Uterine Artery Blood Velocity Research Articles

Ge-Gen Decoction attenuates oxytocin-induced uterine contraction and writhing response: potential application in primary dysmenorrhea therapy

The uterine tetanic contraction and uterine artery blood flow reduction are possible reasons for primary dysmenorrhea (PD). In the present study, we aimed to evaluate the uterine relaxant effect and the influence on uterine artery blood velocity of Ge-Gen Decoction (GGD), a well-known Chinese herbal formula. In female ICR mice, uterine contraction was induced by oxytocin exposure following estradiol benzoate pretreatment, and the uterine artery blood velocity was detected by Doppler ultrasound. Histopathological examination of the uterine tissue samples were performed by H&E staining. Ex vivo studies demonstrated that oxytocin, posterior pituitary, or acetylcholine induced contractions in isolated mouse uterus. GGD inhibited both spontaneous and stimulated contractions. In vivo study demonstrated that GGD significantly reduced oxytocin-induced writhing responses with a maximal inhibition of 87%. Further study demonstrated that GGD normalized oxytocin-induced abnormalities of prostaglandins F2 alpha (PGF2α) and Ca2+ in mice. In addition, injection of oxytocin induced a decrease in uterine artery blood flow velocity. Pretreatment with GGD reversed the oxytocin response on blood flow velocity. Histopathological examination showed pretreatment with GGD alleviated inflammation and edema in the uterus when compared with the model group. Both ex vivo and in vivo results indicated that GGD possessed a significant spasmolytic effect on uterine tetanic contraction as well as improvement on uterine artery blood velocity which may involve PGF2α and Ca2+ signaling, suggesting that GGD may have a clinic potential in PD therapy.

Uterine artery blood flow characteristics assessed during oestrus and the early luteal phase of pregnant and non-pregnant bitches

The aim of this study was to measure uterine artery blood velocity daily using Doppler ultrasonography in 10 young and 10 older clinically normal bitches throughout oestrus.Typical arterial waveforms identified in young bitches were characterised by a systolic peak and subsequent flow throughout diastole, whereas in older bitches, flow was sometimes absent in diastole. For 3days immediately prior to ovulation, at the time of declining plasma oestrogen and increasing progesterone concentrations, resistance index (RI) increased, principally associated with decreased diastolic velocity; in some bitches there was absent late diastolic flow during this time. In older bitches, the waveform appearance was more variable, with absent late and early diastolic flow observed in some cases. Mean RI was higher throughout oestrus for older bitches compared with young bitches, although both groups had a similar 3-day duration increase before ovulation. Nine of the young bitches and five of the older bitches became pregnant; litter size was smaller for the older bitches. Non-pregnant bitches: (1) were significantly older; (2) had fewer waveforms with continuous diastolic flow 2days before ovulation; (3) had lower end diastolic velocity, higher RI and fewer waveforms with continuous diastolic flow 2days after ovulation, and (4) had lower plasma progesterone concentrations 5days after ovulation. These are the first detailed observations of uterine artery blood velocity and waveform appearance throughout oestrus in bitches, and this is the first description of a link between impaired diastolic flow and reduced fertility. Assessment of uterine artery velocity could be useful to promote understanding of physiological mechanisms and could also become an important tool to assess potential infertility.

Delayed uterine fluid clearance and reduced uterine perfusion in bitches with endometrial hyperplasia and clinical management with postmating antibiotic

In many species a transient uterine inflammatory response follows mating and is proposed to remove excess spermatozoa, bacteria, and other contaminants from the uterus. Similar events have been documented in the bitch involving increased uterine contractions, polymorphonuclear neutrophil influx and uterine artery vasodilation. Some healthy bitches with endometrial hyperplasia have increased numbers of uterine luminal polymorphonuclear neutrophils after mating and reduced fertility; it is purported that this represents a presumed postmating endometritis. This study used B-mode and Doppler ultrasonography at the time of mating to measure uterine contractions, clearance of ejaculated fluid, and uterine artery velocity in normal bitches and those with endometrial hyperplasia. Mating resulted in an increase in the number of uterine contractions, although fewer mating-induced contractions were noted in bitches with endometrial hyperplasia. Interestingly, uterine fluid cleared significantly more slowly after mating from the bitches with endometrial hyperplasia than the normal bitches (P = 0.01). In a further study, Doppler ultrasonography showed that in normal bitches there was a significant increase in uterine artery blood velocity (P = 0.04) and a decrease in the resistance index after mating (P = 0.04), indicating vasodilation. In bitches with endometrial hyperplasia the baseline resistance index was significantly higher than normal bitches (P = 0.05), and furthermore, although there was a significant decrease in resistance index after mating, in the bitches with endometrial hyperplasia this was of a smaller magnitude that in normal bitches. These findings indicate lower baseline uterine perfusion, and a blunted vasodilation response to mating in bitches with endometrial hyperplasia. Short-duration postmating administration of systemic antibiotic increased pregnancy rates in bitches with endometrial hyperplasia (P < 0.01). Litter sizes in bitches with endometrial hyperplasia were lower than those of normal bitches both before and after treatment with postmating antibiotic (P = 0.04 and < 0.01, respectively). Mating-induced endometritis in bitches with endometrial hyperplasia appears to affect fertility by reducing the uterine vasodilatory response to mating and delaying clearance of uterine fluid as a result of decreased uterine contractions but the effect can be ameliorated in part by the postmating administration of antibiotic.

The bitch uterine response to semen deposition and its modification by male accessory gland secretions

Little is known about the response of the bitch's reproductive tract to semen deposition. In this study, an influx of polymorphonuclear neutrophils (PMNs) into the uterus was detected after artificial insemination, but there was normal fertility. Doppler ultrasonography showed that insemination induced an increase in uterine artery blood velocity and a decrease in the resistance index of short duration, indicating vasodilation. Semen that was extended in fluid from the sperm rich fraction of the ejaculate (seminal plasma, SP), or third fraction of the ejaculate (prostatic fluid, PF), produced a similar magnitude of effect but of longer duration. It was hypothesised that vasodilation following insemination was largely induced by SP and PF which, together with PMN influx, was part of a normal uterine response. Physiological concentrations of PMNs in vitro reduced the ability of spermatozoa to attach to uterine epithelium, most likely as a result of spermatozoa becoming attached to PMNs. However, both SP and PF increased attachment of spermatozoa to the uterine epithelium by reducing sperm attachment to PMNs, and potentially by an additional mechanism that did not involve inhibition of sperm binding to PMNs. These are the first canine studies to document an apparent physiological response by the uterus to semen, associated with uterine artery vasodilation and PMN influx. Moreover, these investigations are the first to demonstrate that canine SF and PF are part of the mechanism for increasing uterine perfusion and that both fluids have a modulatory effect on PMN-induced inhibition of spermatozoal attachment to uterine epithelium, most likely mediated by reduced sperm attachment to PMNs.

Effects of Methyldopa and Nifedipine on Uteroplacental and Fetal Hemodynamics in Gestational Hypertension

Objective. Investigation of methyldopa and nifedipine effects on maternal and fetal hemodynamics in women with mild gestational hypertension during the third pregnancy trimester. Methods. A prospective cohort study. Methyldopa effects were followed in 28 patients, and nifedipine effects in another 28 patients. There were also 28 healthy controls. Results. Uterine artery blood velocity waveform indices were improved only by nifedipine. Neither of the drugs affected the indices in umbilical and fetal middle cerebral artery. Both drugs normalized maternal blood pressure and pulse. Conclusions. Methyldopa and nifedipine did not show clinically significant influence on umbilical artery and fetal cerebral blood flow.

A longitudinal study of the relationship between maternal cardiac output measured by impedance cardiography and uterine artery blood flow in the second half of pregnancy

To study serial changes in maternal systemic and uterine artery haemodynamics and establish reference ranges for the second half of pregnancy. Prospective longitudinal observational study. University hospital in Norway. Low-risk pregnant women. Fifty-three low-risk pregnancies were evaluated at approximately 4-weekly intervals. Maternal systemic haemodynamics was assessed with impedance cardiography. Uterine artery blood velocity and diameter were measured using Doppler ultrasonography and uterine artery volume blood flow (Q(uta)) was calculated as the product of mean velocity and cross-sectional area of the uterine artery. The fraction of cardiac output (CO) distributed to the uterine circulation was calculated as: Q(uta)/CO x 100. CO, Q(uta), uterine vascular resistance (R(uta)) and the fraction of CO distributed to the uterine circulation. The CO increased (P = 0.0063) until 34 weeks and remained stable until term. Total Q(uta) increased from 299 to 673 ml/minute and R(uta) halved from 0.26 to 0.13 mmHg/ml/minute (P < 0.0001). The fraction of CO distributed to the uterine circulation increased from 5.6% to 11.7% (P < 0.0001). During the second half of pregnancy, Q(uta) and the fraction of maternal CO distributed to the uterine circulation increase approximately two-fold, mainly as a result of decrease in R(uta).

Evaluation of third trimester uterine artery flow velocity indices in relationship to perinatal complications

Objective. Uterine artery Doppler is becoming a routine part of pregnancy surveillance in high-risk pregnancies. Which blood flow velocity waveform index to measure is debated and the ‘notch’ in early diastole is not widely accepted, as it is a subjective measure. The aim of the present study was to evaluate the different indices in the prediction of adverse outcome of pregnancies suspected for intrauterine fetal growth restriction (IUGR).Methods. Uterine artery blood flow was recorded in 217 pregnancies admitted for Doppler ultrasound surveillance due to suspected IUGR. The median gestational age at examination was 38 weeks (range 25–42 weeks). Only cases having bilateral uterine artery notching were included in the evaluation. The uterine artery Doppler spectrum was analyzed for different indices, including evaluation of notch and end-diastolic velocities. Umbilical artery Doppler velocimetry was also performed. The outcome variables chosen were: a small-for-gestational-age (SGA) newborn, preterm birth, and abdominal delivery. ROC-curve calculations were used to compare the different indices.Results. The uterine artery blood velocity pulsatility index (PI) and resistance indices (RI) were the best predictors of adverse outcome of pregnancy. Apart from premature birth, the systolic/end-diastolic ratio was less predictive of adverse outcome. The indices including only diastolic blood velocities were the least predictive of adverse outcome. The group with notch velocity above end-diastolic velocity was compared with those having notch velocity below the end-diastolic velocity. No difference in outcome was seen between the two groups.Conclusions. RI and PI as measures of third trimester utero-placental vascular impedance are the best predictors of adverse outcome of IUGR-suspected pregnancies.