[Doppler flow velocity waveforms in uteroplacental and fetal circulation in normal pregnancy and pregnancy-induced hypertension].
The present study was conducted to elucidate circulation dynamics in uteroplacental and fetal circulation in 130 normal pregnancies and in 40 patients with pregnancy-induced hypertension (PIH). A sector and pulsed Doppler system was employed to measure the uterine artery pulsatility index (UtA-PI), umbilical artery pulsatility index (UAPI), fetal middle cerebral artery pulsatility index (MCPI) and fetal descending aorta peak velocity (AoPV). Furthermore, peak velocity during early diastolic (E) and atrial contraction (A) periods through the mitral (M) and tricuspid (T) valves was measured to determine their ratios (M-E/A and T-E/A). Twelve of the 40 PIH women had UtA-PIs of 95% or higher in normal pregnant women. Ten of the 12 fetuses in women with high UtA-PIs had high UAPIs, 5 of whom demonstrated an MCPI decrease. Two of them represented an increase in M-E/A and a decrease in T-E/A and AoPV, and the prognosis was poor. Only 2 of the PIH women with normal UtA-PIs had high UAPIs. The fact that both M-E/A and T-E/A were inversely correlated with MCPI and UAPI, respectively, suggests that these parameters could be used as indexes demonstrating cardiac afterload in fetuses. UtA-PI measurement in combination with fetal circulation indexes could predict fetal and neonatal well-being.
Ochi
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Department of Obstetrics and Gynecology, Ehime University, School of Medicine.
D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D005333:Fetus / Q000098:blood supply*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D010920:Placenta / Q000098:blood supply*; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D011673:Pulsatile Flow; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000098:blood supply*