The relation of increased uterine artery blood flow resistance and impaired trophoblast invasion in pre-eclamptic pregnancies.
OBJECTIVE
To assess the association between histopathologically confirmed vascular abnormalities developed during pre-eclampsia and abnormal arterial blood flows recorded during Doppler sonographies.


METHODS
From pregnant women who attended our clinic between 01/03/2002 and 01/07/2002, a detailed medical history was obtained and routine biochemical blood tests, fetal ultrasonography and UA Doppler scans were performed. In addition, from pre-eclamptic and normal pregnant women who underwent cesarean sections, placental bed biopsies were taken. Thirty two pre-eclamptic [12 mild, 20 severe cases according to American College of Obstetricians and Gynecologists (ACOG) criteria] cases and as a control group 20 normal pregnancies were included in the study. In our study trophoblast invasion into decidual spiral arteries was observed in 75% of mild (9/12), and 55% of severe (11/20) pre-eclampsias. In the control group all the cases demonstrated trophoblast invasion in decidual spiral arteries. Trophoblast invasion in myometrial spiral arteries was noted in 50% (6/12) of mild and 25% (5/20) of severe pre-eclamptic pregnancies. It was seen in 16 cases out of 20 (80%) pregnancies. In the control group, decidual spiral artery invasion manifests significant differences (P<0.01) among groups studied. Invasion in decidual spiral arteries was seen in all normal pregnancies of the control group. There is not any significant difference between mild and severely pre-eclamptic groups (P>0.05).


CONCLUSIONS
Doppler ultrasonography is not only a non-invasive method for evaluating fetal status in pre-eclamptic pregnancies, but it also correlates with partial trophoblastic invasion in spiral arteries, which contributes to the pathophysiologic mechanisms involved in pre-eclampsia.
Guzin
Kadir
K
Department of Obstetrics and Gynecology, SSK Göztepe Educational Hospital, Kadiköy, Istanbul, Turkey. kguzin@ttnet.net.tr
Tomruk
Sedat
S
Tuncay
Yildiz Ayhan
YA
Naki
Murat
M
Sezginsoy
Selen
S
Zemheri
Ebru
E
Yucel
Nese
N
Kanadikirik
Fahrettin
F
D000328:Adult; D001706:Biopsy; D001783:Blood Flow Velocity; D003656:Decidua / Q000473:pathology; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000473:pathology*; D011247:Pregnancy; D014327:Trophoblasts / Q000473:pathology*; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging; D014655:Vascular Resistance