P01.03: Myometrial blood flow analysis in pregnant women with IUGR

Abstract

We previously analyzed the hemodynamics of myometrial vessels just behind the placenta and demonstrated the possibility that such analysis may predict the placental function. In the present study, we measured myometrial blood flow in patients with IUGR and compared the data to those observed in normal pregnancy. Subjects were 29 normal pregnant women who provided informed consent to participate in this study. Color Doppler imaging was used to measure the following factors for the largest blood vessel in the myometrium of the uterine wall behind the center of the placenta: pulsatility index (PI), resistance index (RI), maximum velocity (Vmax), and mean velocity (Vmean). Measurements were conducted every two week from the 18th to 41st week of pregnancy. Myometrial blood flow analysis was also performed for 4 pregnant women with IUGR. IUGR case 1 had the following data at 34 weeks of pregnancy: EFBW 1500 g; Vmax, 30.9 cm/sec (⩽ mean − 1.5 SD); and Vmean, 26.3 cm/sec (⩽ mean − 1.5 SD). IUGR case 2 had the following data at 36 weeks of pregnancy: EFBW 1991 g; Vmax, 67.0 cm/sec (⩽ mean − 1.5 SD); and Vmean, 55.7 cm/sec (⩽ mean − 1.5 SD). IUGR case 3 had the following data at 32 weeks of pregnancy: EFBW 1442 g; Vmax, 49.1 cm/sec (⩽ mean − 1.5 SD); and Vmean, 40.2 cm/sec (⩽ mean − 1.5 SD). IUGR case 4 had the following data at 35 weeks of pregnancy: EFBW 1722 g; Vmax, 50.2 cm/sec (⩽ mean − 1.5 SD); and Vmean, 38.8 cm/sec (⩽ mean − 1.5 SD). No maternal complications such as pregnancy-induced hypertension and fetal abnormalities were observed in IUGR cases. In addition, no definite fetal growth was observed after the measurements in three cases. The Vmax and Vmean in the myometrial vessels of the 4 pregnant women with IUGR in the present study showed values below mean − 1.5 SD of the normal pregnant. These findings suggest that blood flow analysis of myometrial vessels may facilitate early detection of IUGR.