Measurement of spiral artery jets: general principles and differences observed in small-for-gestational-age pregnancies
Open accessAbstract
OBJECTIVE: To investigate whether the jets of blood from the mouths of the spiral arteries could be measured reliably, as well as their relationship with the uterine artery (UtA) and any differences in small-for-gestational-age (SGA) pregnancies. METHODS: Participants underwent serial ultrasound scans, from 11 weeks' gestation. Pulsatility index (PI) and resistance index (RI) of jets into the intervillous space (IVS) and UtA were recorded at every visit. Intra- and interobserver variability studies were performed. Customized birth weight centiles were calculated and SGA was defined as < 10(th) centile. Linear mixed model analysis was used to allow for the longitudinal nature of the data. RESULTS: Sixty-six women were recruited; 58 remained normotensive and delivered at term. Of these, six women delivered SGA newborns and 52 delivered appropriate-for-gestational-age newborns. All had pulsatile jets until 20 weeks' gestation. The PI and RI of the jets decreased with advancing gestation, following a trend similar to that of the UtAs. There was no correlation between the jets and UtA waveforms when gestational age was controlled for. For intraobserver variability the intraclass correlation coefficient was 0.9. The interobserver study showed no significant difference between the observers. Mixed model analysis demonstrated that PI and RI of jets were different in SGA pregnancies (P < 0.06). This difference was not seen for the UtAs (P = 0.8). CONCLUSION: This technique enables examination of characteristics of the jets of blood flowing from spiral arteries into the IVS. It is both precise and reproducible, with biologically plausible results. Further work is required to assess differences in pregnancies with adverse outcomes.
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The placenta and much of its vasculature are easily identifiable with ultrasonography from 11-14 weeks' gestation.
“The placenta is easily identifiable with ultrasonography from 11–14 weeks’ gestation, along with much of it’s vasculature [16]”
From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [16]
Pilot data demonstrates that the Jet PI is significantly altered in cSGA pregnancies, an effect that was not seen in the UtA Doppler indices.
“Indeed, pilot data demonstrates that the Jet PI is significantly altered in cSGA pregnancies, an effect that was not seen in the UtA Doppler indices [16].”
From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [16]
Early attempts at identification of the spiral arteries based on approximate location and distinctive bidirectional waveform are flawed because lack of defined anatomical landmarks makes consistent measurement impossible, angle correction is not appropriate due to tortuous nature, and seeking the classic waveform might lead to preferential selection of normal vessels.
“Unfortunately this method is flawed as lack of defined anatomical landmarks means it is impossible to measure vessels consistently at the same point, angle correction is not appropriate due to the tortuous nature of the spiral artery, and seeking the classic waveform might lead to preferential selection of normal vessels for measurement [16].”
From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [16]
The pulsatility index (PI) and resistance index (RI) of the spiral artery jets decrease with advancing gestational age, likely due to progressive remodelling of the vessel.
“The pulsatility index (PI) and resistance index (RI) of the spiral artery jets have been shown to decrease with advancing gestational age, likely due to the progressive remodelling of the vessel.”
From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [16]
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- Authors
- Collins, S. L., Birks, J. S., Stevenson, G. N., Papageorghiou, A. T., Noble, J. A., & Impey, L.
- Affiliations
- John Radcliffe Hospital (GB)
- University of Oxford (GB)
- Corresponding author
- Collins, S. L.
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2012-07-30
- Volume
- 40
- Issue
- 2
- Pages
- 171-178
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W1977233655
- Cited by
- 55
- References
- 24
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 7 · 2020: 8 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 1 · 2015: 1 · 2014: 4 · 2013: 1 · 2012: 2
- FWCI
- 2.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- intervillous space, uterine artery, pulsatility index, resistance index, fetal growth restriction, Doppler ultrasound, measurement reproducibility, gestational age
- MeSH terms
- Adolescent, Adult, Female, Humans, Infant, Newborn, Infant, Small for Gestational Age, Pregnancy, Pulsatile Flow, Observer Variation, Ultrasonography, Prenatal, Ultrasonography, Doppler, Color, Ultrasonography, Doppler, Pulsed, Young Adult, Uterine Artery
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