Uterine Artery Blood Flow Velocity Research Articles

Umbilical and uterine artery blood flow velocities after vibratory acoustic stimulation

Twelve healthy pregnant women between 37 and 41 weeks' gestational age were studied to determine the effects of external vibratory acoustic stimulation on the blood flow velocity waveform in the umbilical and uterine arteries. There was a significant decrease in umbilical peak-systolic/end-diastolic ratio during the first 5 minutes after stimulus after comparison with control ratios. Analysis of the frequency distribution of instantaneous fetal heart rate values during Doppler measurements suggested that the decrease in umbilical peak-systolic/end-diastolic ratio was due to fetal tachycardia rather than a change in the placental vascular resistance. The uterine artery peak-systolic/end-diastolic ratio was not altered after vibratory acoustic stimulation.

The uterine artery blood flow velocity waveform: reproducibility and results in normal pregnancy

Uterine artery blood flow velocity waveforms (FVW) were recorded longitudinally in normal pregnancies (n = 41) at 4-week intervals from a gestational age of 18 weeks onwards. Furthermore, reproducibility of the uterine artery FVWs and the relation with maternal heart rate (MHR) was studied. The uterine artery FVW showed a low resistance flow pattern already from 18 weeks onwards, with high diastolic flow velocity relative to systolic flow velocity. Mean values (+/- S.D.) for the Pulsatility-Index (PI) before and after 32 weeks of normal pregnancy were 0.73 (+/- 0.17) and 0.67 (+/- 0.15) respectively; for the A/B ratio these values were 1.98 (+/- 0.30) and 1.85 (+/- 0.25) respectively. Intra- and interobserver reproducibility could be established for uterine artery FVW analysis. A varying time-period between the FVWs (0-4 min), repositioning of the flow probe and different observers did not cause any systematic effect on the PI, although variation increased in case of a longer time-period between the FVWs. Overall variation of the PI in the reproducibility experiments appeared to be caused more by inter- than intrapatient variance. Inter- and intrapatient variance were in the same range for the results of the longitudinal study. A statistically significant, inverse relationship between uterine artery PI and MHR could be established in a majority of cases. The mean regression coefficient for all patients of the reproducibility study was -0.0061; PI decreases with 0.0061 when maternal heart rate increases 1 beats/min.

The Effect of Vasopressor Agents upon Uterine Artery Blood Flow Velocity in the Gravid Guinea Pig Subjected to Ritodrine Infusion

The Effect of Vasopressor Agents upon Uterine Artery Blood Flow Velocity in the Gravid Guinea Pig Subjected to Ritodrine Infusion

The effect of epidural anaesthesia for caesarean section on maternal uterine and fetal umbilical artery blood flow velocity waveforms

Summary. The blood flow resistance in the maternal uteroplacental and fetal umbilical artery circulation was studied in eight otherwise normal patients undergoing elective lower segment caesarean section. The systolic/diastolic A/B ratio (the ratio of peak systolic to least diastolic flow velocity) for the uteroplacental and fetal umbilical circulation was determined from the artery blood flow velocity-time waveform and used as an index of blood flow resistance. Each patient received a 1 litre intravenous crystalloid infusion before an epidural bupivicaine injection. Both crystalloid infusion and epidural anaesthesia resulted in a significant decrease in the maternal uteroplacental systolic/diastolic (A/B) ratios, associated with a decrease in fetal umbilical artery A/B ratio. This study suggests a beneficial fetal effect from the improved maternal uterine perfusion after epidural anaesthesia.

The Effect of Ephedrine Upon Uterine Artery Blood Flow Velocity in the Pregnant Guinea Pig Subjected to Terbutaline Infusion and Acute Hemorrhage

The purpose of the present study was to determine the effect of intravenously administered ephedrine upon uterine artery blood flow velocity (UBFV) in the gravid guinea pig subjected to terbutaline infusion and acute hemorrhage. Ephedrine, 1.0 mg/kg, was administered intravenously to ten chronically instrumented pregnant guinea pigs near term, before and after intravenous infusion of terbutaline and acute hemorrhage. Before terbutaline and hemorrhage, ephedrine increased maternal mean arterial pressure (MMAP) by 30 +/- 1% (P = .0001) and 17 +/- 1% (P = .0001) at 30 s and at 1 min after injection, respectively; UBFV was decreased by 10 +/- 4% (P less than .01) and 14 +/- 4% (P less than .01) at 1 min and at 90 s after injection, respectively. Infusion of terbutaline (1.5-6.0 ug X kg-1 X min-1) increased maternal heart rate (MHR) by 22 +/- 1% (P = .0001), decreased MMAP by 13 +/- 2% (P = .0001), and decreased UBFV by 24 +/- 3% (P = .0001). During hypotension resulting from acute hemorrhage, ephedrine, 1.0 mg/kg, was superior to placebo in restoring MMAP and UBFV toward the prebleed values. The authors concluded that ephedrine, 1.0 mg/kg, results in a small, transient decrease in UBFV in the normotensive gravid guinea pig. However, ephedrine aids restoration of UBFV in the gravid guinea pig rendered hypotensive by acute hemorrhage during terbutaline infusion.

The Effect of Epidural Anaesthesia for Caesarean Section on Maternal Uterine and Fetal Umbilical Artery Blood Flow Velocity Waveforms

Summary. The blood flow resistance in the maternal uteroplacental and fetal umbilical artery circulation was studied in eight otherwise normal patients undergoing elective lower segment caesarean section. The systolic/diastolic A/B ratio (the ratio of peak systolic to least diastolic flow velocity) for the uteroplacental and fetal umbilical circulation was determined from the artery blood flow velocity-time waveform and used as an index of blood flow resistance. Each patient received a 1 litre intravenous crystalloid infusion before an epidural bupivicaine injection. Both crystalloid infusion and epidural anaesthesia resulted in a significant decrease in the maternal uteroplacental systolic/diastolic (A/B) ratios, associated with a decrease in fetal umbilical artery A/B ratio. This study suggests a beneficial fetal effect from the improved maternal uterine perfusion after epidural anaesthesia.

THE EFFECT OF VASOPRESSOR AGENTS UPON UTERINE ARTERY BLOOD FLOW VELOCITY IN THE NORMOVOLEMIC GRAVID GUINEA PIG SUBJECTED TO RITODRINE INFUSION

The purpose of the present study was to assess the effects of intravenously administered vasopressors upon uterine artery blood flow velocity (UBFV) in the gravid guinea pig subjected to ritodrine infusion. Fourteen experiments were performed in 14 chronically instrumented pregnant guinea pigs near term. Immediately following a 1-h intravenous infusion of ritodrine (0.05-0.20 mg.kg.min-1), each animal received an intravenous bolus of vasopressor solution: 1) epinephrine, 0.001 mg/kg; 2) phenylephrine, 0.01 mg/kg; 3) mephentermine, 1.0 mg/kg; 4) ephedrine, 1.0 mg/kg; or 5) placebo. The experimental sequence was performed five times, so that each animal received all five solutions. The vasopressor sequence was randomly altered between animals. Infusion of ritodrine increased maternal heart rate 18 +/- 1% (P less than .0001), decreased maternal mean arterial pressure (MMAP) 4 +/- 1% (P less than .01), and decreased UBFV 5 +/- 1% (P less than .001). The four active vasopressor solutions resulted in similar, though not equivalent, increases in MMAP. Further, the MMAP response to each active vasopressor differed from the response to placebo (P less than .0001). Epinephrine and phenylephrine each significantly decreased UBFV (P less than .002). Ephedrine clearly preserved UBFV, whereas mephentermine appeared to result in an intermediate response.

Effect of Intravenous Epinephrine on Uterine Artery Blood Flow Velocity in the Pregnant Guinea Pig

The purpose of the present study was to determine the effect of intravenously administered epinephrine on the maternal cardiovascular response and uterine artery blood flow velocity (UBFV) in the pregnant guinea pig. Epinephrine (0.2, 0.5, and 1.0 micrograms/kg) and lidocaine (0.4 mg/kg, with and without 0.2 micrograms/kg of epinephrine) were administered intravenously to seven chronically instrumented pregnant guinea pigs near term. Lidocaine without epinephrine did not significantly alter maternal heart rate (MHR), maternal mean arterial pressure (MMAP), or UBFV. Epinephrine, with and without lidocaine, resulted in a transient decrease in MHR. Further, epinephrine, with and without lidocaine, resulted in significant elevations in MMAP and significant, dose-related reductions in UBFV. Mean (+/- SEM) UBFV was 72 +/- 4%, 56 +/- 4%, and 40 +/- 5% of baseline at 30 s after administration of epinephrine, 0.2, 0.5, and 1.0 micrograms/kg, respectively. It is concluded that these small intravenous boluses of epinephrine result in significant, although transient, reductions in UBFV in the pregnant guinea pig.

The effect of ephedrine upon uterine artery blood flow velocity in the pregnant guinea pig subjected to terbutaline infusion and acute hemorrhage.

The purpose of the present study was to determine the effect of intravenously administered ephedrine upon uterine artery blood flow velocity (UBFV) in the gravid guinea pig subjected to terbutaline infusion and acute hemorrhage. Ephedrine, 1.0 mg/kg, was administered intravenously to ten chronically instrumented pregnant guinea pigs near term, before and after intravenous infusion of terbutaline and acute hemorrhage. Before terbutaline and hemorrhage, ephedrine increased maternal mean arterial pressure (MMAP) by 30 +/- 1% (P = .0001) and 17 +/- 1% (P = .0001) at 30 s and at 1 min after injection, respectively; UBFV was decreased by 10 +/- 4% (P less than .01) and 14 +/- 4% (P less than .01) at 1 min and at 90 s after injection, respectively. Infusion of terbutaline (1.5-6.0 ug X kg-1 X min-1) increased maternal heart rate (MHR) by 22 +/- 1% (P = .0001), decreased MMAP by 13 +/- 2% (P = .0001), and decreased UBFV by 24 +/- 3% (P = .0001). During hypotension resulting from acute hemorrhage, ephedrine, 1.0 mg/kg, was superior to placebo in restoring MMAP and UBFV toward the prebleed values. The authors concluded that ephedrine, 1.0 mg/kg, results in a small, transient decrease in UBFV in the normotensive gravid guinea pig. However, ephedrine aids restoration of UBFV in the gravid guinea pig rendered hypotensive by acute hemorrhage during terbutaline infusion.

The effect of epidural anaesthesia for caesarean section on maternal uterine and fetal umbilical artery blood flow velocity waveforms.

The blood flow resistance in the maternal uteroplacental and fetal umbilical artery circulation was studied in eight otherwise normal patients undergoing elective lower segment caesarean section. The systolic/diastolic A/B ratio (the ratio of peak systolic to least diastolic flow velocity) for the uteroplacental and fetal umbilical circulation was determined from the artery blood flow velocity-time waveform and used as an index of blood flow resistance. Each patient received a 1 litre intravenous crystalloid infusion before an epidural bupivicaine injection. Both crystalloid infusion and epidural anaesthesia resulted in a significant decrease in the maternal uteroplacental systolic/diastolic (A/B) ratios, associated with a decrease in fetal umbilical artery A/B ratio. This study suggests a beneficial fetal effect from the improved maternal uterine perfusion after epidural anaesthesia.

Effect of intravenous epinephrine on uterine artery blood flow velocity in the pregnant guinea pig.

The purpose of the present study was to determine the effect of intravenously administered epinephrine on the maternal cardiovascular response and uterine artery blood flow velocity (UBFV) in the pregnant guinea pig. Epinephrine (0.2, 0.5, and 1.0 micrograms/kg) and lidocaine (0.4 mg/kg, with and without 0.2 micrograms/kg of epinephrine) were administered intravenously to seven chronically instrumented pregnant guinea pigs near term. Lidocaine without epinephrine did not significantly alter maternal heart rate (MHR), maternal mean arterial pressure (MMAP), or UBFV. Epinephrine, with and without lidocaine, resulted in a transient decrease in MHR. Further, epinephrine, with and without lidocaine, resulted in significant elevations in MMAP and significant, dose-related reductions in UBFV. Mean (+/- SEM) UBFV was 72 +/- 4%, 56 +/- 4%, and 40 +/- 5% of baseline at 30 s after administration of epinephrine, 0.2, 0.5, and 1.0 micrograms/kg, respectively. It is concluded that these small intravenous boluses of epinephrine result in significant, although transient, reductions in UBFV in the pregnant guinea pig.

Chronic measurement, using a Doppler probe, of uterine artery flow in the gravid guinea-pig.

A chronic animal model is described which permits for the first time the continuous measurement of uterine artery blood flow velocity in the pregnant guinea-pig by using a miniaturized Doppler flow probe. Preliminary validation revealed that alterations in actual blood flow are directly and proportionally related to the change in the Doppler shift (r = 0.984) from 0 to 100 ml/h. The velocity signal baseline was as stable as that of systemic blood pressure. Depending upon the individual animal's flow velocity, a deviation of 2-5% from baseline was statistically significant. With experience, greater than 90% of preparations were successful and a 30-day interval was often available for study. Uterine artery flow velocity increased steadily between 45 and 55 days of gestation. Instrumentation did not result in fetal growth retardation. A reduction in flow velocity occurred during general anaesthesia using ketamine and the antianxietal xylazine. In agreement with the reports of other investigators using a different model, both hydralazine and angiotensin II increased uterine blood velocity and adrenaline reduced it.