title: Comparison of ultrasonographic and Doppler mapping of the intervillous circulation in normal and abnormal early pregnancies.
abstract: OBJECTIVE
  To assess the value of ultrasonography and Doppler imaging in characterizing the intervillous circulation in normal and abnormal early pregnancy.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Tertiary care academic hospital.
  
  
  METHODS
  Eighty-five normal pregnancies and 125 missed miscarriages at 7 to 13 weeks of gestation.
  
  
  METHODS
  Grey-scale ultrasonography was used to evaluate the placental anatomy and detect moving echoes inside the intervillous space, and color power Doppler imaging was used to detect continuous venous-like flow in the placental tissue.
  
  
  METHODS
  Degree of agreement between two investigators for use of grey-scale imaging, comparison of detection of moving echoes in normal and abnormal pregnancies, and comparison of detection of intervillous circulation with grey-scale and color Doppler imaging in abnormal pregnancies.
  
  
  RESULTS
  The overall degree of agreement between the two investigators was good. A significantly different distribution of blood flow was found between normal and abnormal pregnancies at 7 to 9 weeks and 10 to 11 weeks but not at 12 to 13 weeks. Intervillous moving echoes were detected by grey-scale imaging significantly more frequently than an intervillous blood flow was detected with color Doppler imaging.
  
  
  CONCLUSIONS
  In early pregnancy failure, there is a premature and diffuse onset of intervillous blood flow that can be detected by grey-scale imaging. This abnormal blood flow pattern may increase the oxidative stress on the early placental tissue and subsequently impair placental development.
authors.affiliation: Academic Department of Obstetrics and Gynaecology Royal Free and University College London Medical School, London, United Kingdom. e.jauniaux@ucl.ac.uk
authors.forename: Eric
authors.initials: E
authors.lastname: Jauniaux
authors.forename: Natalie
authors.initials: N
authors.lastname: Greenwold
authors.forename: Joanne
authors.initials: J
authors.lastname: Hempstock
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Burton
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D010920:Placenta / Q000098:blood supply* / Q000000981:diagnostic imaging*; D011247:Pregnancy; D012039:Regional Blood Flow; D018615:Ultrasonography, Doppler, Color / Q000379:methods*