Document Detail


Color Doppler ultrasound of spiral artery blood flow for prediction of hypertensive disorders and intra uterine growth restriction: a longitudinal study.
MedLine Citation:
PMID:  17721908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To construct reference ranges for spiral artery (SA) flow velocities and examine the possibility to predict intra uterine growth restricted (IUGR) fetuses, pregnancy-induced hypertension (PIH) and/or preeclampsia. METHODS: Spiral artery flow velocity measurements were performed using Color Doppler between 11 to 13 + 6, between 14 to 17 + 6 and between 18 to 24 weeks of gestation, each measurement was performed twice. Spiral artery flow velocities were analyzed with multilevel modeling: individual regression curves were estimated and combined to obtain the reference intervals for SA flow velocities in normal pregnancies. Mann-Whitney U tests was used to compare the deviation from expected flow velocity between normal and complicated pregnancies. RESULTS: One hundred and eight pregnancies were included; 4 pregnancies were complicated with preeclampsia, 10 pregnancies with IUGR fetuses (<P10) and 7 with PIH. In the uncomplicated pregnancies, systolic/diastolic (SD) ratios, resistance index (RI) and pulsatility index (PI) decreased progressively with advancing gestational age. The best fits for SD, RI and PI versus gestational age were linear regression equations. According to these equations, the mean predicted SD ratio decreased from 1.75 at 11 weeks of gestation (P5-P95: 1.32-2.17) to 1.48 at 24 weeks of gestation (P5-P95: 1.01-2.20). The predicted RI en PI showed similar decrement: mean RI from 0.44 (P5-P95: 0.26-0.60) at 11 weeks of gestation to 0.34 (P5-P95: 0.15-0.50) at 24 weeks of gestation, mean PI from 0.59 (P5-P95: 0.31-0.75) at 11 weeks of gestation to 0.40 (P5-P95: 0.11-0.66) at 24 weeks of gestation. The Mann-Whitney tests found no difference in PI, SD-ratio or PI in pregnancies complicated by PE and IUGR fetuses. However, significantly lower RI, PI and SD-ratio were found preclinically in pregnancies complicated by PIH. CONCLUSION: Spiral artery flow velocities decrease progressively with advancing gestational age. Reference ranges for SA blood velocities are wide and early measurements of PI, RI or SD-ratios are not sensitive enough to predict preeclampsia, PIH or IUGR fetuses. The significantly lower spiral artery impedance values preceding pregnancies complicated by PIH are likely caused by a hyperdynamic circulation in women with preexistent hypertension.
Authors:
K L Deurloo; M D Spreeuwenberg; A C Bolte; J M G Van Vugt
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  27     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-29     Completed Date:  2008-02-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  1011-6     Citation Subset:  IM    
Affiliation:
VU Medical Center, Department of Obstetrics and Gynecology, The Netherlands. kl.deurloo@vumc.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Fetal Growth Retardation / diagnosis*
Gestational Age
Humans
Hypertension, Pregnancy-Induced / diagnosis*
Longitudinal Studies
Placenta / blood supply*,  ultrasonography
Pregnancy
Pregnancy Outcome
Prognosis
Regional Blood Flow
Ultrasonography, Doppler, Color*
Ultrasonography, Prenatal

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


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