Decreased endovascular trophoblast invasion in first trimester pregnancies with high-resistance uterine artery Doppler indices.
BACKGROUND
Defective trophoblastic invasion in early pregnancy is involved in the pathogenesis of pre- eclampsia. This study investigates the relationship between Doppler assessment of uterine artery resistance and endovascular trophoblastic invasion in the first trimester of pregnancy.


METHODS
Patients undergoing termination of pregnancy for non-medical reasons were categorized as having a low- or high-resistance uterine artery blood flow pattern by transabdominal Doppler ultrasound. Products of conception were examined histologically with regard to the extent of decidual endovascular trophoblast invasion.


RESULTS
There were 14 low-resistance and 17 high-resistance uterine artery blood flow pregnancies identified at 10-14 weeks of gestation. Normal intradecidual endovascular trophoblast invasion was identified with a similar frequency in both groups (P=0.79). However, the proportion of decidual vessels with endovascular trophoblast invasion was significantly higher in the low-resistance pregnancies (49%) compared with the high-resistance ones (34%, P=0.02).


CONCLUSIONS
The findings of this study support the use of uterine artery Doppler investigation for the non-invasive assessment of trophoblast invasion in early pregnancy. Further studies are necessary to clarify the biological significance of these observations and their potential clinical applications.
Prefumo
F
F
Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London SW17 0RE, UK.
Sebire
N J
NJ
Thilaganathan
B
B
D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D003656:Decidua / Q000098:blood supply* / Q000473:pathology; D010064:Embryo Implantation; D005260:Female; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012039:Regional Blood Flow; D014327:Trophoblasts / Q000473:pathology*; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014655:Vascular Resistance