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. 2024 Aug 28;10(17):e36687.
doi: 10.1016/j.heliyon.2024.e36687. eCollection 2024 Sep 15.

Comprehensive evaluation of fetal renal ultrasound parameters for fetal growth restriction

Qinxiao Wang  1 , Liang Wang  2 , Mingzi Hu  1 , Sisi Yang  1 , Wen Zhang  1 , Haiying Chen  1 , Yan Jiao  1
Affiliations

Comprehensive evaluation of fetal renal ultrasound parameters for fetal growth restriction

Qinxiao Wang et al. Heliyon. .

Abstract

Objective: This study aims to investigate variances in renal ultrasound parameters between fetuses experiencing fetal growth restriction (FGR) and those with normal intrauterine development, with the intent to offer actionable insights for clinical management.

Method: Forty-five pregnant women diagnosed with FGR between 28 and 36 weeks of gestation, who underwent examination at Wenzhou People's Hospital from September 2021 to June 2023, constituted the FGR group. Concurrently, 65 pregnant women with normal intrauterine development at matching gestational weeks formed the control group. Renal ultrasound parameters, encompassing renal artery peak systolic velocity (PSV), end diastolic velocity (EDV), time averaged maximum velocity (TAMX), resistive indices (S/D, PI, RI), ratios of renal volume to gestational age (RV/WEEK) and estimated fetal weight (RV/EFW), vascular indices (VI, FI, VFI), were compared between the two groups. All parameters represented the mean values of bilateral kidneys.

Result: In the FGR group, fetal renal artery PSV (37.71 ± 9.93 cm/s), EDV (6.19 ± 1.50 cm/s), TAMX (15.10 ± 3.83 cm/s), RV/WEEK (0.45 ± 0.12), RV/EFW (7.53 ± 3.24), VI (22.19 ± 15.00), and VFI (5.53 ± 3.63) were significantly lower compared to the control group (PSV: 47.11 ± 11.24 cm/s, EDV: 7.13 ± 2.00 cm/s, TAMX: 17.85 ± 3.85 cm/s, RV/WEEK: 0.66 ± 0.19, RV/EFW:9.20 ± 3.17, VI: 28.67 ± 14.72, VFI: 7.40 ± 3.68). Conversely, fetal renal artery resistive indices (S/D: 9.09 ± 2.58, PI: 2.71 ± 0.56, RI: 0.92 ± 0.04) in the FGR group were notably higher than those in the control group (S/D: 6.22 ± 1.93, PI: 2.20 ± 0.73, RI: 0.87 ± 0.04), with statistical significance (P < 0.05). No significant difference was found in renal FI between the FGR group (26.78 ± 6.59) and the control group (26.89 ± 5.82) (P > 0.05). Receiver operating characteristic (ROC) curve analysis revealed higher diagnostic efficacy for RV/WEEK and RI among individual indicators, while combined parameter application yielded the highest diagnostic efficiency.

Conclusion: Utilizing a comprehensive evaluation of fetal kidney ultrasound parameters with multiple indices facilitates early screening and diagnosis of FGR fetuses, thereby aiding clinical decision-making and enhancing newborn birth outcomes.

Keywords: Diagnostic efficacy; Fetal growth restriction; Multi-parameter evaluation; Renal ultrasound.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Color Doppler spectrum of the renal artery of a fetus in the FGR group.
Fig. 2
Fig. 2
Color Doppler spectrum of the renal artery of a fetus in the control group.
Fig. 3
Fig. 3
Three-dimensional power Doppler ultrasonography images of the fetal kidney in the FGR group. (A) Manual delineation of the kidney's envelope. (B) Automatic generation of a histogram and computation of parameters.
Fig. 4
Fig. 4
Three-dimensional power Doppler ultrasonography images of the fetal kidney in the control group. (A) Manual delineation of the kidney's envelope. (B) Automatic generation of a histogram and computation of parameters.
Fig. 5
Fig. 5
ROC curves of diagnostic efficiency of each parameter for FGR detection.
See this image and copyright information in PMC

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