and mothers.

Materials and Methods

This cross-sectional study included a group of 25 patients with pPROM before 26 weeks' gestation. Color Doppler imaging was used to measure the impedance index and quantitative blood flow in the DV and systolic/diastolic ratio (S/D) of the UMA before and 30 minutes after the end of amnioinfusion. The following velocity parameters were measured: (1) DV peak systolic velocity; (2) DV time-averaged velocity; (3) DV maximum forward velocity during atrial contraction; (4) DV S/D; (5) DV pulsatility index (PI); (6) DV Pourcelot's resistance index (RI); (7) fetal heart rate; and (8) UMA S/D.

Results

Twenty-one of the 25 patients underwent a total of 27 amnioinfusions. The mean PI and RI of the DV, and S/D of the DV and UMA decreased significantly after amnioinfusion (PI, 0.75 ± 0.24 vs. 0.60 ± 0.18, p = 0.009; RI, 0.60 ± 0.15 vs. 0.50 ± 0.13; DV S/D, 3.07 ± 1.81 vs. 2.13 ± 0.66, p = 0.008; UMA S/D, 3.58 ± 0.87 vs. 2.88 ± 0.62, p = 0.001).

Conclusion

Amnioinfusion increases the space for the fetuses and reduces the impedance of the fetoplacental circulation. Improvements in DV and UMA flow may benefit fetuses suffering severe oligohydramnios in mid-pregnancy.

Key Words:  amnioinfusion , Doppler , ductus venosus , preterm premature rupture of membranes

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References 

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PII: S1028-4559(09)60302-8

doi:10.1016/S1028-4559(09)60302-8

Taiwanese Journal of Obstetrics and Gynecology
Volume 48, Issue 3 , Pages 268-272, September 2009

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