Summary
Blood flow velocity waveforms (FVW) were recorded weekly from the umbilical and arcuate arteries in 58 hospitalised women with a pregnancy complicated by pre-eclampsia. The maximum velocity waveform was analysed for pulsatility index (PI) and the results from the final antenatal examination were related to the outcome of pregnancy. The umbilical artery FVW was abnormal in 36% of the pre-eclamptic pregnancies, as was the arcuate artery FVW in 42%. No difference in FVW was found between mild and severe pre-eclampsia. Abnormal FVW in the umbilical artery was associated significantly both with intra-uterine growth retardation (IUGR) (P<0.001) and with signs of fetal distress (FD) (P<0.05). Abnormal arcuate artery FVW was associated with FD (P<0.05), but not with IUGR. The outcome of pregnancy was related to Placenta Waveform Class, which was derived from the blood velocity on both maternal and fetal sides of placenta. The results suggest that ultrasound Doppler examination of the umbilical artery is a useful aid in monitoring pregnancies complicated by preeclampsia, but that arcuate artery examination needs further evaluation.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Atkinson P, Woodcock JP (1982) Doppler ultrasound and its use in clinical measurement. Academic Press, London, pp 178 and 182
Brosens I (1964) A study of the spiral arteries of the decidua basalis in normotensive and hypertensive pregnancies. J Obstet Gyn Br Cwlth 71:222–230
Brosens I, Robertson WB, Dixon HG (1967) The physiological response of the vessels of the placental bed in normal pregnancy. J Pathol Bact 93:569–579
Campbell S, Diaz-Recasens J, Griffin DR, Cohen-Overbeek T, Pearce JMF, Willson K, Teague MJ (1983) New Doppler technique for assessing uteroplacental blood flow. Lancet 1: 675–677
Campbell S, Pearce JMF, Hackett G, Cohen-Overbeek T, Hernandes C (1986) Qualitative assessment of uteroplacental blood flow: early screening test for high-risk pregnancies. Obstet Gynecol 68:649–653
Cohen-Overbeek T, Pearce JM, Campbell S (1985) The antenatal assessment of utero-placental and feto-placental blood flow using Doppler ultrasound. Ultrasound Med Biol 11:329–339
Eik-Nes S, Brubakk AO, Ulstein M (1980) Measurement of human blood flow. Br Med J 1:283–284
Eik-Nes SH, Maršál K, Kristoffersen K (1984) Methodology and basic problems related to blood flow studies in the human fetus. Ultrasound Med Biol 10:329–337
Fleischer A, Schulman H, Farmakides G, Bracero L, Grunfeld L, Rochelson B, Koenigsberg M (1986) Uterine artery Doppler velocimetry in pregnant women with hypertension. Am J Obstet Gynecol 154:806–813
Giles WB, Trudinger BJ, Cook CM (1982) Umbilical artery velocity time waveforms in pregnancy. J Ultrasound Med 1 [Suppl] 98
Gill RW, Kossoff G (1979) Pulsed doppler combined with B-mode imaging for blood flow measurement. Contr Gynecol Obstet 6:139–141
Gosling RG, Dunbar G, King DH (1971) The quantitative analysis of occlusive peripheral arterial disease by a nonintrusive ultrasound technique. Angiology 22:52–55
Gudmundsson S, Maršál K (1988) Umbilical and uteroplacental blood flow velocity waveform in normal pregnancy — a cross-sectional study. Acta Obstet Gynaecol Scand 67 (in press)
Krissmann A, Bollinger A, Keller H (1982) Praxis der Doppler-Sonographie; periphere Arterien und Venen, hirnversorgende Arterien (Ger). Thieme, Stuttgart, S 206–207
Metcalfe J, Romney SL, Ramsy LH, Reid De, Burwell CS (1955) Estimation of uterine blood flow in normal human pregnancy at term. J Clin Invest 34:1632–1638
Moll W, Kunzel W, Herberger J (1975) Hemodynamic implications of hemochorial placentation. Eur J Obstet Gynaecol Repr Biol 5:67–74
Naeye R, Friedman EA (1979) Causes of perinatal death associated with gestational hypertension and proteinuria. Am J Obstet Gynecol 133:8–10
Nylund L, Lunell N-O, Lewander R, Sarby B (1983) Uteroplacental blood flow index in intrauterine growth retardation of fetal or maternal origin. Br J Obstet Gynaecol 90:16–20
Pearce JMF, Hernandez CE, Cohen-Overbeek T, Campbell S (1984) A classification of intrauterine growth retardation based upon flow velocity waveform obtained from the uteroplacental and fetoplacental circulation. XI. Annual Confrence of the Society for the Study of Fetal Physiology. Oxford 21–22 july, Abstract no. 15
Robertson WB, Brosens I, Dixon G (1975) Uteroplacental vascular pathology. Eur J Obstet Gynecol Reprod Biol 52:47–65
Sterky G (1970) Swedish standard curves for intra-uterine growth. Pediatrics 46:7–8
Sykes GS, Mollow PM, Johnson P (1983) Fetal distress and the condition newborn infant. Br Med J 287:943–945
Trudinger BJ, Giles WB, Cook CM, Bombardieri J (1985) Fetal umbilical artery flow velocity waveforms and placental resistance: clinical significance. Br J Obstet Gynecol 92:23–30
Trudinger BJ, Giles WB, Cook CM (1985) Flow velocity waveforms in the maternal uteroplacental and fetal umbilical placental circulations. Am J Obstet Gynecol 152:155–160
Wladimiroff J, Tonge HM, Stewart PA (1986) Doppler ultrasound assessment of cerebral blood flow in the human fetus. Br J Obstet Gynaecol 93:471–475
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gudmundsson, S., Maršál, K. Ultrasound Doppler evaluation of uteroplacental and fetoplacental circulation in pre-eclampsia. Arch Gynecol Obstet 243, 199–206 (1988). https://doi.org/10.1007/BF00932268
Issue Date:
DOI: https://doi.org/10.1007/BF00932268