open access

Vol 89, No 6 (2018)
Research paper
Published online: 2018-06-29
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Assessment of nasal and oral flow of amniotic fluid in 46 non-anomalous fetuses with sonographic and echocardiographic examination

Rafał Zieliński1, Maria Respondek-Liberska2, Stuart Weiner3
DOI: 10.5603/GP.a2018.0054
·
Pubmed: 30010180
·
Ginekol Pol 2018;89(6):316-320.
Affiliations
  1. Faculty of Medicine and Medical Sciences, Jan Kochanowski University, Kielce, Poland
  2. Department of Diagnostics and Prevention of Congenital Malformations, Chair of Morphology and Embryology, Medical University of Lodz, Polish Mother's Memorial Hospital
  3. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA

open access

Vol 89, No 6 (2018)
ORIGINAL PAPERS Obstetrics
Published online: 2018-06-29

Abstract

Objectives: The aim of the paper was to assess nasal and oral amniotic fluid flows, with the use of color ultrasound and spectral Doppler, in normal fetuses.

Material and methods: Forty-six fetuses of singleton gestations were studied prospectively. Spectrum imaging and maximal nasal fluid flow velocities were described. Episodes of regurgitation (external flow from the mouth), swallowing (internal flow at the level of oropharynx and then entrance to the esophagus) were evaluated in two groups: Fetuses < 27 weeks of gestation and 27 weeks of gestation and older. Statistical analysis was done using Fischer exact test and t-test at p = 0.05.

Results: Twenty-one fetuses were < 27 weeks of gestational age and presented mean maximal both inspiratory and expiratory nasal fluid flow velocities significantly lower than twenty-five fetuses who were ≥ 27 weeks of gestational age (p = 0.035 and p = 0.031 respectively, t-test). Episodes of regurgitation were observed more frequently in group of “younger” fetuses (p = 0.006, Fischer exact test). There was no statistically significant relationship between irregular nasal flow spectrum by color Doppler and gestational age group (p = 0.264, Fischer exact test).

Conclusions: Episodes of regurgitation occurred in normal fetuses < 27th week of gestation. Fast amniotic nasal fluid flows without episodes of regurgitation were observed more frequently in fetuses ≥ 27 weeks and it could be interpreted as an additional sonographic feature of prenatal maturation.

Abstract

Objectives: The aim of the paper was to assess nasal and oral amniotic fluid flows, with the use of color ultrasound and spectral Doppler, in normal fetuses.

Material and methods: Forty-six fetuses of singleton gestations were studied prospectively. Spectrum imaging and maximal nasal fluid flow velocities were described. Episodes of regurgitation (external flow from the mouth), swallowing (internal flow at the level of oropharynx and then entrance to the esophagus) were evaluated in two groups: Fetuses < 27 weeks of gestation and 27 weeks of gestation and older. Statistical analysis was done using Fischer exact test and t-test at p = 0.05.

Results: Twenty-one fetuses were < 27 weeks of gestational age and presented mean maximal both inspiratory and expiratory nasal fluid flow velocities significantly lower than twenty-five fetuses who were ≥ 27 weeks of gestational age (p = 0.035 and p = 0.031 respectively, t-test). Episodes of regurgitation were observed more frequently in group of “younger” fetuses (p = 0.006, Fischer exact test). There was no statistically significant relationship between irregular nasal flow spectrum by color Doppler and gestational age group (p = 0.264, Fischer exact test).

Conclusions: Episodes of regurgitation occurred in normal fetuses < 27th week of gestation. Fast amniotic nasal fluid flows without episodes of regurgitation were observed more frequently in fetuses ≥ 27 weeks and it could be interpreted as an additional sonographic feature of prenatal maturation.

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Keywords

fetal, sonography, doppler, respiratory, digestive

About this article
Title

Assessment of nasal and oral flow of amniotic fluid in 46 non-anomalous fetuses with sonographic and echocardiographic examination

Journal

Ginekologia Polska

Issue

Vol 89, No 6 (2018)

Article type

Research paper

Pages

316-320

Published online

2018-06-29

DOI

10.5603/GP.a2018.0054

Pubmed

30010180

Bibliographic record

Ginekol Pol 2018;89(6):316-320.

Keywords

fetal
sonography
doppler
respiratory
digestive

Authors

Rafał Zieliński
Maria Respondek-Liberska
Stuart Weiner

References (17)
  1. Zieliński R, Respondek-Liberska M. [Craniofacial malformations in prenatal ultrasound evaluation. Literature review]. Ginekol Pol. 2013; 84(9): 801–806.
  2. Zielinski R, Respondek-Liberska M. Retrospective chart review of 44 fetuses with cervicofacial tumors in the sonographic assessment. Int J Pediatr Otorhinolaryngol. 2015; 79(3): 363–368.
  3. Sikorski M. Rapidly progressive, large nascent cervical myoma with intrauterine device – case report and review of literature. Medical Studies. 2017; 1: 51–54.
  4. Beall MH, van den Wijngaard JP, van Gemert MJC, et al. Amniotic fluid water dynamics. Placenta. 2007; 28(8-9): 816–823.
  5. Panting-Kemp A, Nguyen T, Castro L. Substance abuse and polyhydramnios. Am J Obstet Gynecol. 2002; 187(3): 602–605.
  6. Modena AB, Fieni S. Amniotic fluid dynamics. Acta Biomed. 2004; 75 Suppl 1: 11–13.
  7. Badalian SS, Chao CR, Fox HE, et al. Fetal breathing-related nasal fluid flow velocity in uncomplicated pregnancies. Am J Obstet Gynecol. 1993; 169(3): 563–567.
  8. Kalache KD, Chaoui R, Bollmann R. Doppler assessment of tracheal and nasal fluid flow during fetal breathing movements: preliminary observations. Ultrasound Obstet Gynecol. 1997; 9(4): 257–261.
  9. GE Healthcare Voluson 730 product site. 2015 [27/11/2015]. http://www3.gehealthcare.com/en/Products/Categories/Ultrasound/Voluson/Voluson_730..
  10. Ultrasound by Philips. 2015. http://www.healthcare.philips.com/main/products/ultrasound/. (27/11/2015).
  11. Cosmi EV, Anceschi MM, Cosmi E, et al. Ultrasonographic patterns of fetal breathing movements in normal pregnancy. Int J Gynaecol Obstet. 2003; 80(3): 285–290.
  12. La Torre R, Cosmi E, Anceschi MH, et al. Preliminary report on a new and noninvasive method for the assessment of fetal lung maturity. J Perinat Med. 2003; 31(5): 431–434.
  13. Suzuki M, Saito H, Yanaihara T. Assessment of fetal nasal fluid flow by two-dimensional color Doppler ultrasonography during pregnancy. J Matern Fetal Med. 1999; 8(4): 159–163, doi: 10.1002/(SICI)1520-6661(199907/08)8:4<159::AID-MFM4>3.0.CO;2-O.
  14. Macedonia C, Miller JL, Sonies BC. Power Doppler imaging of the fetal upper aerodigestive tract using a 4-point standardized evaluation: preliminary report. J Ultrasound Med. 2002; 21(8): 869–878.
  15. Badalian SS, Fox HE, Zimmer EZ, et al. Patterns of perinasal fluid flow and contractions of the diaphragm in the human fetus. Ultrasound Obstet Gynecol. 1996; 8(2): 109–113.
  16. Petrikovsky BM, Kaplan GP, Pestrak H. The application of color Doppler technology to the study of fetal swallowing. Obstet Gynecol. 1995; 86(4 Pt 1): 605–608.
  17. Levy DS, Zielinsky P, Aramayo AM, et al. Repeatability of the sonographic assessment of fetal sucking and swallowing movements. Ultrasound Obstet Gynecol. 2005; 26(7): 745–749.

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