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

Haberman, Shoshana; Friedman, Zvi

doi:10.1159/000291810

Cited by 12 publications

(8 citation statements)

References 22 publications

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“…Thus, as on the maternal side of the placental circulation, blood velocity decreased as it approached the exchange surfaces within the placenta. The ability to monitor velocity in the intraplacental arteries is valuable because this site is closer to known sites of vascular pathology in human IUGR placentas (22) and because waveforms in intraplacental fetal arteries may be abnormal before waveforms in the umbilical artery are affected in human fetuses with IUGR (52). The number of detectable fetal intraplacental arteries in human fetuses with intrauterine growth retardation is also reduced (40).…”

Section: Discussionmentioning

confidence: 99%

Developmental changes in hemodynamics of uterine artery, utero- and umbilicoplacental, and vitelline circulations in mouse throughout gestation

Adamson²

2006

American Journal of Physiology-Heart and Circulatory Physiology

110

104

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In human pregnancy, abnormal placental hemodynamics likely contribute to the etiology of early-onset preeclampsia and fetal intrauterine growth restriction. The mouse is increasingly being deployed to study normal and abnormal mammalian placental development, yet the placental hemodynamics in normal pregnancy in mice is currently unknown. We used ultrasound biomicroscopy to noninvasively image and record Doppler blood velocity waveforms from the maternal and embryonic placental circulations in mice throughout gestation. In the uterine artery, peak systolic velocity (PSV) increased significantly from 23 ± 2 (SE) to 59 ± 3 cm/s, and end-diastolic velocity (EDV) increased from 7 ± 1 to 28 ± 2 cm/s in nonpregnant versus full-term females so that the uterine arterial resistance index (RI) decreased from 0.70 ± 0.02 to 0.53 ± 0.02. Velocities in the maternal arterial canal in the placenta were low and nearly steady and increased from 0.9 ± 0.03 cm/s at embryonic day 10.5 (E10.5) to 2.4 ± 0.07 cm/s at E18.5. PSV in the umbilical artery increased steadily from 0.8 ± 0.1 cm/s at E8.5 to 15 ± 0.6 cm/s at E18.5, whereas PSV in the vitelline artery increased from 0.6 ± 0.1 cm/s at E8.5 to 4 ± 0.2 cm/s at E13.5 and then remained stable to term. In the umbilical artery, the EDV detection rate was 0% at ≤E14.5 and 94% at E18.5, and the RI decreased from 1 to 0.82 ± 0.01 during this interval. We conclude that ultrasound biomicroscopy can be used to monitor placental hemodynamics during pregnancy in mice. These results provide novel information concerning the development of the vitelline and placental circulations in mice and reveal strong similarities in placental hemodynamics between mice and humans.

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Section: Discussionmentioning

confidence: 99%

Developmental changes in hemodynamics of uterine artery, utero- and umbilicoplacental, and vitelline circulations in mouse throughout gestation

Adamson²

2006

American Journal of Physiology-Heart and Circulatory Physiology

110

104

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“…Nutrients and oxygen are transported to the developing fetus via placental circulation, whereas waste products are excreted through it as well . The reported worldwide prevalence of gestational diabetes mellitus (GDM) varies widely (ranging from 1% to 38%, depending on the population studied and the diagnostic tests employed) .…”

Section: Introductionmentioning

confidence: 99%

“…Nutrients and oxygen are transported to the developing fetus via placental circulation, whereas waste products are excreted through it as well. 1,2 The reported worldwide prevalence of gestational diabetes mellitus (GDM) varies widely (ranging from 1% to 38%, depending on the population studied and the diagnostic tests employed). 3,4 In diabetic pregnancies, the resistance of placental blood vessels might be increased, which can affect uteroplacental blood flow and have influence on the oxygen and nutrient supply of fetus and on fetal growth.…”

Section: Introductionmentioning

confidence: 99%

Placental three‐dimensional power Doppler indices in mid‐pregnancy and late pregnancy complicated by gestational diabetes mellitus

et al. 2013

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“…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]. However, the clinical usefulness of the distribution curves of the Doppler indices and the intraplacental Doppler velocimetry indices obtained by the SDIM remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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

Cited by 12 publications

References 22 publications

Developmental changes in hemodynamics of uterine artery, utero- and umbilicoplacental, and vitelline circulations in mouse throughout gestation

Developmental changes in hemodynamics of uterine artery, utero- and umbilicoplacental, and vitelline circulations in mouse throughout gestation

Placental three‐dimensional power Doppler indices in mid‐pregnancy and late pregnancy complicated by gestational diabetes mellitus

Spectral Doppler Index Mapping of the Umbilicoplacental Circulation and Pregnancy Outcome

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