FETAL DOPPLER BLOOD-FLOW ALTERATIONS FOLL OWING HYPERVOLEMIC HEMODILUTION WITH HYDROXYETHYLSTARCH

Early diagnosis of intrauterine growth retardation is important to ens ure optimal obstetric monitoring. Current methods of diagnosing and as sessing the growth retardation include clinical evaluation, various ul trasonic parameters and Doppler ultrasound. In this study Dopplersonog raphic measurements of the umbilical artery, fetal aorta and the middl e cerebral artery were performed on 19 patients having been diagnosed with a placental insufficiency and maternal haemoconcentration. The pa tients were treated 10 days by a daily hypervolemic haemodilution with 500 ml 10% hydroxyethylstarch and 1000 ml ringersolution. The blood n ow velocimetry showed changes in the fetal circulation characterized b y a redistribution of the fetal blood flow. The aortic and umbilical r esistance indices decreased. The resistance index of the middle cerebr al artery demonstrated a signficant rise during the haemodilution. The fetal circulatory changes represents a better oxygenation during the therapy with hydroxyethylstarch. The intravenous haemodilution can be seen as an effective and easy treatment of fetal growth retardation by increasing the placenta perfusion.