Uterine arcuate artery Doppler and decidual microvascular pathology in pregnancies complicated by type I diabetes mellitus.
The objective was to correlate Doppler indices from the uterine arcuate arteries with an analysis of the decidual vascular histology in patients with type I diabetes. Pulsed wave Doppler was used to sample the uterine arcuate artery system beneath the placenta within 8 days of delivery in 47 patients with type I diabetes mellitus. A placental pathologist, without knowledge of either clinical outcome or Doppler information, classified the histological appearance of the decidual arteries as normal, type A (hyalinization, mural thickening), or type B (fibrinoid necrosis, atherosis, thrombosis). Patients were then grouped according to the histology of the decidual arteries. An analysis of variance (ANOVA) of the systolic/diastolic (S/D) ratios (log. S/D) showed significant variation (p < 0.025). A multiple range comparison test showed that patients with normal or only mildly abnormal (type A) vessels had similar values, whereas those with severe vasculopathy (type B) had significantly higher S/D ratios (p < 0.05). The study confirmed a relationship between arcuate artery Doppler indices and downstream decidual vascular pathology.
Barth
W H
WH
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
Genest
D R
DR
Riley
L E
LE
Frigoletto
F D
FD
Benacerraf
B R
BR
Greene
M F
MF
D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D001783:Blood Flow Velocity; D003656:Decidua / Q000098:blood supply* / Q000473:pathology; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008833:Microcirculation / Q000473:pathology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000473:pathology / Q000503:physiopathology*; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging