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Ultraschall Med 2024; 45(02): 184-189
DOI: 10.1055/a-2075-3021
Original Article

The association between fetal Doppler and uterine artery blood volume flow in term pregnancies: a pilot study

Zusammenhang zwischen fetalem Doppler und Blut-Volumenfluß der Uterinarterien bei Schwangerschaften am Termin: eine Pilotstudie
Marco La Verde
1   Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Ringgold ID: RIN18994)
,
Marco Torella
1   Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Ringgold ID: RIN18994)
,
Carlo Ronsini
1   Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Ringgold ID: RIN18994)
,
Gaetano Riemma 
1   Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Ringgold ID: RIN18994)
,
Luigi Cobellis
1   Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Ringgold ID: RIN18994)
,
Maria Maddalena Marrapodi
1   Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Ringgold ID: RIN18994)
,
Carlo Capristo
1   Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Ringgold ID: RIN18994)
,
Agnese Maria Chiara Rapisarda
2   Department of General Surgery and Medial Surgical Specialties, University of Catania, Catania, Italy (Ringgold ID: RIN9298)
,
Maddalena Morlando 
1   Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Ringgold ID: RIN18994)
,
Pasquale De Franciscis
1   Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy (Ringgold ID: RIN18994)
› Author Affiliations Clinical Trial: Registration number (trial ID): NCT05389553, Trial registry: ClinicalTrials.gov (http://www.clinicaltrials.gov/), Type of Study: Prospective
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Abstract

Purpose To investigate the relationship between uterine artery blood volume flow and fetal Doppler indices in term pregnancies.

Materials and Methods A prospective observational study in a tertiary-care university hospital was performed between December 2021 and May 2022. We included only term pregnancies that received accurate ultrasound scans until a week before the birth. The uterine artery (UtA) diameter and UtA volume blood flow were estimated and recorded. The volume of each artery was summed to obtain the total uterine artery volume blood flow (QUtA). The following fetal Doppler indices were evaluated: Umbilical artery (UA), middle cerebral artery (MCA), ductus venosus (DV), and cerebroplacental ratio (CPR). Linear regression analysis was performed to investigate the relationship between the QUtA and the fetal Doppler indices.

Results 49 pregnancies were included. The UA pulsatility index (PI) analysis showed a significant association with QUtA (r2=0.40, p=0.01), demonstrating a decrease of the UA PI when the QUtA increased. The same relationship was noted between the UtA mean PI and QUtA (r2=0.41, p=0.005). A weak correlation between the newborn weight and the QUtA was also noted (r2=0.31, p=0.048), with an elevated newborn weight when the QUtA was high.

Conclusion This study showed that UA, UtA PI, and birth weight seem to be linked to QUtA. QUtA had an inverse correlation with UA and UtA PI. In addition, increasing the QUtA showed a linear increase in fetal birth weight. These findings could be helpful in high-risk pregnancy management, but additional research is needed to identify how QUtA in the third trimester impacts labor and fetal outcomes.

Zusammenfassung

Ziel Untersuchung des Zusammenhangs zwischen dem Blut-Volumenfluss in den Uterin-Arterien und den fetalen Doppler-Indizes bei Schwangerschaften am Termin.

Material und Methoden Zwischen Dezember 2021 und Mai 2022 wurde eine prospektive Beobachtungsstudie in einer Universitätsklinik der Tertiärversorgung durchgeführt. Wir schlossen nur Schwangerschaften ein, bei denen bis eine Woche vor Partus genaue Ultraschall-Untersuchungen durchgeführt wurden. Der Durchmesser der Uterin-Arterien (UtA) und der UtA-Blut-Volumenfluss wurden abgeschätzt und aufgezeichnet. Die Volumen jeder Arterie wurden summiert, um den gesamten Blut-Volumenfluss der Uterin-Arterien (QUtA) zu erhalten. Die folgenden fetalen Doppler-Indizes wurden ausgewertet: A. umbilicalis (UA), A. cerebri media (MCA), Ductus venosus (DV) und cerebroplazentare Ratio (CPR). Eine lineare Regressionsanalyse wurde durchgeführt, um die Beziehung zwischen der QUtA und den fetalen Doppler-Indizes zu untersuchen.

Ergebnisse Es wurden 49 Schwangerschaften eingeschlossen. Die Analyse des UA-Pulsatilitätsindex (PI) zeigte einen signifikanten Zusammenhang mit dem QUtA (r2=0,40; p=0,01), der eine Abnahme des UA-PI zeigte, wenn der QUtA anstieg. Die gleiche Beziehung wurde zwischen dem mittleren UA-PI und dem QUtA festgestellt (r2=0,41; p=0,005). Eine schwache Korrelation wurde auch zwischen dem Geburtsgewicht und dem QUtA festgestellt (r2=0,31; p=0,048), wobei das Geburtsgewicht erhöht war, wenn der QUtA hoch war.

Schlussfolgerung Diese Studie zeigte, dass UA, UtA-PI und Geburtsgewicht mit dem QUtA in Verbindung zu stehen scheinen. QUtA hatte eine inverse Korrelation mit UA und UtA-PI. Darüber hinaus zeigte eine Erhöhung des QUtA einen linearen Anstieg des Geburtsgewichts an. Diese Ergebnisse könnten für das Management von Risikoschwangerschaften hilfreich sein. Es sind jedoch weitere Untersuchungen erforderlich, um zu ermitteln, wie sich der QUtA im dritten Trimester auf die Wehen und das fetale Outcome auswirkt.

Keywords

uterine artery volume blood flow - uterine arteries diameter - middle cerebral artery - uterine artery pulsatility index - fetal Doppler indices


Publication History

Received: 31 October 2022

Accepted after revision: 17 April 2023

Accepted Manuscript online:
17 April 2023

Article published online:
06 October 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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