Document Detail


Blood flow volume of uterine arteries in human pregnancies determined using 3D and bi-dimensional imaging, angio-Doppler, and fluid-dynamic modeling.
MedLine Citation:
PMID:  19945159     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The primary aim of this pilot study was to study uterine artery (UtA) blood flow volume in uneventful human pregnancies delivered at term, at mid and late gestation by means of 3D and bi-dimensional ultrasound imaging with angio-Doppler combined with fluid-dynamic modeling. Secondary aims were to correlate flow volume to placental site and to UtA Pulsatility Index (PI). Women with singleton, low-risk pregnancies were examined at mid and late gestation. The structure and course of the uterine artery (UtA) was studied in each patient by means of 3D-angio-Doppler and included vessel diameter D, blood flow velocity and PI (measured along the UtA). Fetal weight estimation and placental insertion site were assessed by ultrasound. A robust fluid-dynamic modeling was applied to calculate absolute flow and flow per unit fetal weight. Mean UtA diameter and blood flow velocity increased significantly (p < 0.0001) from mid-gestation to late gestation from 2.6 mm and 67.5 cm/s, to 3.0 mm and 85.3 cm/s, respectively, yielding an increasing absolute flow troughout gestation. h coefficient, derived by fluid-dynamic modeling to calculate mean velocity, increased significantly from 0.52 at mid-gestation to 0.57 at late gestation. UtA blood flow volume ml/min/kg-fetal weight was significantly higher at mid-gestation than at late gestation (535 ml/min/kg vs 193 ml/min/kg; p < 0.0001). In cases with strictly lateral placentas the ipsilateral UtA accommodates at mid and late gestation 63% and 67% of the total UtA flow. In central placentas UtA flow was evenly distributed between the two vessels. An inverse correlation was observed between PI and blood flow volume ml/min/kg (Pearson's coefficient r = -0.54). Our work confirms the technological and methodological limitations in the measurement of uterine artery blood flow. However, Doppler measurements supported by three-dimensional angio imaging of the uterine vessel, high resolution imaging and diameter measurement, and a robust mathematical model of local circulation adds a genuine new area of investigation into human uterine circulation during pregnancy.
Authors:
S Rigano; E Ferrazzi; S Boito; G Pennati; A Padoan; H Galan
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2009-11-27
Journal Detail:
Title:  Placenta     Volume:  31     ISSN:  1532-3102     ISO Abbreviation:  Placenta     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-19     Completed Date:  2010-04-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006349     Medline TA:  Placenta     Country:  England    
Other Details:
Languages:  eng     Pagination:  37-43     Citation Subset:  IM    
Affiliation:
Buzzi Children's Hospital - Clinical Sciences Department Sacco, University Department of Clinical Sciences, Dept Obstet Gynecol, University of Milan, Via Catelvetro 32, 20157 Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Angiography / methods
Birth Weight / physiology
Diagnostic Techniques, Cardiovascular
Female
Gestational Age
Hemodynamics / physiology*
Humans
Imaging, Three-Dimensional / methods
Infant, Newborn
Models, Theoretical
Pilot Projects
Placenta / blood supply,  ultrasonography
Pregnancy
Pulsatile Flow / physiology
Regional Blood Flow / physiology*
Term Birth
Ultrasonography, Doppler, Color / methods*
Ultrasonography, Prenatal / methods*
Uterine Artery / physiology*,  radiography,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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