title: Doppler parameters of the maternal hepatic artery blood flow in normal pregnancy: maternal hepatic artery blood flow in normal pregnancy.
abstract: OBJECTIVE
  Objective of our study was to evaluate changes in Doppler resistance indices in the common hepatic artery during normal pregnancy.
  
  
  METHODS
  Cross-sectional study included 210 healthy pregnant women gestational age 6-40 weeks, 40 healthy non-pregnant women and 30 women after delivery. We divided all pregnant women by pregnancy trimester. We registered pulsatility index (PI) and resistive index (RI) in the common hepatic artery and compared the evaluated values among non-pregnant women and women in first, second and third trimester and post partum and tested correlation of both parameters with gestational age. Statistical analysis was done by Chi square test, one-way ANOVA followed by post-hoc test and two-tailed Pearson and Spearman correlation. The difference was considered to be significant if p<0.05.
  
  
  RESULTS
  We found lower values of PI and RI in the third trimester compared to control group and first and second trimester (p<0.01). There is negative correlation between the values of PI and RI with the gestation (p<0.01).
  
  
  CONCLUSIONS
  Hepatic artery resistance indices decrease during the third trimester of pregnancy. This decrease may be the result of systemic arterial vasodilatation in normal pregnancy. The arterial resistance indices may be more useful for the evaluation of liver blood flow over the total blood flow as they are more reliable, being angle independent, easier to obtain, reflect vascular changes and might help in quick orientation about liver blood flow in pregnancies complicated by preeclampsia and HELLP syndrome. Our study is a pilot one, and further studies are needed to establish nomograms for the PI and RI during the gestation.
authors.affiliation: School of Medicine, University of Belgrade, University Clinic for Gynecology and Obstetrics "Narodni front", Belgrade, Serbia. Electronic address: vesna.m.mandic@gmail.com.
authors.forename: Vesna D
authors.initials: VD
authors.lastname: Mandic-Markovic
authors.affiliation: School of Medicine, University of Belgrade, University Clinic for Gynecology and Obstetrics "Narodni front", Belgrade, Serbia.
authors.forename: Zeljko M
authors.initials: ZM
authors.lastname: Mikovic
authors.affiliation: School of Medicine, University of Belgrade, University Clinic for Gynecology and Obstetrics "Narodni front", Belgrade, Serbia.
authors.forename: Milan K
authors.initials: MK
authors.lastname: Djukic
authors.affiliation: School of Medicine, University of Belgrade, University Clinic for Gynecology and Obstetrics "Narodni front", Belgrade, Serbia.
authors.forename: Mladenko D
authors.initials: MD
authors.lastname: Vasiljevic
authors.affiliation: School of Medicine, University of Belgrade, Clinic for Gastroenterology and Hepatology, Clinical Centre of Serbia, Belgrade, Serbia.
authors.forename: Goran Lj
authors.initials: GLj
authors.lastname: Jankovic
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000502:physiology*; D006801:Humans; D008102:Liver Circulation / Q000502:physiology; D010865:Pilot Projects; D049590:Postpartum Period / Q000502:physiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000502:physiology; D011262:Pregnancy Trimester, Second / Q000502:physiology; D011263:Pregnancy Trimester, Third / Q000502:physiology; D011673:Pulsatile Flow; D018615:Ultrasonography, Doppler, Color; D014655:Vascular Resistance; D055815:Young Adult
keywords: Common hepatic artery; Doppler; Liver; Maternal; Pregnancy