Doppler sonography of the uterine and the cubital arteries in normal pregnancies, preeclampsia and intrauterine growth restriction: evidence for a systemic vessel involvement.
OBJECTIVE
The decrease in uterine resistance during normal pregnancy is known to be related to invading trophoblast cells which derive from placental tissue. Uterine and peripheral resistance is elevated in preeclampsia. The aim of the present study was to prospectively examine uterine and peripheral resistance in pregnancies complicated by preeclampsia (PE), fetal intrauterine growth restriction (IUGR) and pregnancy induced hypertension (PIH).


METHODS
Sixty-seven women with normal pregnancies, 17 with PE, 12 with IUGR underwent Doppler sonographic investigation of the uterine and the cubital arteries. The Pulsatility Index (PI) was calculated for each vessel. Statistical analysis was performed and a P-value <0.05 was considered significant.


RESULTS
Patients with preeclampsia and IUGR showed a significant higher resistance at the placental (mean PI 1.267 and 1.063), nonplacental (mean PI 1.631 and 1.124) and cubital artery (mean PI 3,777 and 3.995) compared to the normal pregnancy group (mean PI 0.678; 0.859 and 2.95 respectively). Mean birth weight in the PE group was 1409 g, in the IUGR group 1649 g and 3419 g in the normal pregnancy group.


CONCLUSIONS
Pregnancies with IUGR are associated with elevated peripheral resistance in the maternal arterial system as seen in pregnancies with preeclampsia. Our findings encourage to further investigate the maternal vascular system in high risk pregnancies.
Schiessl
Barbara
B
Department of Obstetrics and Gynecology, Prenatal Medicine Unit, Ludwig-Maximilians University Munich, Germany. Barbara.Schiessl@med.uni-muenchen.de
Kainer
Franz
F
Oberhoffer
Renate
R
Jundt
Katharina
K
Friese
Klaus
K
D001158:Arteries / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D004550:Elbow / Q000098:blood supply; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D006801:Humans; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D011446:Prospective Studies; D018617:Ultrasonography, Doppler, Pulsed; D014599:Uterus / Q000098:blood supply*; D014655:Vascular Resistance / Q000502:physiology*