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3D ULTRASONOGRAPHY TO EVALUATE FETAL URINARY PRODUCTION RATES IN TWIN GESTATION: CONSTRUCTION OF A NORMAL VALUE CURVE
Twin Pregnancy
Fetal Bladder Volume Measurement
Fetal Urine Production Rate
Author
Affilliation
Grupo Perinatal. Rio de Janeiro, RJ, Brasil / Hospital Servidores do Estado do Rio de Janeiro. Departamento de Obstetrícia. Rio de Janeiro, RJ, Brasil.
Hospital Servidores do Estado do Rio de Janeiro. Departamento de Obstetrícia. Rio de Janeiro, RJ, Brasil / Universidade Federal Fluminense. Rio de Janeiro, RJ, Brasil.
Universidade Federal Fluminense. Rio de Janeiro, RJ, Brasil.
Grupo Perinatal. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Obstetrícia. Rio de Janeiro, RJ, Brasil.
Université Paris Descartes. Department of Obstetrics and Maternal-Fetal Medicine. Paris, France.
Hospital Servidores do Estado do Rio de Janeiro. Departamento de Obstetrícia. Rio de Janeiro, RJ, Brasil / Universidade Federal Fluminense. Rio de Janeiro, RJ, Brasil.
Universidade Federal Fluminense. Rio de Janeiro, RJ, Brasil.
Grupo Perinatal. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Obstetrícia. Rio de Janeiro, RJ, Brasil.
Université Paris Descartes. Department of Obstetrics and Maternal-Fetal Medicine. Paris, France.
Abstract
Objective: The aim of this study was to assess fetal urinary production rates (FUPR) in twin gestations
using 3D ultrasonography with VOCAL R (virtual organ computer-aided analysis) and to develop a curve
of normal values for the target population. Methods: A cross-sectional study was performed in 30 normal
twin pregnancies with gestational ages ranging from 20 to 34 weeks. FUPR was measured using a threedimensional
ultrasound (3D US) virtual organ computer-aided analysis (VOCAL) system. FUPR (ml/hour)
was calculated during the filling phase using the equation UPR = (VFB2 - VFB1)/time. The values for UPR
were plotted as a function of fetal biometry (biparietal diameter) to generate a nomogram. Results: A total
of 41 normal twin fetuses with gestational ages between 20 and 34 weeks were investigated. Eleven were
excluded because of inadequate bladder contour image quality and/or the observation of micturition in
one or both fetuses. Linear regression analysis of FUPR as a function of biparietal diameter (BPD) shows
the normal range for UPR by fetal biometry and is expressed by the following equation: Ln(UPR) = -5.0121
+ 0.0548 BPD (R2 0.3386, p value <.001). There was no statistically significant difference when the UPR
was stratified by chorionicity. Conclusions: The use of biometric parameters to predict fetal FUPR seems
to be useful. In twin pregnancies, BPD is the variable that is most closely related to FUPR. For each 1 mm
increase in BPD, there is a 5% increase in FUPR. Chorionicity did not affect FUPR.
Keywords
3D UltrasonographyTwin Pregnancy
Fetal Bladder Volume Measurement
Fetal Urine Production Rate
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