The relation of increased uterine artery blood flow resistance and impaired trophoblast invasion in pre-eclamptic pregnancies

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• 作者：Kadir Guzin ; Sedat Tomruk ; Yildiz Ayhan Tuncay ; Murat Naki ; Selen Sezginsoy ; Ebru Zemheri ; Nese Yucel and Fahrettin Kanad?k?r?k
• 关键词：Pre ; eclampsia ; Doppler ultrasonography ; Placenta ; Trophoblast ; Invasion
• 刊名：Archives of Gynecology and Obstetrics
• 出版年：2005
• 出版时间：December 2005
• 年：2005
• 卷：272
• 期：4
• 页码：283-288
• 全文大小：314 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gynecology
  Obstetrics and Perinatology
  Endocrinology
  Human Genetics
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0711

文摘

Objective: To assess the association between histopathologically confirmed vascular abnormalities developed during pre-eclampsia and abnormal arterial blood flows recorded during Doppler sonographies. Materials and methods: From pregnant women who attended our clinic between 01/03/2002 and 01/07/2002, a detailed medical history was obtained and routine biochemical blood tests, fetal ultrasonography and UA Doppler scans were performed. In addition, from pre-eclamptic and normal pregnant women who underwent cesarean sections, placental bed biopsies were taken. Thirty two pre-eclamptic [12 mild, 20 severe cases according to American College of Obstetricians and Gynecologogists (ACOG) criteria] cases and as a control group 20 normal pregnancies were included in the study. In our study trophoblast invasion into decidual spiral arteries was observed in 75% of mild (9/12), and 55% of severe (11/20) pre-eclampsias. In the control group all the cases demonstrated trophoblast invasion in decidual spiral arteries. Trophoblast invasion in myometrial spiral arteries was noted in 50% (6/12) of mild and 25% (5/20) of severe pre-eclamptic pregnancies. It was seen in 16 cases out of 20 (80%) pregnancies. In the control group, decidual spiral artery invasion manifests significant differences (P<0.01) among groups studied. Invasion in decidual spiral arteries was seen in all normal pregnancies of the control group. There is not any significant difference between mild and severely pre-eclamptic groups (P>0.05). Conclusion: Doppler ultrasonography is not only a non-invasive method for evaluating fetal status in pre-eclamptic pregnancies, but it also correlates with partial trophoblastic invasion in spiral arteries, which contributes to the pathophysiologic mechanisms involved in pre-eclampsia.