Doppler and immunohistochemical evaluation of decidual spiral arteries in early pregnancy.
OBJECTIVE
The purpose of this study was to estimate spiral artery subchorionic flow at 8-11 gestational weeks (GW) by Doppler ultrasound and then to analyze these vessels in the decidua basalis using histologic, morphometric and immunohistochemical analyses.


METHODS
Subchorionic spiral arteries were evaluated in 5 women scheduled for aspiration at 8-11 GW. Flow velocity waveforms were sought using color and pulsed Doppler, and the diastolic/systolic (D/S) index was calculated. Transcervical biopsy specimens and aspiration products were thoroughly examined to investigate the structure of the spiral artery at the implantation site using cytotrophoblastic and arterial smooth muscle cell immunohistochemical markers (anti-cytokeratin 7 and anti-actin monoclonal antibodies). Spiral artery cross-sectional inner areas were measured and compared with the D/S index in each case.


RESULTS
Low-impedance pulsatile flow could be detected below the trophoblastic ring in all cases. Complete obstruction of a spiral artery lumen was never observed and cytotrophoblastic cells were incorporated into the vessel wall starting from the perivascular cuff.


CONCLUSIONS
Both techniques evidenced that decidual spiral arteries in the placental bed are not completely obstructed at 8-11 GW.
Carbillon
Lionel
L
Department of Obstetrics and Gynecology, Hôpital Jean-Verdier, Assistance Publique, Hôpitaux de Paris, Université Paris 13, Bondy, France. lionel.carbillon@jvr.ap-hop-paris.fr
Ziol
Marianne
M
Challier
Jean-Claude
JC
Perrot
Nicolas
N
Uzan
Michèle
M
Prevot
Sophie
S
Uzan
Serge
S
D000199:Actins / Q000276:immunology; D000906:Antibodies / Q000097:blood; D001158:Arteries / Q000502:physiology; D001783:Blood Flow Velocity; D003656:Decidua / Q000098:blood supply*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007150:Immunohistochemistry; D053552:Keratin-7; D007633:Keratins / Q000276:immunology; D021041:Placental Circulation / Q000502:physiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood / Q000502:physiology; D011673:Pulsatile Flow; D016216:Ultrasonography, Prenatal
D000199:Actins; D000906:Antibodies; C507497:KRT7 protein, human; D053552:Keratin-7; D007633:Keratins