The renal artery PI was 0.79 and 1.75, respectively, in normally growing foetuses and growth restricted foetuses; and there was a statically significant correlation between these two groups [13]. They also detected a negative correlation between the foetal arterial pO2 and AFI. A reduction in the foetal arterial pO2 or AFI caused increased resistance in the renal arterial PI. Rosnes et al. [14] compared the foetal cardiac and renal blood flows between the foetuses with normal AFIs and polyhydramnios in their study. They found that the total cardiac 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 arteryPI should not be used as a marker for the foetuses with polyhydramnios. The limited number of patients who accepted the conservative treatment was one limitation of this study. Therefore, new studies with extensive groups will further contribute to the literature.
The renal artery PI was 0.79 and 1.75, respectively, in normally growing foetuses and growth restricted foetuses; and there was a statically significant correlation between these two groups [13]. They also detected a negative correlation between the foetal arterial pO2 and AFI. A reduction in the foetal arterial pO2 or AFI caused increased resistance in the renal arterial PI. Rosnes et al. [14] compared the foetal cardiac and renal blood flows between the foetuses with normal AFIs and polyhydramnios in their study. They found that the total cardiac 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 arteryPI should not be used as a marker for the foetuses with polyhydramnios. The limited number of patients who accepted the conservative treatment was one limitation of this study. Therefore, new studies with extensive groups will further contribute to the literature.
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