OP08.06: Fetal hemodynamic change after aspiration/thoraco‐amniotic shunting for fetal hydrothorax: conventional Doppler and ultrasonic phased‐tracking study

Fetal therapies for hydrothorax, including aspiration of effusion (ASP) and thoraco-amniotic shunting (TAS), potentially cause fetal hypovolemia and hypotension. We evaluated fetal hemodynamics on Doppler studies, pulse wave velocity (PWV) and estimated pulse pressure (ePP) which can be analysed using ultrasonic phased-tracking method (PTM). PTM, originally developed modality, can evaluate elastic wave on vessel walls analysing raw radiofrequency signal data. We analysed fetal hydrothorax cases retrospectively who underwent ASP or TAS with measurements of conventional Doppler, umbilical flow volume (UVFV), combined cardiac output (CCO), PWV and ePP before and after ASP/TAS within 24 hours. Eleven fetal cases with 9 ASP and 9 TAS procedure were enrolled. All ASP/TAS were decided to be effective for decreased volume of effusion. PWV and ePP were decreased after the all ASP (P < 0.05, PWV = -2.7+/-0.60m/s, ePP = -2.4+/-0.51kPa) and all TAS (P < 0.05, PWV = -2.4 ± 0.26, ePP = -1.8 ± 0.30kPa) (see figure 1], but changes in UVFV, CCO and conventional Doppler indices were inconstant. PWV/ePP, indicators of fetal blood pressure, were proven to be decreased after ASP/TAS for hydrothorax. Hypovolemia due to rapid drainage of effusion was suggested to be the dominated factor for decreased PWV/ePP, though relief of elevated intrathoracic pressure can cause increase of cardiac output. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.