Behavioural states and Doppler velocimetry of the renal artery in the near term human fetus

Abstract

Transition of fetal behavioural state 1F to 2F coincides with cardiovascular changes measured by Doppler velocimetry e.g. a decrease in pulsatility index (PI) in the internal carotid arteries and in the descending aorta, indicating redistribution of blood flow. Recently, we reported a considerable reduction in fetal urine production rate of 47% during fetal behavioural state 2F as compared to 1F. It was suggested that this reduction is caused by an increase in renal vascular resistance during 2F. Using Doppler ultrasound, flow velocity waveforms (FVW) of fetal renal arteries were recorded during behavioural states 1F and 2F. Fetal behavioural states 1F and 2F were assessed by recording fetal heart rate pattern, eye movements and body movements. The PI of the renal artery FVWs were calculated as an index of renal vascular resistance to blood flow. Fifteen healthy pregnant women between 36 and 40 weeks gestational age were studied and the relationship between fetal renal vascular resistance to blood flow and behavioural states was determined. We found that PI values in the renal arteries did not change relative to behavioural state 1F and 2F. These findings suggest that renal vascular resistance to blood flow is not appreciably different in 1F and 2F. This is in contrast with urine production rate which is almost reduced by half during 2F in the near term fetus.