Relationship of utero- and fetoplacental blood flow velocity wave forms with pathomorphological placental findings.

Abstract

Pulsed Doppler examinations were performed in 143 risk pregnancies. The resistance index (RI) values of the uteroplacental vessels and umbilical artery on the last examination before delivery were correlated to specific patterns of morphological placental findings. The sensitivity and specificity of Doppler blood flow velocity wave forms to predict placental disease as well as the significant relationships were calculated. Impaired uteroplacental perfusion is correlated with: disturbances in growth, such as reduced weight and reduced basal area (p < 0.005, p < 0.05); disturbances in villous maturation, such as prematurity or a reduction in intermediate sized villi (p < 0.05, p < 0.01), and circulation disorders, such as acute or chronic infarcts (p < 0.05), villous fibrosis (p < 0.005) or microfibrin deposits (p < 0.05). Villous immaturity was not correlated to either pathological utero- or fetoplacental blood flow. Except for acute infarcts, all these findings as well as endangiopathy of truncal arteries are also combined with high RI values in umbilical arteries (p < 0.005) possibly reflecting the 'down-stream impedance' of the fetoplacental circulation.