Human Reproduction, Vol. 19, No. 1, 206-209,
January 2004
© 2004 European Society of Human Reproduction and Embryology
Decreased endovascular trophoblast invasion in first trimester pregnancies with high-resistance uterine artery Doppler indices
1 Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George’s Hospital Medical School, London SW17 0RE, UK and 2 Department of Pathology, Great Ormond Street Hospital for Children, London WC1N 3JH, UK
3 To whom correspondence should be addressed. e-mail: basky{at}pobox.com
BACKGROUND: Defective trophoblastic invasion in early pregnancy is involved in the pathogenesis of pre- eclampsia. This study investigates the relationship between Doppler assessment of uterine artery resistance and endovascular trophoblastic invasion in the first trimester of pregnancy. METHODS: Patients undergoing termination of pregnancy for non-medical reasons were categorized as having a low- or high-resistance uterine artery blood flow pattern by transabdominal Doppler ultrasound. Products of conception were examined histologically with regard to the extent of decidual endovascular trophoblast invasion. RESULTS: There were 14 low-resistance and 17 high-resistance uterine artery blood flow pregnancies identified at 10–14 weeks of gestation. Normal intradecidual endovascular trophoblast invasion was identified with a similar frequency in both groups (P = 0.79). However, the proportion of decidual vessels with endovascular trophoblast invasion was significantly higher in the low-resistance pregnancies (49%) compared with the high-resistance ones (34%, P = 0.02). CONCLUSIONS: The findings of this study support the use of uterine artery Doppler investigation for the non-invasive assessment of trophoblast invasion in early pregnancy. Further studies are necessary to clarify the biological significance of these observations and their potential clinical applications.
Key words: Doppler/early pregnancy/placentation/trophoblast invasion/uterine arteries
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