الفهرس 
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Abstract
The current study was conducted at Ain Shams University Maternity Hospital during the period between March 2015 and December 2015. Two groups of women were included: group I [Study Group] (n=20), including women with fetal growth restriction; and group II [Control Group] (n=20), including women with normal growth pattern. All included women were ≥ 36 weeks of gestation.
In the current study, a small fetus was defined when the sonographic estimated fetal weight or abdominal circumference was less than 5th percentile. Multiple pregnancies, fetuses that showed congenital malformations, those who have normal UA blood flow, and those who have unclear renal morphology due to structural anomalies or gross maternal obesity were not included in the study.
Fetal biometry included measurements of the BPD, HC, FL and AC. Fetal weight was sonographically estimated using the Hadlock’s formula. Fetal renal volume was measured using the 3D VOCAL method. Each of the right and left renal volumes was measured, as well as the combined renal volumes.
Doppler ultrasound velocimetry of the umbilical, middle cerebral and renal arteries was measured in both groups.
Both groups were matched for maternal age and menstrual gestational age [25.45 ± 3.09 years vs. 25.85 ± 2.6 years, respectively, p=0.660; and 38.05 ± 0.94 weeks vs. 37.95 ± 0.76 weeks, respectively, p=0.714]. The mean sonographic gestational age in women of group I was 32.85 ± 0.81 weeks, while that of group II was 37.95 ± 0.75 weeks. The mean values of EFW in both groups were 2180.03 ± 101.29 g and 3471.48 ± 147.95 g, respectively. The mean values of AFI in both groups were 6.95 ± 0.22 cm and 13.45 ± 0.94 cm, respectively.
The current study showed that the mean values of UA PI, UA RI, renal artery RI and renal artery PI were significantly higher, while the mean value of MCA-RI was significantly lower in women of group I when compared to those of women of group II. The right renal volume, left renal volume and combined renal volume in included women were significantly lower in women of group I when compared to those of women of group II.
The current study, therefore, shows a Doppler ultrasound changes that were consistent with the “brain-sparing phenomenon” in fetuses with growth restriction, which maintains a preferentially higher blood flow to the brain circulation and lower blood flow to the abdomen (including the renal blood flow). The current study showed also that this lowered renal blood flow was significant enough to cause significantly smaller renal volumes in those fetuses.
In conclusion, the current study showed that intrauterine fetal growth restriction due to placental insufficiency seems to be associated with significantly lower fetal renal blood flow and significantly smaller renal volumes, when compared to normally-grown fetuses.