Seminars in Perinatology
Volume 31, Issue 4 , Pages 232-239 , August 2007

State of the Art: Non-Invasive Ultrasound Assessment of the Uteroplacental Circulation

  • Gabriele Urban, MD, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Milan Bicocca, San Gerardo Hospital, Monza, Italy.
    • Corresponding Author InformationAddress reprint requests to Gabriele Urban MD, PhD, University of Milan Bicocca, Obstetrics and Gynecology Clinics, San Gerardo Hospital, Via Solferino 16, 20052 Monza (MB), Italy.
    • ,
  • Patrizia Vergani, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Milan Bicocca, San Gerardo Hospital, Monza, Italy.
    • ,
  • Alessandro Ghidini, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Milan Bicocca, San Gerardo Hospital, Monza, Italy.
    • ,
  • Piero Tortoli, PhD

      Affiliations

    • Department of Electronics and Telecommunications, University of Florence, Florence, Italy.
    • ,
  • Stefano Ricci, PhD

      Affiliations

    • Department of Electronics and Telecommunications, University of Florence, Florence, Italy.
    • ,
  • Pasquale Patrizio, MD, MBE

      Affiliations

    • Yale University Fertility Center, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT.
    • ,
  • Michael J. Paidas, MD

      Affiliations

    • Yale Women and Children’s Center for Blood Disorders, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT.

References 

  1. Trudinger BJ, Giles WB, Cook CM. Uteroplacental blood flow velocity-time waveforms in normal and complicated pregnancy. Br J Obstet Gynaecol. 1985;92:39–45
  2. Jurkovic D, Jauniaux E, Kurjak A, et al. Transvaginal color Doppler assessment of the uteroplacental circulation in early pregnancy. Obstet Gynecol. 1991;77:365–369
  3. Jauniaux E, Jurkovic D, Campbell S, et al. Doppler ultrasonographic features of the developing placental circulation; correlation with anatomic findings. Am J Obstet Gynecol. 1992;166:585–587
  4. Arduini D, Rizzo G, Romanini C. Doppler ultrasonography in early pregnancy does not predict adverse pregnancy outcome. Ultrasound Obstet Gynaecol. 1991;1:180–185
  5. Voigt JH, Becker V. Uteroplacental insufficiency: comparison of uteroplacental blood flow velocimetry and histomorphology of placental bed. J Maternal Fetal Invest. 1992;2:251–255
  6. Campbell S, Pearce JM, Hackett G, et al. Qualitative assessment of uteroplacental blood flow: early screening test for high-risk pregnancies. Obstet Gynecol. 1986;68:649–653
  7. Hanretty KP, Primrose MH, Neilson JP, et al. Pregnancy screening by Doppler uteroplacental and umbilical artery waveforms. Br J Obstet Gynaecol. 1989;96:1163–1167
  8. Aardema MW, Saro MCS, Lander M, et al. Second trimester Doppler ultrasound screening of the uterine arteries differentiates between subsequent normal and poor outcomes of hypertensive pregnancy: two different pathophysiological entities?. Clin Sci. 2004;106:377–382
  9. Parretti E, Mealli F, Magrini A, et al. Cross-sectional and longitudinal evaluation of uterine artery Doppler velocimetry for the prediction of pre-eclampsia in normotensive women with specific risk factors. Ultrasound Obstet Gynecol. 2003;22:160–165
  10. Harrington K, Goldfrad C, Carpenter RG, et al. Transvaginal uterine and umbilical artery Doppler examination of 12-16 weeks and the subsequent development of pre-eclampsia and intrauterine growth retardation. Ultrasound Obstet Gynecol. 1997;9:94–100
  11. Lees C. Uterine artery Doppler: time to establish the ground rules. Ultrasound Obstet Gynecol. 2000;16:607–609
  12. Sagol S, Ozkinay E, Oztekin K, et al. The comparison of uterine artery Doppler velocimetry with the histopathology of the placental bed. Aust N Z J Obstet Gynaecol. 1999;39:324–329
  13. Lin S, Shimizu I, Suehara N, et al. Uterine artery Doppler velocimetry in relation to trophoblast migration into the myometrium of the placental bed. Obstet Gynecol. 1995;85:760–765
  14. Aardema MW, Oosterhof H, Timmer A, et al. 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;22:405–411
  15. Voigt HJ, Becker V. Doppler flow measurements and histomorphology of the placental bed in uteroplacental insufficiency. J Perinat Med. 1992;20:139–147
  16. Ferrazzi E, Bulfamante G, Mezzopane R, et al. Uterine Doppler velocimetry and placental hypoxic-ischemic lesion in pregnancies with fetal intrauterine growth restriction. Placenta. 1999;20:389–394
  17. Arduini D, Rizzo GJ. Normal values of Pulsatility Index from fetal vessels: a cross-sectional study on 1556 healthy fetuses. Perinat Med. 1990;18:165–172
  18. Irion O, Masse J, Forest JC, et al. Prediction of pre-eclampsia, low birthweight for gestation and prematurity by uterine artery blood flow velocity waveforms analysis in low risk nulliparous women. Br J Obstet Gynaecol. 1998;105:422–429
  19. Antsaklis A, Daskalakis G, Tzortzis E, et al. The effect of gestational age and placental location on the prediction of pre-eclampsia by uterine artery Doppler velocimetry in low-risk nulliparous women. Ultrasound Obstet Gynecol. 2000;16:635–639
  20. Chien PF, Arnott N, Gordon A, et al. How useful is uterine artery Doppler flow velocimetry in the prediction of pre-eclampsia, intrauterine growth retardation and perinatal death?. An overview Br J Obstet Gynaecol. 2000;107:196–208
  21. Smith GC, Yu CK, Papageorghiou AT, et al. Maternal uterine artery Doppler flow velocimetry and the risk of stillbirth. Obstet Gynecol. 2007;109:144–151
  22. Papageorghiou AT, Yu CK, Erasmus IE, et al. Assessment of risk for the development of pre-eclampsia by maternal characteristics and uterine artery Doppler. Br J Obstet Gynaecol. 2005;112:703–709
  23. Parretti E, Mealli F, Magrini A, et al. Cross-sectional and longitudinal evaluation of uterine artery Doppler velocimetry for the prediction of pre-eclampsia in normotensive women with specific risk factors. Ultrasound Obstet Gynecol. 2003;22:160–165
  24. Harrington K, Carpenter RG, Goldfrad C, et al. Transvaginal Doppler ultrasound of the uteroplacental circulation in the early prediction of pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol. 1997;104:674–681
  25. Harrington K, Goldfrad C, Carpenter RG, et al. Transvaginal uterine and umbilical artery Doppler examination of 12-16 weeks and the subsequent development of pre-eclampsia and intrauterine growth retardation. Ultrasound Obstet Gynecol. 1997;9:94–100
  26. Martin AM, Bindra R, Curcio P, et al. Screening for pre-eclampsia and fetal growth restriction by uterine artery Doppler at 11-14 weeks of gestation. Ultrasound Obstet Gynecol. 2001;18:583–586
  27. Gomez O, Martinez JM, Figueras F, et al. Uterine artery Doppler at 11-14 weeks of gestation to screen for hypertensive disorders and associated complications in an unselected population. Ultrasound Obstet Gynecol. 2005;26:490–494
  28. Spencer K, Cowans NJ, Chefetz I, et al. Second-trimester uterine artery Doppler pulsatility index and maternal serum PP13 as markers of pre-eclampsia. Prenat Diagn. 2007;27:258–263
  29. Dugoff L, Lynch AM, Cioffi-Ragan D, et al. FASTER Trial Research Consortium (First trimester uterine artery Doppler abnormalities predict subsequent intrauterine growth restriction). Am J Obstet Gynecol. 2005;193:1208–1212
  30. Papageorghiou AT, Yu CK, Bindra R, et al. Fetal Medicine Foundation Second Trimester Screening Group (Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation). Ultrasound Obstet Gynecol. 2001;18:441–449
  31. Yu CK, Smith GC, Papageorghiou AT, et al. An integrated model for the prediction of preeclampsia using maternal factors and uterine artery Doppler velocimetry in unselected low-risk women. Am J Obstet Gynecol. 2005;193:429–436
  32. Hafner E, Metzenbauer M, Hofinger D, et al. Comparison between three-dimensional placental volume at 12 weeks and uterine artery impedance/notching at 22 weeks in screening for pregnancy-induced hypertension, pre-eclampsia and fetal growth restriction in a low-risk population. Ultrasound Obstet Gynecol. 2006;27:652–657
  33. Li H, Gudnason H, Olofsson P, et al. Increased uterine artery vascular impedance is related to adverse outcome of pregnancy but is present in only one-third of late third-trimester pre-eclamptic women. Ultrasound Obstet Gynecol. 2005;25:459–463
  34. Frusca T, Soregaroli M, Platto C, et al. Uterine artery velocimetry in patients with gestational hypertension. Obstet Gynecol. 2003;102:136–140
  35. Hafner E, Metzenbauer M, Hofinger D, et al. Comparison between three-dimensional placental volume at 12 weeks and uterine artery impedance/notching at 22 weeks in screening for pregnancy-induced hypertension, pre-eclampsia and fetal growth restriction in a low-risk population. Ultrasound Obstet Gynecol. 2006;27:652–657
  36. Dubiel M, Breborowicz GH, Ropacka M, et al. Computer analysis of three-dimensional power angiography images of foetal cerebral, lung and placental circulation in normal and high-risk pregnancy. Ultrasound Med Biol. 2005;31:321–327
  37. Yu CH, Chang CH, Ko HC, et al. Assessment of placental fractional moving blood volume using quantitative three-dimensional power doppler ultrasound. Ultrasound Med Biol. 2003;29:19–23
  38. Jaffe R. Multigate spectral Doppler velocimetry for fast assessment of intraplacental fetal circulation: a preliminary study. J Ultrasound Med. 1996;15:309–312
  39. Haberman S, Bracero LA, Byrne DW. Spectral Doppler index mapping of the umbilicoplacental circulation and pregnancy outcome. Gynecol Obstet Invest. 2004;58:1–7
  40. Prapas N, Mari G, Liang RI, et al. Assessment of Doppler velocimetry of the fetal umbilical artery by multigate spectral Doppler scanning and traditional pulsed Doppler ultrasonography plus color flow mapping. J Ultrasound Med. 1999;18:831–835
  41. Yagel S, Anteby EY, Shen O, et al. Placental blood flow measured by simultaneous multigate spectral Doppler imaging in pregnancies complicated by placental vascular abnormalities. Ultrasound Obstet Gynecol. 1999;14:262–266
  42. Urban G, Ricci S, Copel J, et al. Real time velocity profile of uterine artery (UtA) and vein (UtV) by global acquisition and signal processing (GASP) software for multigate spectral Doppler analysis (MSDA). Ultrasound Obstet Gynecol. 2006;28:594
  43. Urban G, Tortoli P, Ricci P, et al. Doppler evaluation of hemodynamic changes in uterine blood flow. In:  Lynch C,  Keith LG,  Lalonde AB, et al. editor. A Textbook of Postpartum Hemorrhage. (ed 1). Duncow, Kirkmahoe, Dumfriesshire DGI ITA, UK: Sapiens Publishing; 2006;
  44. Urban G, Patrizio P, Tortoli P, et al. Fetal descending aorta detailed velocity profiles in real-time using a novel global acquisition and signal processing (G.A.S.P.) software for the multigate spectral doppler analysis. Am J Obstet Gynecol. 2007;195:S219
  45. Ricci G, Urban MJ, Paidas P, et al. Blood flow imaging in maternal and fetal vessels. Acoustical Imaging. 2007;28:1–6
  46. Ricci G, Urban MJ, Paidas P, et al. A novel US method for the assessment of maternal, placental and fetal circulation during pregnancy. IEEE Ultrasonics Symposium. 2006;2011–2014
  47. Urban G, Ricci S, Guidi F, et al. Realtime human fetal aorta velocity profile using global acquisition and signal processing (GASP). Ultrasound Obstet Gynecol. 2006;27:716–718

PII: S0146-0005(07)00067-5

doi: 10.1053/j.semperi.2007.06.002

Seminars in Perinatology
Volume 31, Issue 4 , Pages 232-239 , August 2007

Article Tools

* Image Usage & Resolution