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a Chapter 27 Doppler Investigation of the Fetal Inferior Vena Cava 405<br />

Fig. 27.3. Chronological change<br />

of the preload index (PLI) after<br />

20 weeks of gestation. (With<br />

permission from [18])<br />

Fig. 27.4. Preload index (PLI) among controls<br />

and those with fetal disease. Group<br />

1, hydrops associated with heart disease<br />

(n =9); group 2, structural heart disease<br />

without hydrops (n =8); group 3, hydrops<br />

without heart disease (n=11)<br />

Normal Fetuses<br />

The PLI value of normal fetuses ranged from 0 to<br />

0.37 (median 0.13). The PLI gradually decreased after<br />

20 weeks (Fig. 27.3) [18]. The decrease was so slight<br />

after 24 weeks of gestation that the influence of age<br />

can be ignored on any analysis done beyond 24<br />

weeks of pregnancy [3].<br />

Fetuses with Hydrops and Heart Disease<br />

The PLI values in the three groups of fetuses with<br />

disease are compared in Fig. 27.4. The PLI values for<br />

those with hydrops associated with heart disease<br />

(group 1) are significantly higher than those for normals<br />

and for the group with heart disease without<br />

hydrops (group 2). PLI values for group 1 ranged<br />

from 0.52 to 1.05. All PLI values in this group with<br />

cardiogenic hydrops were more than 0.5. PLI values

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