Uterine Artery Doppler Velocimetry in Relation to Trophoblast Migration into the Myometrium of the Placental Bed

Lin, Shiko; Shimizu, Ikuya; Suehara, Noriyuki; Nakayama, Masahiro; Aono, Toshihiro

doi:10.1016/0029-7844(95)00020-r

Cited by 168 publications

(89 citation statements)

References 14 publications

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“…This mechanism leads to structural changes in the arteries, reducing arterial wall muscle, making them bigger and establishing low resistance connections, which culminates in a change in the blood flow to the uterine artery (LIN et al, 1995). This phenomenon brings about decreased PVR and a fall in arterial pressure both in pregnant women and pregnant female dogs (LONGO, 1983).…”

Section: Gestational Hemodynamicsmentioning

confidence: 99%

Hemodynamic gestational adaptation in bitches

et al. 2017

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Throughout pregnancy, maternal hemodynamic adaptation is needed to ensure proper uterine perfusion and fetal development. When the uteroplacental vascular system is formed, starting with reduced resistance to uterine arterial flow, this results in decreased total vascular resistance, an activation of neuroendocrine vasoactive peptides, an increase in circulating blood and changes in the cardiovascular system morphophysiology to respond to the increasing demands of uterine perfusion. There has been considerable study of hemodynamic adaptation in pregnant women and this assessment has become a diagnostic tool for fatal obstetric disorders. However, in bitches the available information in this regard is limited; therefore a parallel was drawn between other species of animals and women, in order to subsidize the paucity of information about this process and facilitate the understanding of maternal-fetal hemodynamic adaptation in pregnant bitches. This review and literature analysis aimed\ to discuss morphophysiological cardiovascular adaptations during pregnancy and the possible disorders that can affect this process in pregnant female dogs.

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Section: Gestational Hemodynamicsmentioning

confidence: 99%

Hemodynamic gestational adaptation in bitches

et al. 2017

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“…[88][89][90][91][92] An updated systematic review [77] on the predictive accuracy of uterine artery Doppler velocimetry for preeclampsia concluded that, in low risk populations, the sensitivity and specificity of the uterine artery Doppler indices ranged from 34% to 76%, and between 83 and 93%, respectively. [87] In this study, the sensitivity of an abnormal uterine artery Doppler velocimetry in the midtrimester for predicting preeclampsia, as well as preterm and early-onset preeclampsia was 32%, 43% and 78%, with a positive likelihood ratio of 2.7, 3.5 and 6.4, respectively.…”

Section: Uterine Artery Doppler Velocimetrymentioning

confidence: 99%

A prospective cohort study of the value of maternal plasma concentrations of angiogenic and anti-angiogenic factors in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia

Kusanovic¹,

Romero²,

Chaiworapongsa³

et al. 2009

DJMF

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OBJECTIVE-Changes in the maternal plasma concentrations of angiogenic (such as PlGF and VEGF) and anti-angiogenic factors (such as sEng and sVEGFR-1) precede the clinical presentation of preeclampsia. This study was conducted to examine the role of maternal plasma PlGF, sEng and sVEGFR-1 concentrations in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia.METHODS-This longitudinal cohort study included 1,622 consecutive singleton pregnant women. Plasma samples were obtained in early pregnancy (6-15 weeks) and midtrimester (20-25 weeks). Maternal plasma PlGF, sEng and sVEGFR-1 concentrations were determined using sensitive and specific immunoassays. The primary outcome was the development of preeclampsia. Secondary outcomes included term, preterm and early-onset preeclampsia. Receiving operating characteristic (ROC) curves, sensitivity, specificity, positive and negative likelihood ratios, and multivariable logistic regression were used for statistical analyses. A p-value of <0.05 was considered significant. RESULTS-1)The prevalence of preeclampsia, term, preterm (<37 weeks) and early-onset preeclampsia (<34 weeks) was 3.8% (62/1,622), 2.5% (40/1,622), 1.4% (22/1,622) and 0.6% (9/1,622), respectively; 2) Higher likelihood ratios were provided by ratios of midtrimester plasma concentrations of PlGF, sEng, and sVEGFR-1 than single analytes; 3) Individual angiogenic and anti-angiogenic factors did not perform well in the identification of preeclampsia as a whole; in particular, they perform poorly in the prediction of term preeclampsia; 4) In contrast, a NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript combination of these analytes such as the PlGF/sEng ratio, its delta and slope had the best predictive performance with a sensitivity of 100%, a specificity of 98%-99%, and likelihood ratios for a positive test of 57.6, 55.6 and 89.6, respectively, for predicting early-onset preeclampsia. CONCLUSIONS-1)The PlGF/sEng ratio and its delta and slope had an excellent predictive performance for the prediction of early-onset preeclampsia, with very high likelihood ratios for a positive test result and very low likelihood ratios for a negative test result; and 2) Although the positive likelihood ratios are high and the positive predictive values low, the number of patients needed to be closely followed is 4:1 for the PlGF/sEng ratio and 3:1 for the slope of PlF/sEng.

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“…, mas a grande maioria destes relaciona os achados dopplerfluxométricos aos resultados clínicos 2,3,5 . Somente na década de 1990 surgem os primeiros trabalhos buscando avaliar a associação da dopplerfluxometria da circulação útero-placentária com os aspectos histológicos do leito placentário 10,[17][18][19] . O trabalho de revisão publicado por Pijnenborg 11 afirma que "estudos da correlação entre as características do fluxo útero-placentário e achados histopatológicos do leito placentário são ansiosamente esperados".…”

Section: Pacientes E Métodosunclassified

“…Lin et al 18 estudaram a relação entre a medida da relação S/D da artéria uterina placentária e a migração do trofoblasto no miométrio do leito placentário em 43 gestações, incluindo gestações normais, com PE e a ocorrên-cia de SFA. Encontraram que o valor preditivo positivo da relação S/D da artéria uterina para ausência de migração trofoblástica foi de 92% quando utilizaram o ponto de corte de 2,5, mas a sensibilidade e o valor preditivo negativo da relação S/ D foram baixos (~45%).…”

unclassified

Associação entre a Incisura Diastólica das Artérias Uterinas e a Histologia do Leito Placentário em Grávidas com Pré-eclâmpsia

Aguiar¹,

Cabral²,

Lana³

2001

Rev. Bras. Ginecol. Obstet.

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Uterine Artery Doppler Velocimetry in Relation to Trophoblast Migration into the Myometrium of the Placental Bed

Abstract: The results suggest that abnormal uterine artery flow velocity waveforms may indicate impaired trophoblast migration into the myometrium of the placental bed.

Cited by 168 publications

References 14 publications

Hemodynamic gestational adaptation in bitches

Hemodynamic gestational adaptation in bitches

A prospective cohort study of the value of maternal plasma concentrations of angiogenic and anti-angiogenic factors in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia

Associação entre a Incisura Diastólica das Artérias Uterinas e a Histologia do Leito Placentário em Grávidas com Pré-eclâmpsia

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