title: Placental ischemia and changes in umbilical and uteroplacental arterial and venous hemodynamics.
abstract: OBJECTIVE
  To relate Doppler velocimetry findings in fetoplacental and uteroplacental circulation to placental histomorphology.
  
  
  METHODS
  In 14 uncomplicated and 31 high-risk pregnancies Doppler velocimetry was performed in umbilical artery and vein, and in maternal uterine veins and arteries during the second half of gestation. Histopathology of the placentas was examined, especially for signs of ischemia and inflammation.
  
  
  RESULTS
  All fetuses in uncomplicated pregnancies had normal flow velocity waveforms in umbilical artery; in the high-risk group, 18 fetuses had abnormal flow (increased PI or absent/reverse end-diastolic flow). The latter group had more often high ischemic score and infarctions in the placenta than found in pregnancies with normal umbilical artery flow (p < 0.001 and p = 0.02, respectively). Similarly, the abnormal uterine artery flow pattern (uterine artery score 3-4) occurred more often with high ischemic score and placenta infarctions (p < 0.001 and p < 0.001, respectively). No significant associations were found between the uterine venous flow type and placental ischemia.
  
  
  CONCLUSIONS
  Placental ischemic morphological changes were associated with Doppler ultrasound signs of increased resistance to arterial blood flow, both on the fetal and maternal sides of the placenta. No significant relation to the uterine venous flow velocities was found.
authors.affiliation: Department of Obstetrics and Gynecology, Clinical Sciences Lund, Lund University, Lund, Sweden. Ann.Thuring@med.lu.se
authors.forename: Ann
authors.initials: A
authors.lastname: Thuring
authors.forename: Karel
authors.initials: K
authors.lastname: Maršál
authors.forename: Ricardo
authors.initials: R
authors.lastname: Laurini
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D001783:Blood Flow Velocity; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007511:Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D010920:Placenta / Q000098:blood supply* / Q000502:physiology; D021041:Placental Circulation / Q000502:physiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D018608:Ultrasonography, Doppler / Q000379:methods; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000502:physiology*; D014471:Umbilical Veins / Q000000981:diagnostic imaging / Q000502:physiology*; D055815:Young Adult