A New Technique for Improved Diagnosis of Local Placental Abnormalities: Fourier Analysis of Intraplacental Waveforms

Haberman, Shoshana; Friedman, Zvi

doi:10.1159/000292632

Cited by 7 publications

(12 citation statements)

References 18 publications

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“…In our previous work [29] we were able to show theo retically that there is a downstream pulsatility gradient within the vascular tree of the normal placenta as also observed and hypothesized by Jauniax et al [30] and Hsic et al [31], Our model proved theoretically that local intra placental vascular disorders, which may have a negligible effect on the UA Doppler waveforms, could be detected based on the placental arterial downstream pulsatility gra dient. The theory has also been supported by some clini cal data.…”

supporting

confidence: 84%

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Intraplacental Spectral Doppler Scanning: Fetal Growth Classification Based on Doppler Velocimetry

Haberman

Friedman²

1997

Gynecol Obstet Invest

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The purpose of the study was to develop a Doppler modality for effective assessment of the fetoplacental circulation. Calculations based upon a theoretical model were employed to predict downstream pulsatility values in the fetoplacental circulation. The clinical study included 83 pregnancies between 32 and 36 weeks of gestation. Sixty-nine women were recruited from our low-risk clinic and had uncomplicated pregnancies. Fourteen patients had complications suspected to be associated with placental pathology. All 83 patients demonstrated UA Doppler indices within the normal limits for the gestational age. The study included intraplacental and UA Doppler waveform analyses. The ratios between intraplacental and UA PI values (at the cord insertion to the placenta) were calculated. Nineteen patients with intraplacental to UA (placental cord insertion) PI ratios > 1 (abnormal) had adverse pregnancy outcome. The study demonstrates the importance of detailed scanning of the intraplacental pulsatile waveforms and the importance of using the ratio between the intraplacental and UA Doppler indices as an additional method for evaluation of the fetoplacental circulation. The method might be proven more effective mainly in the early stages of placental disease when a relatively small number of the placental terminal arterioles are affected with a negligible effect on the UA Doppler indices, and also in the evaluation of the large placenta. A fetal growth classification based on detailed intraplacental velocimetry and cord to intraplacental flow gradient is proposed.

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supporting

confidence: 84%

“…Based on our proposed theoretical model [29], a new Doppler method for the early diagnosis of placental disorders, in terms of the described classification scheme is proposed. The method is based on a mathematical analysis of the UA waveforms as well as the intraplacental downstream pul satility gradient.…”

mentioning

confidence: 99%

Intraplacental Spectral Doppler Scanning: Fetal Growth Classification Based on Doppler Velocimetry

Haberman

Friedman²

1997

Gynecol Obstet Invest

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“…The advantage of a detailed analysis of intraplacental Doppler waves is that it may identify fetoplacental circulation abnormalities earlier in gestation before these changes elicit an effect on the UA Doppler indices. Preliminary studies on the assessment of the intraplacental Doppler pulsatile indices (PI) during the second and third trimesters have been encouraging [15][16][17]. We have previously shown that the new Doppler method is reliable and can be used for the assessment of the fetoplacental circulation [1].The efficacy of this method in the prediction of adverse pregnancy outcome related to placental pathology has been described previously [17][18][19].…”

Section: Introductionmentioning

confidence: 93%

“…The major decrease in the arterial pressure across the umbilicoplacental circulation occurs in the small arteries and arterioles, the resistance vessels, of the tertiary stem villi, leading to the UA-intraplacental resistance gradient. Current sensitive Doppler technology allows imaging of flow and direct measurements of Doppler indices in very small vessels [13][14][15]. The intraplacental fetal artery may be a more appropriate site for studying vascular resistance in the fetoplacental vascular tree [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Current sensitive Doppler technology allows imaging of flow and direct measurements of Doppler indices in very small vessels [13][14][15]. The intraplacental fetal artery may be a more appropriate site for studying vascular resistance in the fetoplacental vascular tree [14][15][16]. However, meticulous analysis of the fetal intraplacental vessels using spectral Doppler sonography is tedious and time-consuming.…”

Section: Introductionmentioning

confidence: 99%

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Spectral Doppler Index Mapping of the Umbilicoplacental Circulation and Pregnancy Outcome

Haberman

Bracero

Byrne³

2004

Gynecol Obstet Invest

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Objective: To determine the value of Doppler measurements obtained by a new multigate Doppler modality, the spectral Doppler index mapping (SDIM) technique, to predict adverse outcome among pregnant women with normal conventional umbilical artery (UA) Doppler indices. Design: A cross-sectional prospective cohort study. Subjects: 183 women with well-dated singleton pregnancies who underwent prenatal ultrasound examination between 18 and 40 weeks of gestation were included in the study. At the time of the initial Doppler examination, all patients had normal UA and uterine artery Doppler indices, size appropriate for gestational age, no evidence of fetal anomalies or fetal distress. Methods: SDIM data included the distribution curves of the pulsatility indices (PI) as well as the mean of the PI detected in the placenta and in the umbilical cord. The mean PI values were also calculated using conventional spectral Doppler sonography. Logistic regression analysis was used to control for gestational age while assessing various Doppler variables in predicting outcome. Results: Adverse outcomes occurred in 26.6% of the pregnancies. In pregnancies with adverse outcome, the umbilicoplacental PI gradient was significantly lower (0.10 vs. 0.28, p < 0.003), the maximum intraplacental PI value was higher (1.28 vs. 1.16, p = 0.031), and there was a greater proportion with skewed UA distribution curves. Using forward stepwise logistic regression to compare the predictive value of the conventional Doppler ultrasound with SDIM, we found that the most accurate predictors of adverse outcome were the maximum intraplacental PI value (p < 0.028), skewed distributions (p = 0.002) and the gradient between the umbilical and intraplacental PI distributions (p = 0.006). Conclusions: Our results suggest that the SDIM system may enhance the ability of Doppler technology to predict obstetrical outcomes in patients with normal UA Doppler indices.

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Simultaneous multigate spectral Doppler imaging of the umbilical artery and placental vessels: novel ultrasound technology

Anteby¹,

Shen²,

Cohen³

et al. 1999

Ultrasound in Obstet & Gyne

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A New Technique for Improved Diagnosis of Local Placental Abnormalities: Fourier Analysis of Intraplacental Waveforms

Cited by 7 publications

References 18 publications

Intraplacental Spectral Doppler Scanning: Fetal Growth Classification Based on Doppler Velocimetry

Intraplacental Spectral Doppler Scanning: Fetal Growth Classification Based on Doppler Velocimetry

Spectral Doppler Index Mapping of the Umbilicoplacental Circulation and Pregnancy Outcome

Simultaneous multigate spectral Doppler imaging of the umbilical artery and placental vessels: novel ultrasound technology

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