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Titolo:
Screening for placental insufficiency by uterine artery Doppler
Autore:
Papageorghiou, AT; Cicero, S; Yu, CKH; Bower, S; Nicolaides, KH;
Indirizzi:
Univ London Kings Coll Hosp, Harris Birthright Res Ctr Fetal Med, London SE5 8RX, England Univ London Kings Coll Hosp London England SE5 8RX ndon SE5 8RX, England
Titolo Testata:
PRENATAL AND NEONATAL MEDICINE
fascicolo: 1, volume: 6, anno: 2001,
pagine: 27 - 37
SICI:
1359-8635(200102)6:1<27:SFPIBU>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
UTEROPLACENTAL BLOOD-FLOW; INTRAUTERINE GROWTH-RETARDATION; GESTATIONAL-AGE INFANTS; VELOCITY WAVE-FORMS; BED SPIRAL ARTERIES; HYPERTENSIVE DISORDERS; NULLIPAROUS WOMEN; RISK PREGNANCIES; ACUTE ATHEROSIS; 2ND TRIMESTER;
Keywords:
Doppler ultrasound; uterine artery; uteroplacental circulation; pregnancy screening; pre-eclampsia; intrauterine growth restriction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Nicolaides, KH Univ London Kings Coll Hosp, Harris Birthright Res Ctr Fetal Med, Denmark Hill, London SE5 8RX, England Univ London Kings Coll Hosp Denmark Hill London England SE5 8RX
Citazione:
A.T. Papageorghiou et al., "Screening for placental insufficiency by uterine artery Doppler", PRENAT N M, 6(1), 2001, pp. 27-37

Abstract

Doppler ultrasound provides a non-invasive method for the study of the uteroplacental circulation. In normal pregnancy, impedance to flow in the uterine arteries decreases with gestation, which may be the consequence of trophoblastic invasion of the spiral arteries and their conversion into low-resistance vessels. Preeclampsia and intrauterine growth restriction are associated with failure of trophoblastic invasion of spiral arteries, and Doppler studies in these conditions have shown that impedance to flow in the uterine arteries is increased. A series of screening studies involving assessment of impedance to flow in the uterine arteries have examined the potentialvalue of Doppler in identifying pregnancies at risk of the complications of impaired placentation. This review examines the findings of Doppler studies in unselected populations that provided sufficient data to allow calculation of the performance of the test. The literature search identified 15 such studies, but they provided discrepant results, which may be the consequence of differences in Doppler technique for sampling, the definition of abnormal flow velocity waveform, differences in the populations examined, the gestational age at which women were studied, and different criteria for thediagnosis of pre-eclampsia and intrauterine growth restriction. Nevertheless, the studies provided evidence that increased impedance to flow in the uterine arteries is associated with increased risk for subsequent development of pre-eclampsia, intrauterine growth restriction and perinatal death. Inaddition, women with normal impedance to flow in the uterine arteries constitute a group that have a low risk of developing obstetric complications related to uteroplacental insufficiency. It is possible that increased impedance identifies about 50% of pregnancies that subsequently develop preeclampsia and about 30% of those that develop intrauterine growth restriction. Abnormal Doppler is better in predicting severe rather than mild disease. The sensitivity for severe disease requiring early delivery is about 80% for pre-eclampsia and 60% for intrauterine growth restriction.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 07:59:08