Uterin ve spiral arter doppler velosimetrisinin abortus imminens hastalarında abortusu öngörmedeki etkisi

Year 2021, Volume: 5 Issue: 4, 376 - 379, 01.04.2021

Nefise Tanrıdan Okçu , Tuğba Gürbüz

https://doi.org/10.28982/josam.889709

Abstract

Giriş: Uterin ve spiral arter doppler bulgularının sağlıklı gebeler ve abortus imminens tanılı hastalar arasında karşılaştırılması.
Yöntemler: Çalışma prospektif vaka-kontrol çalışması olarak planlandı. 12-20 hafta arası gebeliği olan abortus imminens tanılı hastalar ve sağlıklı gebeler arasında uterin ve spiral arter doppler bulguları (pulsalite indeksleri, rezistan indeksleri, sistol/diyastol oranları) karşılaştırıldı.
Bulgular: Ortalama yaş abortus imminens tanılı hastalarda kontrol grubundan yüksekti (p <0.001). Gruplar arasında uterin ve spiral arter pulsalite indeksleri, rezistan indeksleri, sistol/diyastol oranları arasında istatistiksel anlamlı fark saptanmadı (p> 0.05).
Sonuç: İlk trimesterde uterus vasküler yatağını değerlendiren az sayıda çalışma mevcuttur. Uterin vasküler yatağı değerlendirerek, ilk trimesterde abortus imminens prognozunu öngören daha fazla sayıda çalışmaya ihtiyaç vardır.

Keywords

Abortus imminens,, Pulsalite indeks,, Rezistans indeks ,, Spiral arter doppler,, Uterin arter doppler.

Supporting Institution

Yok

Project Number

yok

The effect of uterine and spiral artery Doppler velocimetry in predicting miscarriage in threatened miscarriage patients

Abstract

Background/Aim: Doppler sonography was used to investigate the effect of abnormal placentation on early and late pregnancy complications with conflicting results on changes in uterine blood flow and spiral arteries in early pregnancy. This study aimed to compare the uterine and spiral artery Doppler findings between healthy pregnant women and patients with threatened miscarriage.
Methods: In this prospective case-control study, the uterine and spiral artery Doppler findings of 60 patients with threatened miscarriage between 12-20 weeks of gestation were compared with those of 60 healthy pregnant women at similar gestational weeks. Resistance index, spiral artery pulsatility index, systolic/diastolic ratio, and uterine artery Doppler values were evaluated.
Results: The patients in the threatened miscarriage group had a higher mean age than those in the control group (P<0.001). No significant difference was found between the groups in terms of uterine artery and spiral artery resistance index, systolic/diastolic ratio, and pulsatility index values (P>0.05 for each).
Conclusions: Our results showed that there was no significant difference between the indexes of spiral and uterine artery in Doppler ultrasonography. Further studies are needed to evaluate uterine vascular bed alterations to predict the threatened miscarriage prognosis in the first trimester.

Keywords

Resistance index, Pulsatility index, Spiral artery Doppler, Threatened miscarriage, Uterine artery Doppler

Project Number

yok

References

• 1. Alp MN, Oral D. Genetic screening of couples with recurrent spontaneous abortion. Dicle Tıp Dergisi. 2006;33(2):71-80.
• 2. Makrydimas G, Sebire NJ, Lolis D, Vlassis N, Nicolaides KH. Fetal loss following ultrasound diagnosis of a live fetus at 6-10 weeks of gestation. Ultrasound Obstet Gynecol. 2003;22(4):368-72.
• 3. Tong S, Kaur A, Walker SP, Bryant V, Onwude JL, Permezel M. Miscarriage risk for asymptomatic women after a normal first-trimester prenatal visit. Obstet Gynecol. 2008;111(3):710-4.
• 4. Ozdemirci S, Karahanoglu E, Esinler D, Gelisen O, Kayıkcıoglu F. Influence of threatened miscarriage on pregnancy and the early postpartum period: a case-control report. J Matern Fetal Neonatal Med. 2015;28(10):1186-9.
• 5. Kurdi W, Fayyad A, Thakur V, Harrington K. Delayed normalization of uterine artery Doppler waveforms is not a benign phenomenon. Eur J Obstet Gynecol Reprod Biol. 2004;117(1):20-3.
• 6. Prefumo F, Sebire NJ, Thilaganathan B. Decreased endovascular trophoblast invasion in first trimester pregnancies with high resistance uterine artery Doppler indices. Hum Reprod. 2004;19(1):206-9.
• 7. Dugoff L, Lynch AM, Cioffi-Ragan D, et al. First trimester uterine artery Doppler abnormalities predict subsequent intrauterine growth restriction. Am J Obstet Gynecol. 2005;193(3 Pt 2):1208-12.
• 8. Makikallio K, Jouppila P, Tekay A. First trimester uterine, placental and yolk sac haemodynamics in preeclampsia and preterm labour. Hum Reprod. 2004;19(3):729-33.
• 9. Guedes-Martins L, Saraiva J, Gaio R, Macedo F, Almeida H. Uterine artery impedance at very early clinical pregnancy. Prenat Diagn. 2014;34(8):719-25.
• 10. Marchi L, Zwertbroek E, Snelder J, Kloosterman M, Bilardo CM. Intra- and inter-observer reproducibility and generalizability of first trimester uterine artery pulsatility index by transabdominal and transvaginal ultrasound. Prenat Diagn. 2016;36(13):1261-9.
• 11. Jauniaux E, Burton GJ. Pathophysiology of histological changes in early pregnancy loss. Placenta. 2005;26(2-3):114–23.
• 12. Aardema MW, Oosterhof H, Timmer A, Van Rooy I, Aarnoudse JG. Uterine artery Doppler flow and uteroplacental vascular pathology in normal pregnancies and pregnancies complicated by pre-eclampsia and small for gestational age fetuses. Placenta. 2001;22(5):405–11.
• 13. Collins SL, Stevenson GN, Noble J, Impey L. Developmental changes in spiral artery blood flow in the human placenta observed with colour Doppler ultrasonography. Placenta. 2012;33(10):782–7.
• 14. Pellizzari P, Pozzan C, Marchiori S, Zen T, Gangemi M. Assessment of uterine artery blood flow in normal first-trimester pregnancies and in those complicated by uterine bleeding. Ultrasound Obstet Gynecol. 2002;19:366–70.
• 15. Özkan MB, Ozyazici E, Emiroglu B, Özkara E. Can we measure the spiral and uterine artery blood flow by real-time sonography and Doppler indices to predict spontaneous miscarriage in a normal-risk population? Australas J Ultrasound Med. 2015; 18(2):60-6.
• 16. Roberts VHJ, Morgan TK, Bednarek P, et al. Early first trimester uteroplacental flow and the progressive disintegration of spiral artery plugs: new insights from contrast-enhanced ultrasound and tissue histopathology. Hum Reprod. 2017;32(12):2382-93.
• 17. Stabile I, Grudzinskas J, Campbell S. Doppler ultrasonographic evaluation of abnormal pregnancies in the first trimester. J Clin Ultrasound. 1990;18(6):497–501.
• 18. Kurjak A, Zudenigo D, Predanic M, Kupesic S, Funduk B. Assessment of the fetomaternal circulation in threatened abortion by transvaginal color Doppler. Fetal Diagn Ther. 1994;9(5):341-7.
• 19. Ozkaya U, Ozkan S, Ozeren S, Corakçi A. Doppler examination of uteroplacental circulation in early pregnancy: can it predict adverse outcome? J Clin Ultrasound. 2007; 35(7):382-6.
• 20. Ganapathy R, Ayling LJ, Whitley GS, Cartwright JE, Thilaganathan B. Effect of first-trimester serum from pregnant women with high-resistance uterine artery Doppler resistance on extravillous trophoblast invasion. Hum Reprod. 2006;21(5):1295–8.
• 21. Shehata NAA, Ali HAA, Hassan AEGMA, Katta MA, Ali ASF. Doppler and biochemical assessment for the prediction of early pregnancy outcome in patients experiencing threatened spontaneous abortion. Int J Gynaecol Obstet. 2018;143(2):150-5.
• 22. Papaioannou GI, Syngelaki A, Maiz N, Ross JA, Nicolaides KH. Ultrasonographic prediction of early miscarriage. Hum Reprod. 2011;26(7):1685-92.
• 23. Bhide A, Acharya G, Bilardo CM, et al. ISUOG Practice Guidelines: use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol. 2013;41(2):233-9.