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A high uterine artery pulsatility index reflects a defective development of placental bed spiral arteries in pregnancies complicated by hypertension and fetal growth retardation

Olofsson, Per LU ; Laurini, Ricardo LU and Marsal, Karel LU (1993) In European Journal of Obstetrics, Gynecology, and Reproductive Biology 49(3). p.161-168
Abstract
INTRODUCTION: The development of PIH is associated with a defective trophoblast invasion and conversion of spiral arteries into low-resistance uteroplacental arteries. Hypertension may then be a compensatory response to a defective uteroplacental perfusion. Similar mechanisms may operate in IUGR. AIM: To compare uterine artery Doppler blood flow measurements with placental bed histology. The hypothesis was that placental bed vessel pathology plays a role for a raised flow resistance. MATERIALS AND METHODS: After blood flow measurements, a placental bed biopsy was taken at CS in 26 complicated (study group) and 29 uncomplicated pregnancies (control group). RESULTS: The uterine artery PI was significantly more often abnormally high in the... (More)
INTRODUCTION: The development of PIH is associated with a defective trophoblast invasion and conversion of spiral arteries into low-resistance uteroplacental arteries. Hypertension may then be a compensatory response to a defective uteroplacental perfusion. Similar mechanisms may operate in IUGR. AIM: To compare uterine artery Doppler blood flow measurements with placental bed histology. The hypothesis was that placental bed vessel pathology plays a role for a raised flow resistance. MATERIALS AND METHODS: After blood flow measurements, a placental bed biopsy was taken at CS in 26 complicated (study group) and 29 uncomplicated pregnancies (control group). RESULTS: The uterine artery PI was significantly more often abnormally high in the study group compared with the control group, and also in hypertensive pregnancies compared with normotensive IUGR pregnancies. Physiological vessel changes were found in all controls but were absent in 76% of study cases. Physiological changes were significantly more often absent in SGA than in AGA newborns. Absence of physiological changes were significantly more often found in cases with an abnormally high PI. DISCUSSION: The results link together circulatory and structural pathophysiological changes of the uteroplacental unit. A defective physiological conversion of the spiral arteries was associated with an increased uterine flow resistance. CONCLUSION: This study gave further support for the existence of a triad of defective placental bed vessel maturation, increased uteroplacental flow resistance, and hypertension. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Doppler blood flow, Spiral artery, Placental bed, Fetal growth retardation, Hypertension, Pregnancy
in
European Journal of Obstetrics, Gynecology, and Reproductive Biology
volume
49
issue
3
pages
161 - 168
publisher
Elsevier
external identifiers
  • pmid:8405630
  • scopus:0027282266
ISSN
0301-2115
DOI
10.1016/0028-2243(93)90265-E
language
English
LU publication?
yes
id
7df545ea-2a94-43a1-9ba0-135feed34593 (old id 1107666)
date added to LUP
2008-07-31 14:28:40
date last changed
2017-08-13 03:32:50
@article{7df545ea-2a94-43a1-9ba0-135feed34593,
  abstract     = {INTRODUCTION: The development of PIH is associated with a defective trophoblast invasion and conversion of spiral arteries into low-resistance uteroplacental arteries. Hypertension may then be a compensatory response to a defective uteroplacental perfusion. Similar mechanisms may operate in IUGR. AIM: To compare uterine artery Doppler blood flow measurements with placental bed histology. The hypothesis was that placental bed vessel pathology plays a role for a raised flow resistance. MATERIALS AND METHODS: After blood flow measurements, a placental bed biopsy was taken at CS in 26 complicated (study group) and 29 uncomplicated pregnancies (control group). RESULTS: The uterine artery PI was significantly more often abnormally high in the study group compared with the control group, and also in hypertensive pregnancies compared with normotensive IUGR pregnancies. Physiological vessel changes were found in all controls but were absent in 76% of study cases. Physiological changes were significantly more often absent in SGA than in AGA newborns. Absence of physiological changes were significantly more often found in cases with an abnormally high PI. DISCUSSION: The results link together circulatory and structural pathophysiological changes of the uteroplacental unit. A defective physiological conversion of the spiral arteries was associated with an increased uterine flow resistance. CONCLUSION: This study gave further support for the existence of a triad of defective placental bed vessel maturation, increased uteroplacental flow resistance, and hypertension.},
  author       = {Olofsson, Per and Laurini, Ricardo and Marsal, Karel},
  issn         = {0301-2115},
  keyword      = {Doppler blood flow,Spiral artery,Placental bed,Fetal growth retardation,Hypertension,Pregnancy},
  language     = {eng},
  number       = {3},
  pages        = {161--168},
  publisher    = {Elsevier},
  series       = {European Journal of Obstetrics, Gynecology, and Reproductive Biology},
  title        = {A high uterine artery pulsatility index reflects a defective development of placental bed spiral arteries in pregnancies complicated by hypertension and fetal growth retardation},
  url          = {http://dx.doi.org/10.1016/0028-2243(93)90265-E},
  volume       = {49},
  year         = {1993},
}