Uterine and spiral artery flow velocity waveforms in pregnancy-induced hypertension and/or intrauterine growth retardation
Abstract
The objectives of this study were to characterize spiral artery flow velocity waveforms in normal pregnancies and pregnancies complicated by pregnancy-induced hypertension and/or intrauterine growth retardation, and to examine the diagnostic potential for predicting adverse perinatal outcomes in complicated pregnancies compared with uterine and umbilical artery flow velocity waveforms. In this cross-sectional study, 160 normal and 43 complicated pregnancies were assessed by color and pulsed Doppler during 18-41 weeks of gestation. Flow velocity waveforms were obtained from the spiral, uterine and fetal umbilical arteries. In normal pregnancies, the resistance index of spiral artery flow velocity waveforms decreased significantly with advancing gestation (r = -0.256, p < 0.001). In abnormal pregnancies complicated by pregnancy-induced hypertension and/or intrauterine growth retardation, the incidence of adverse perinatal outcome was significantly higher in patients with abnormal spiral artery resistance indices than in patients with normal spiral artery resistance indices (p < 0.001). An abnormal spiral artery resistance index had a better diagnostic accuracy for adverse perinatal outcome (sensitivity 85.0%, specificity 91.3%, positive predictive value 89.5%, negative predictive value 87.5%, accuracy 88.4%) when compared with the resistance index of uterine and umbilical artery waveforms and presence of a diastolic notch of the uterine artery waveform. Color flow imaging facilitates the precise analysis of spiral artery flow velocity waveforms and provides more accurate information about the uteroplacental circulation in the evaluation of placental function.
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Numerous attempts to directly image the spiral arteries within the myometrium have generated conflicting data.
“Numerous attempts have been made to directly image the spiral arteries within the myometrium but this has generated conflicting data [51–56].”
From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [54]
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“the method previously employed to identify the spiral arteries was flawed [12].”
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“Abnormal uterine artery Doppler flow velocimetry (UADV) is associated with adverse pregnancy outcome.(3) Changes in Doppler waveform patterns detected during the midtrimester are more predictive of severe adverse pregnancy outcome.”
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“Our reference ranges for PI, RI and SDratio are closely comparable to previous reported results by several authors (Murakoshi et al., 1996; Hung et al., 1997a), although our time interval of measurements was different: gestational week 11–24 in our study versus week 13–25 in Hung’s study and week 18–41 in the study of…”
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- Authors
- Murakoshi, T., Sekizuka, N., Takakuwa, K., Yoshizawa, H., & Tanaka, K.
- Affiliations
- Niigata University (JP)
- Corresponding author
- Murakoshi, T.
- ORCID
- Tanaka, K.
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 1996-02
- Volume
- 7
- Issue
- 2
- Pages
- 122-128
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W2062115892
- Cited by
- 38
- References
- 0
- Citations by year
- 2023: 1 · 2021: 1 · 2019: 1 · 2018: 3 · 2016: 3 · 2014: 1 · 2013: 2 · 2012: 1
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- uterine artery, umbilical artery, gestational hypertension, fetal growth restriction, resistance index, uteroplacental circulation, placental function, perinatal complications, color Doppler ultrasound, diastolic notch, complicated pregnancy
- MeSH terms
- Adult, Blood Flow Velocity, Cross-Sectional Studies, Female, Fetal Growth Retardation, Humans, Predictive Value of Tests, Pregnancy, Pregnancy Complications, Cardiovascular, Pregnancy Outcome, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Vascular Resistance, Ultrasonography, Prenatal, Ultrasonography, Doppler, Color, Ultrasonography, Doppler, Pulsed, Placental Circulation
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