output, right ventricular output, renal blood flow, and renal
artery diameter were lower in the foetuses with polyhydramnios
than in normally growing foetuses without polyhydramnios.
Additionally, the renal perfusion was low [14].
In the first control of our study, the mean renal artery PI
was 2.08 (range 1.5-3.0) in the patients with polyhydramnios
who responded to conservative treatment. The mean
renal artery PI was 2.03 (range 1.4-2.8) in those patients who
did not respond to conservative treatment; however, there
were no statically significant correlations between these two
groups. Additionally, the mean renal artery PIs were 2.08
(range 1.5-3.0) and 1.94 (range 1.5-2.69), respectively, before
and after the treatment, in those patients who responded to
conservative treatment. However, there were no statistically
significant correlations between these two groups.
Various treatment options for polyhydramnios may be
considered with the presence of complications and preterm
labour or severely disturbed patients [1]. These treatment
options include drainage of the amniotic fluid or prostaglandin
synthesis inhibitors to decrease the amniotic fluid, and
prolongation of the pregnancy. Additionally, fluid restriction
may be recommended. Drainage of the amniotic fluid is used
in very serious cases of polyhydramnios, and is performed
until the normalization of the AFI. Additionally, no more
than 5 litres of amniotic fluid should be drained at one time
[1]. Inhibitors of prostaglandin synthesis are an alternative
method for this treatment, and indomethacin is often used
for this purpose. Indomethacin reduces the amniotic fluid by
inhibiting the prostaglandin synthesis in the myometrium,
chorion, and decidua; however, one must be careful of the
side effects that may occur during the use of this drug [1].
Indomethacin does not lead to changes in the uteroplacental
blood flow; it just reduces the foetal renal blood flow and
raises the renal vascular resistance [14]. As a result, foetal
urine production decreases and foetal absorption increases,
which contribute to the lowering of the AFI. However, we did
not use indomethacin in our study [15]. We only restricted the
fluid uptake to no more than 2 litres per day, and as a result of
the fluid restriction, only 19 patients reached the normal AFIs.
In the evaluation of renal perfusion, renal artery PI is considered
for the patients with oligohydramnios. In our study,
we found that renal artery PI was not statically significant for
the foetuses with polyhydramnios, and did not contribute to
the foetal outcome. Mari et al. [16] detected that there were
no alterations in the renal artery PI after indomethacin treatment
in the foetuses with polyhydramnios. Additionally, we
did not determine any alterations in the renal artery PIs after
the fluid restriction in the foetuses with polyhydramnios in
our study.
As a result, we suggest that renal artery blood flow alterations
cannot affect the renal artery PIs. Also, the renal artery