2. TITLE OF THESIS:
ASSESSMENT OF FETAL RENAL ARTERY DOPPLER INDICES IN THE
SECOND TRIMESTER TO PREDICT THE DEVELOPMENT OF
OLIGOHYDRAMINOS AND POLYHYDRAMINOS IN THE THIRD TRIMESTER.
3. AIMS AND OBJECTIVES:
To study the relationship of foetal renal artery doppler indices
in second trimester (18 to 22 weeks) and amniotic fluid volume
in the third trimester.
To evaluate the accuracy of renal artery doppler indices in
predicting the development of oligohydramnios and
polyhydramnios in the third trimester.
4. MATERIALS AND METHODS
Antenatal women who undergo routine ultrasound between 18 to 22 weeks in the radiology
department of Lourdes Hospital serves as the subjects for this study. They are followed up
when they revisit for the routine ultrasound in the third trimester, for the development of
oligohydramnios and polyhydramnios
Duration of study: 2 years
Sample Size:127
5. Inclusion Criteria: All antenatal women who comes for
routine antenatal ultrasound to the radiology department
between 18 to 22 weeks of gestation.
Exclusion Criteria:
Antenatal women with known comorbidities like overt
diabetes or pregestational
hypertension.
Multiple pregnancy
Congenital Anomalies
Major foetal renal anomalies
6. Methodology:
This is a prospective observational study.
The steps of performance and technique used are as follows:
After fulfilment of the aforementioned criteria and prerequisites, all the eligible antenatal women are subjected
to routine ultrasound between 18 to 22 weeks of pregnancy.
Pulsed wave Doppler sonographic studies are to be performed in the participants with a 3.5-MHz convex
transducer. The wall filter was set at the lowest available setting (50–75 Hz) to preserve the end-diastolic
component of the waveform.
7. The angle between the ultrasound beam and the direction of blood flow is to be maintained below 30°. All recordings
should be obtained in the absence of foetal movements. An average of three consecutive Doppler velocity waveforms is
then used for analysis.
For evaluating Renal artery blood flow, axial image of the foetal abdomen is obtained at the level of the foetal kidneys.
Using colour flow Doppler, the renal arteries are evaluated at the level of their origin from the abdominal aorta. The
Doppler gate is placed within the lumen in a straight segment of the vessel.
Single deepest pocket is also noted.
When the patient revisit in the third trimester, foetal biometric measurements are obtained, and the amniotic fluid index
will be evaluated in four quadrants.
Amnion fluid index of less than 5 cm will be considered to be oligohydramnios.
Amnion fluid index of more than 25 cm will be considered to be polyhydramnios.
Then data obtained in the 2nd trimester and 3rd trimester will be compared.
8. Ethical considerations
No extra burden for the patient.
No extra invasive techniques required.
No extra financial requirement.
