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Assessment of Fetal Urine Production Rate by Three-dimensional Ultrasonography Using VOCAL during Normal Human Gestation and in Fetuses with Congenital Heart Disease and Hydronephrosis

Author: HouMin
Tutor: LvGuoRong
School: Fujian Medical
Course: Medical Imaging and Nuclear Medicine
Keywords: 3D ultrasound volume automatic measurement technology Rate of production of urine Fetus Three-dimensional ultrasound Congenital heart disease Fetal hydronephrosis Rate of fetal production of urine VOCAL
CLC: R714.5
Type: Master's thesis
Year: 2011
Downloads: 30
Quote: 0
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Abstract


Objective To investigate the three-dimensional ultrasound volume measurement the fetus normal people singleton pregnancies bladder capacity automatic measurement technique (VOCAL) in order to estimate the gestational age of the fetus producing urine rate. Pregnancy method ⑴ select the normal single tire 30, respectively, using the two-dimensional method and three-dimensional measurements of the fetal bladder capacity consistency. The two-dimensional method using the mathematical formula V = 0.5 × L × H × W, three-dimensional method using VOCAL technique; ⑵ 314 normal late single tire fetal 3D ultrasound, the use of three-dimensional ultrasound volume automatic measurement technique (VOCAL) interval of 5 ~ 15 min, repeat 2 or 3 times to measure fetal bladder capacity. To calculate the average value of the rate of production of urine, using linear regression analysis of its correlation with the gestational age (GA). Results ⑴ the fetal bladder capacity measurement consistency, the same operator and operator between application of the consistency of the three-dimensional method is better than the two-dimensional method, the correlation coefficient (ICC) in its group were: 0.942 vs. 0.879 and 0.967 vs. 0.865; the ⑵ fetal rate of production of urine (UPR) with gestational age (GA) increases from 21 weeks pregnant 4.48 ml / h was raised to 40 weeks pregnant 66.54ml / h, between significantly associated relationship, and come to the equation: Ln (UPR) = - 4.748 (0.398 × GA) (-0.004 × GA - 2), of r ~~ 2 = 0.916, P lt; 0.05; ⑶ the UPR and the AFI was no significant correlation. Conclusion (1) three-dimensional ultrasound (VOCAL) the fetal bladder capacity measurement repeatability is better than two-dimensional ultrasound; ⑵ use of three-dimensional ultrasound volume measurement technique (VOCAL) automatically measuring fetal bladder capacity changes normal people singleton pregnancies the fetus can be estimated production of urine rate. The purpose of the assessment of congenital heart disease (CHD) fetal hydronephrosis (HN) fetus the UPR to change the situation. Methods 314 cases of the normal 21 to 40 weeks of gestation single pregnancy the fetus as a normal control group. The same period continuous detection of fetal congenital heart disease in 49 cases, and 58 cases of hydronephrosis fetus as a patient group. Kaltman CHD classification method fetal CHD divided into left heart obstructive lesions (10 cases), the right heart obstructive lesions (11 cases) and mixed cardiac malformation group (28 cases); whether the merger heart fetal CHD failure (CHF) and then divided into merger CHF group (11 cases) and unconsolidated CHF group (38 cases). According to the Association of fetal urinary 5 taxonomy: 0 (pyelectasis) Ⅰ (pyelectasis) the Ⅱ-level (dilatation of the renal pelvis, calyceal visible), Ⅲ (renal pelvis, calyceal are expansion), Ⅳ level (pelvis, caliectatic more severe renal cortical thinning), this study is divided into mild group (Ⅰ and Ⅱ stage, 21 cases), moderate group (Ⅲ, 15 cases) and severe group (Ⅳ level, 22 cases). Using 3D ultrasound VOCAL technology to measure the fetal production of urine rate and compare. Results regardless of the type ⑴ the fetal production urine rate of change and whether fetal CHD CHD (P gt; 0.05); (2) fetus produced urine rate of heart function and fetal CHD, fetal UPR when CHD merger CHF decreased (P lt; 0.01); ⑶ related to the degree of fetal production urine rate of fetal hydronephrosis, the severe group hydronephrosis fetal UPR decreased (P lt; 0.01). Conclusion 3D ultrasound the VOCAL technology can be used for the measurement of the fetal UPR. UPR may be a valuable indicator to determine the fetal heart failure and fetal renal.

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CLC: > Medicine, health > Obstetrics and Gynaecology > Obstetrics > Fetus
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