Uterine flow velocity waveform shape as an indicator of maternal and placental development failure mechanisms: a model-based synthesizing approach

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
D G Talbert

Abstract

High pulsatility indices (PIs) and/or notches on the Doppler flow velocity waveforms of the uterine artery have been interpreted as indications of high placental flow impedance, and are known to be associated with poor fetal outcome. A software model of the uteroplacental blood path and its use to investigate possible interactions within the uteroplacental unit in more detail are described. Increasing transcotyledonary resistance to represent intervillous obstruction raised the cotyledonary core pressure and spiral artery PI. Increased spiral artery flow resistance, representing failed spiral artery invasion, reduced the cotyledonary core pressure and reduced the spiral artery PI. In vivo, such changes in cotyledonary core pressure would modify the transplacental water balance, promoting oligohydramnios for spiral artery invasion failure and polyhydramnios for villous obstruction. Both mechanisms increased the uterine and arcuate PI, but failed to produce a notch. It was found that notch formation depended on terms representing increased compliance (distensibility) of the uterine and/or arcuate artery walls, which have no direct effect on uteroplacental mean flow. The same mechanism steepened and increased uterine artery peak s...Continue Reading

Citations

Feb 13, 2001·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·D G Talbert, P Johnson
Feb 13, 2001·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·M W AardemaJ G Aarnoudse
Aug 3, 2002·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·G L Acácio
May 29, 2004·Obstetrical & Gynecological Survey·Khalid FaragWilliam L Ledger
Dec 5, 2006·Journal of Perinatal Medicine·Jimmy EspinozaChong Jai Kim
Oct 20, 2011·Japanese Journal of Radiology·Sema YildizOzlem Turksoy
Jan 5, 2008·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Tinnakorn ChaiworapongsaRoberto Romero
May 13, 2006·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Shunji Suzuki
Aug 11, 2007·BioEssays : News and Reviews in Molecular, Cellular and Developmental Biology·Gill LangleyAnthony Jones
Nov 7, 2006·Neuropathology and Applied Neurobiology·J F Geddes, D G Talbert
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Apr 5, 2005·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Tinnakorn ChaiworapongsaMoshe Mazor
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Feb 19, 2004·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·F PrefumoB Thilaganathan
Sep 20, 2006·European Journal of Morphology·Katrin WasselJohannes Vogel
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Jan 14, 2020·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Biyuan HeYuqing Zhou
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Jul 31, 2021·Placenta·Vijayalakshmi SrinivasanAlys R Clark

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