A longitudinal Doppler ultrasonographic assessment of the alterations in peripheral vascular resistance of uterine arteries and ultrasonographic findings of the involuting uterus during the puerperium
Objective: Our purpose was to assess the alterations in peripheral vascular resistance of uterine arteries in the puerperium. Study Design: In this longitudinal study 42 patients with uncomplicated pregnancies were examined with transabdominal color Doppler ultrasonography before and after delivery...
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| Published in | American journal of obstetrics and gynecology Vol. 168; no. 1; pp. 190 - 198 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | English |
| Published |
Philadelphia, PA
Mosby, Inc
1993
Elsevier |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Objective: Our purpose was to assess the alterations in peripheral vascular resistance of uterine arteries in the puerperium.
Study Design: In this longitudinal study 42 patients with uncomplicated pregnancies were examined with transabdominal color Doppler ultrasonography before and after delivery for 3 months. A total of 266 evaluations were performed.
Results: Within 2 days after delivery the mean pulsatility index of uterine arteries had increased significantly from 0.73 ± 0.15 to 1.19 ± 0.36, and the prediastolic notch had reappeared. After 6 weeks the indexes had started to increase further and reached a level of 1.75 ± 0.56 by the end of the third puerperal month.
Conclusions: Uterine vascular resistance increases soon after delivery. Puerperal changes in pulsatility indexes are triphasic. At the end of the fourteenth puerperal week pulsatility indexes are still much lower than those of nonpregnant women and all flow velocity waveforms represent a continuous end-diastolic component. |
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| AbstractList | OBJECTIVEOur purpose was to assess the alterations in peripheral vascular resistance of uterine arteries in the puerperium.STUDY DESIGNIn this longitudinal study 42 patients with uncomplicated pregnancies were examined with transabdominal color Doppler ultrasonography before and after delivery for 3 months. A total of 266 evaluations were performed.RESULTSWithin 2 days after delivery the mean pulsatility index of uterine arteries had increased significantly from 0.73 +/- 0.15 to 1.19 +/- 0.36, and the prediastolic notch had reappeared. After 6 weeks the indexes had started to increase further and reached a level of 1.75 +/- 0.56 by the end of the third puerperal month.CONCLUSIONSUterine vascular resistance increases soon after delivery. Puerperal changes in pulsatility indexes are triphasic. At the end of the fourteenth puerperal week pulsatility indexes are still much lower than those of nonpregnant women and all flow velocity waveforms represent a continuous end-diastolic component. Our purpose was to assess the alterations in peripheral vascular resistance of uterine arteries in the puerperium. In this longitudinal study 42 patients with uncomplicated pregnancies were examined with transabdominal color Doppler ultrasonography before and after delivery for 3 months. A total of 266 evaluations were performed. Within 2 days after delivery the mean pulsatility index of uterine arteries had increased significantly from 0.73 +/- 0.15 to 1.19 +/- 0.36, and the prediastolic notch had reappeared. After 6 weeks the indexes had started to increase further and reached a level of 1.75 +/- 0.56 by the end of the third puerperal month. Uterine vascular resistance increases soon after delivery. Puerperal changes in pulsatility indexes are triphasic. At the end of the fourteenth puerperal week pulsatility indexes are still much lower than those of nonpregnant women and all flow velocity waveforms represent a continuous end-diastolic component. Objective: Our purpose was to assess the alterations in peripheral vascular resistance of uterine arteries in the puerperium. Study Design: In this longitudinal study 42 patients with uncomplicated pregnancies were examined with transabdominal color Doppler ultrasonography before and after delivery for 3 months. A total of 266 evaluations were performed. Results: Within 2 days after delivery the mean pulsatility index of uterine arteries had increased significantly from 0.73 ± 0.15 to 1.19 ± 0.36, and the prediastolic notch had reappeared. After 6 weeks the indexes had started to increase further and reached a level of 1.75 ± 0.56 by the end of the third puerperal month. Conclusions: Uterine vascular resistance increases soon after delivery. Puerperal changes in pulsatility indexes are triphasic. At the end of the fourteenth puerperal week pulsatility indexes are still much lower than those of nonpregnant women and all flow velocity waveforms represent a continuous end-diastolic component. |
| Author | Jouppila, Pentti Tekay, Aydin |
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| Cites_doi | 10.1093/oxfordjournals.humrep.a137109 10.1111/j.1471-0528.1987.tb02286.x 10.1097/00003081-198012000-00004 10.1111/j.1471-0528.1989.tb03261.x 10.3109/00016349809004301 10.1016/0002-9378(86)90340-6 10.7863/jum.1991.10.8.451 10.1093/oxfordjournals.humrep.a136772 10.1016/0002-9378(68)90428-6 10.1016/S0015-0282(16)53162-8 10.1111/j.1471-0528.1988.tb06819.x 10.1111/j.1365-2559.1989.tb01591.x 10.1016/0002-9378(88)90416-4 |
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| Keywords | vascular resistance involution Color Doppler puerperium Doppler ultrasound study Sonography Human Uterus Female genital system Circulatory velocity Hemodynamics Puerperium Uterine artery |
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| References | Ramsey (bib1) 1989 Robson, Hunter, Moore, Dunlop (bib11) 1987; 94 Long, Boultbee, Hanson, Begent (bib4) 1989; 96 Deutinger, Rudelstorfer, Bernaschek (bib13) 1988; 159 Schulman, Fleischer, Farmakides, Bracero, Rochelson, Grunfeld (bib7) 1986; 155 Jurkovic, Jauniaux, Kurjak, Hustin, Campbell, Nicolaides (bib14) 1991; 77 Steer, Campbell, Pampiglione, Kingsland, Mason, Collins (bib5) 1990; 5 Fuchs (bib18) 1983 Goswamy, Steptoe (bib3) 1988; 3 Hertzberg, Bowie (bib19) 1991; 10 Thoresen, Wesche (bib12) 1988; 67 Kirkinen, Dudenhausen, Baumann, Huch, Huch (bib10) 1988; 33 Anderson, Davis (bib16) 1968; 102 Monheit, Cousins, Resnik (bib17) 1980; 23 Hata, Hata, Aoki, Takamiya, Kitao (bib6) 1988; 7 Andrew, Bulmer, Wells, Morrison, Buckley (bib8) 1989; 15 Baumann, Kirkinen, Mueller, Schnarwyler, Huch, Huch (bib9) 1988; 95 Campbell, Pearce, Hacken, Cohen-Overbeek, Hernandez (bib15) 1986; 68 Scholtes, Wladimiroff, van Rijen, Hop (bib2) 1989; 52 Thoresen (10.1016/S0002-9378(12)90913-8_bib12) 1988; 67 Long (10.1016/S0002-9378(12)90913-8_bib4) 1989; 96 Hata (10.1016/S0002-9378(12)90913-8_bib6) 1988; 7 Hertzberg (10.1016/S0002-9378(12)90913-8_bib19) 1991; 10 Goswamy (10.1016/S0002-9378(12)90913-8_bib3) 1988; 3 Andrew (10.1016/S0002-9378(12)90913-8_bib8) 1989; 15 Fuchs (10.1016/S0002-9378(12)90913-8_bib18) 1983 Anderson (10.1016/S0002-9378(12)90913-8_bib16) 1968; 102 Steer (10.1016/S0002-9378(12)90913-8_bib5) 1990; 5 Jurkovic (10.1016/S0002-9378(12)90913-8_bib14) 1991; 77 Deutinger (10.1016/S0002-9378(12)90913-8_bib13) 1988; 159 Ramsey (10.1016/S0002-9378(12)90913-8_bib1) 1989 Scholtes (10.1016/S0002-9378(12)90913-8_bib2) 1989; 52 Baumann (10.1016/S0002-9378(12)90913-8_bib9) 1988; 95 Robson (10.1016/S0002-9378(12)90913-8_bib11) 1987; 94 Kirkinen (10.1016/S0002-9378(12)90913-8_bib10) 1988; 33 Schulman (10.1016/S0002-9378(12)90913-8_bib7) 1986; 155 Campbell (10.1016/S0002-9378(12)90913-8_bib15) 1986; 68 Monheit (10.1016/S0002-9378(12)90913-8_bib17) 1980; 23 |
| References_xml | – volume: 96 start-page: 588 year: 1989 end-page: 593 ident: bib4 article-title: Doppler time velocity waveform studies of the uterine artery and uterus publication-title: Br J Obstet Gynaecol contributor: fullname: Begent – volume: 67 start-page: 741 year: 1988 end-page: 745 ident: bib12 article-title: Doppler measurements of changes in human mammary and uterine blood flow during pregnancy and lactation publication-title: Acta Obstet Gynecol Scand contributor: fullname: Wesche – volume: 102 start-page: 23 year: 1968 end-page: 33 ident: bib16 article-title: Placental site involution publication-title: Am J Obstet Gynecol contributor: fullname: Davis – volume: 23 start-page: 973 year: 1980 end-page: 983 ident: bib17 article-title: The puerperium: anatomic and physiologic readjustments publication-title: Clin Obstet Gynecol contributor: fullname: Resnik – start-page: 57 year: 1989 end-page: 68 ident: bib1 article-title: Vascular anatomy publication-title: Biology of the uterus contributor: fullname: Ramsey – volume: 10 start-page: 451 year: 1991 end-page: 456 ident: bib19 article-title: Ultrasound of the postpartum uterus: prediction of retained placental tissue publication-title: J Ultrasound Med contributor: fullname: Bowie – volume: 159 start-page: 1072 year: 1988 end-page: 1076 ident: bib13 article-title: Vaginosonographic velocimetry of both main uterine arteries by visual vessel recognition and pulsed Doppler method during pregnancy publication-title: Am J Obstet Gynecol contributor: fullname: Bernaschek – volume: 94 start-page: 1028 year: 1987 end-page: 1039 ident: bib11 article-title: Haemodynamic changes during the puerperium: a Doppler and M-mode echocardiographic study publication-title: Br J Obstet Gynaecol contributor: fullname: Dunlop – volume: 15 start-page: 395 year: 1989 end-page: 405 ident: bib8 article-title: Subinvolution of the uteroplacental arteries in the human placental bed publication-title: Histopathology contributor: 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the ovarian and menstrual cycles publication-title: Hum Reprod contributor: fullname: Collins – start-page: 271 year: 1983 end-page: 287 ident: bib18 article-title: Endocrinology of lactation publication-title: Endocrinology of pregnancy contributor: fullname: Fuchs – volume: 155 start-page: 1031 year: 1986 end-page: 1036 ident: bib7 article-title: Development of uterine artery compliance in pregnancy as detected by Doppler ultrasound publication-title: Am J Obstet Gynecol contributor: fullname: Grunfeld – volume: 33 start-page: 745 year: 1988 end-page: 748 ident: bib10 article-title: Postpartum blood flow velocity waveforms of the uterine arteries publication-title: J Reprod Med contributor: fullname: Huch – volume: 68 start-page: 649 year: 1986 end-page: 653 ident: bib15 article-title: Qualitative assessment of uteroplacental blood flow: early screening test for high-risk pregnancies publication-title: Obstet Gynecol contributor: fullname: Hernandez – volume: 52 start-page: 981 year: 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10.1111/j.1471-0528.1987.tb02286.x contributor: fullname: Robson – volume: 23 start-page: 973 year: 1980 ident: 10.1016/S0002-9378(12)90913-8_bib17 article-title: The puerperium: anatomic and physiologic readjustments publication-title: Clin Obstet Gynecol doi: 10.1097/00003081-198012000-00004 contributor: fullname: Monheit – volume: 96 start-page: 588 year: 1989 ident: 10.1016/S0002-9378(12)90913-8_bib4 article-title: Doppler time velocity waveform studies of the uterine artery and uterus publication-title: Br J Obstet Gynaecol doi: 10.1111/j.1471-0528.1989.tb03261.x contributor: fullname: Long – start-page: 57 year: 1989 ident: 10.1016/S0002-9378(12)90913-8_bib1 article-title: Vascular anatomy contributor: fullname: Ramsey – volume: 67 start-page: 741 year: 1988 ident: 10.1016/S0002-9378(12)90913-8_bib12 article-title: Doppler measurements of changes in human mammary and uterine blood flow during pregnancy and lactation publication-title: Acta Obstet Gynecol Scand doi: 10.3109/00016349809004301 contributor: fullname: Thoresen – volume: 68 start-page: 649 year: 1986 ident: 10.1016/S0002-9378(12)90913-8_bib15 article-title: Qualitative assessment of uteroplacental blood flow: early screening test for high-risk pregnancies publication-title: Obstet Gynecol contributor: fullname: Campbell – volume: 7 start-page: 309 year: 1988 ident: 10.1016/S0002-9378(12)90913-8_bib6 article-title: Changes in myometrial arcuate arterial compliance during the reproductive cycle as assessed by real-time two-dimensional and color flow pulsed Doppler ultrasound publication-title: J Cardiovasc Ultrasonogr contributor: fullname: Hata – volume: 77 start-page: 365 year: 1991 ident: 10.1016/S0002-9378(12)90913-8_bib14 article-title: Transvaginal color Doppler assessment of the uteroplacental circulation in early pregnancy publication-title: Obstet Gynecol contributor: fullname: Jurkovic – volume: 155 start-page: 1031 year: 1986 ident: 10.1016/S0002-9378(12)90913-8_bib7 article-title: Development of uterine artery compliance in pregnancy as detected by Doppler ultrasound publication-title: Am J Obstet Gynecol doi: 10.1016/0002-9378(86)90340-6 contributor: fullname: Schulman – volume: 10 start-page: 451 year: 1991 ident: 10.1016/S0002-9378(12)90913-8_bib19 article-title: Ultrasound of the postpartum uterus: prediction of retained placental tissue publication-title: J Ultrasound Med doi: 10.7863/jum.1991.10.8.451 contributor: fullname: Hertzberg – volume: 3 start-page: 721 year: 1988 ident: 10.1016/S0002-9378(12)90913-8_bib3 article-title: Doppler ultrasound studies of the uterine artery in spontaneous ovarian cycles publication-title: Hum Reprod doi: 10.1093/oxfordjournals.humrep.a136772 contributor: fullname: Goswamy – start-page: 271 year: 1983 ident: 10.1016/S0002-9378(12)90913-8_bib18 article-title: Endocrinology of lactation contributor: fullname: Fuchs – volume: 102 start-page: 23 year: 1968 ident: 10.1016/S0002-9378(12)90913-8_bib16 article-title: Placental site involution publication-title: Am J Obstet Gynecol doi: 10.1016/0002-9378(68)90428-6 contributor: fullname: Anderson – volume: 52 start-page: 981 year: 1989 ident: 10.1016/S0002-9378(12)90913-8_bib2 article-title: Uterine and ovarian flow velocity waveforms in the normal menstrual cycle: a transvaginal study publication-title: Fertil Steril doi: 10.1016/S0015-0282(16)53162-8 contributor: fullname: Scholtes – volume: 95 start-page: 1282 year: 1988 ident: 10.1016/S0002-9378(12)90913-8_bib9 article-title: Blood flow velocity waveforms in large maternal and uterine vessels throughout pregnancy and postpartum: a longitudinal study using dupplex sonography publication-title: Br J Obstet Gynaecol doi: 10.1111/j.1471-0528.1988.tb06819.x contributor: fullname: Baumann – volume: 33 start-page: 745 year: 1988 ident: 10.1016/S0002-9378(12)90913-8_bib10 article-title: Postpartum blood flow velocity waveforms of the uterine arteries publication-title: J Reprod Med contributor: fullname: Kirkinen – volume: 15 start-page: 395 year: 1989 ident: 10.1016/S0002-9378(12)90913-8_bib8 article-title: Subinvolution of the uteroplacental arteries in the human placental bed publication-title: Histopathology doi: 10.1111/j.1365-2559.1989.tb01591.x contributor: fullname: Andrew – volume: 159 start-page: 1072 year: 1988 ident: 10.1016/S0002-9378(12)90913-8_bib13 article-title: Vaginosonographic velocimetry of both main uterine arteries by visual vessel recognition and pulsed Doppler method during pregnancy publication-title: Am J Obstet Gynecol doi: 10.1016/0002-9378(88)90416-4 contributor: fullname: Deutinger |
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Study Design: In this... Our purpose was to assess the alterations in peripheral vascular resistance of uterine arteries in the puerperium. In this longitudinal study 42 patients with... OBJECTIVEOur purpose was to assess the alterations in peripheral vascular resistance of uterine arteries in the puerperium.STUDY DESIGNIn this longitudinal... |
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| SubjectTerms | Adult Arteries - diagnostic imaging Arteries - physiology Biological and medical sciences Color Doppler Female Fundamental and applied biological sciences. Psychology Heart Rate - physiology Humans involution Longitudinal Studies Mother. Fetoplacental unit. Mammary gland. Milk Postpartum Period - physiology Pregnancy Pregnancy. Parturition. Lactation puerperium Pulsatile Flow - physiology Regional Blood Flow Ultrasonography, Prenatal Uterus - blood supply Uterus - diagnostic imaging Uterus - physiology vascular resistance Vascular Resistance - physiology Vertebrates: reproduction |
| Title | A longitudinal Doppler ultrasonographic assessment of the alterations in peripheral vascular resistance of uterine arteries and ultrasonographic findings of the involuting uterus during the puerperium |
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