The association between decidual vasculopathy and abnormal uterine artery Doppler measurement
Abstract Introduction Placental syndrome is an umbrella term encompassing the clinical phenotypes of preeclampsia and fetal growth restriction, and is associated with high maternal and neonatal morbidity. In women with placental syndrome, histologicl examination of the uteroplacental unit commonly d...
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Wiley
2022-08-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14345 |
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| author | Droïma Stevens Veronique Schiffer Carmen Severens‐Rijvers Johnny deNobrega Teixeira Ashlee vanHaren Marc Spaanderman Salwan Al‐Nasiry |
| author_facet | Droïma Stevens Veronique Schiffer Carmen Severens‐Rijvers Johnny deNobrega Teixeira Ashlee vanHaren Marc Spaanderman Salwan Al‐Nasiry |
| author_sort | Droïma Stevens |
| collection | DOAJ |
| description | Abstract Introduction Placental syndrome is an umbrella term encompassing the clinical phenotypes of preeclampsia and fetal growth restriction, and is associated with high maternal and neonatal morbidity. In women with placental syndrome, histologicl examination of the uteroplacental unit commonly demonstrates pathological lesions, such as decidual vasculopathy. Decidual vasculopathy are pathological changes in the spiral arteries, which are associated with adverse outcome in preeclampsia and long‐term maternal cardiovascular health. The relation between placental syndrome phenotypes and placental pathology has been previously demonstrated; however, the role of uteroplacental Doppler measurements as a link between placental syndrome phenotypes and the underlying placental pathology is still unclear. We hypothesized that decidual vasculopathy is associated with abnormal uteroplacental Doppler profiles and ultrasound placental parameters, independent of clinical phenotype. Material and Methods We performed a retrospective analysis of data from a prospective cohort of pregnancies with placental syndrome, as well as cases without hypertensive disease or fetal growth restriction. The study group was divided into women with decidual vasculopathy on histologic analysis of placental specimen and those without the lesions. Outcome parameters included maternal and fetal Dopplers, estimated fetal weight, placental weight and thickness, placental lacunae and abnormal placental calcification. Results Compared with the women without the lesions (n = 91), the group with decidual vasculopathy (n = 25) had a higher mean uterine artery pulsatility index (1.70 vs 0.81, p < 0.001) and uterine artery pulsatility index percentile (>p99 vs p67, p < 0.001). Decidual vasculopathy was associated with abnormal uterine artery Doppler profile (defined as pulsatility index p > 95 and/or bilateral notch) (82%) compared with women without the lesions (33%) (odds ratio [OR] 9.3, 95% CI 2.4–36.0), which remained significant after adjusting for possible confounding factors preeclampsia, tobacco use and gestational age at birth (OR 7.1, 95% CI 1.3–39.1). Decidual vasculopathy was not associated with fetal Doppler abnormalities or placental parameters and only modestly so with lower cerebroplacental ratio (p = 0.036). Conclusions Histologic decidual vasculopathy is associated with abnormal uterine artery Doppler, independent of clinical phenotype during pregnancy. |
| format | Article |
| id | doaj-art-ef06887bcb474a489d872ffd36ada836 |
| institution | Kabale University |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2022-08-01 |
| publisher | Wiley |
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| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-ef06887bcb474a489d872ffd36ada8362025-08-20T03:31:01ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-08-01101891091610.1111/aogs.14345The association between decidual vasculopathy and abnormal uterine artery Doppler measurementDroïma Stevens0Veronique Schiffer1Carmen Severens‐Rijvers2Johnny deNobrega Teixeira3Ashlee vanHaren4Marc Spaanderman5Salwan Al‐Nasiry6Department of Obstetrics and Gynecology Erasmus University Medical Center Rotterdam The NetherlandsDepartment of Obstetrics and Gynecology Maastricht University Medical Centre (MUMC+) Maastricht The NetherlandsGROW School for Oncology and Developmental Biology Maastricht University Maastricht The NetherlandsDepartment of Obstetrics and Gynecology Maastricht University Medical Centre (MUMC+) Maastricht The NetherlandsDepartment of Obstetrics and Gynecology Maastricht University Medical Centre (MUMC+) Maastricht The NetherlandsDepartment of Obstetrics and Gynecology Maastricht University Medical Centre (MUMC+) Maastricht The NetherlandsDepartment of Obstetrics and Gynecology Maastricht University Medical Centre (MUMC+) Maastricht The NetherlandsAbstract Introduction Placental syndrome is an umbrella term encompassing the clinical phenotypes of preeclampsia and fetal growth restriction, and is associated with high maternal and neonatal morbidity. In women with placental syndrome, histologicl examination of the uteroplacental unit commonly demonstrates pathological lesions, such as decidual vasculopathy. Decidual vasculopathy are pathological changes in the spiral arteries, which are associated with adverse outcome in preeclampsia and long‐term maternal cardiovascular health. The relation between placental syndrome phenotypes and placental pathology has been previously demonstrated; however, the role of uteroplacental Doppler measurements as a link between placental syndrome phenotypes and the underlying placental pathology is still unclear. We hypothesized that decidual vasculopathy is associated with abnormal uteroplacental Doppler profiles and ultrasound placental parameters, independent of clinical phenotype. Material and Methods We performed a retrospective analysis of data from a prospective cohort of pregnancies with placental syndrome, as well as cases without hypertensive disease or fetal growth restriction. The study group was divided into women with decidual vasculopathy on histologic analysis of placental specimen and those without the lesions. Outcome parameters included maternal and fetal Dopplers, estimated fetal weight, placental weight and thickness, placental lacunae and abnormal placental calcification. Results Compared with the women without the lesions (n = 91), the group with decidual vasculopathy (n = 25) had a higher mean uterine artery pulsatility index (1.70 vs 0.81, p < 0.001) and uterine artery pulsatility index percentile (>p99 vs p67, p < 0.001). Decidual vasculopathy was associated with abnormal uterine artery Doppler profile (defined as pulsatility index p > 95 and/or bilateral notch) (82%) compared with women without the lesions (33%) (odds ratio [OR] 9.3, 95% CI 2.4–36.0), which remained significant after adjusting for possible confounding factors preeclampsia, tobacco use and gestational age at birth (OR 7.1, 95% CI 1.3–39.1). Decidual vasculopathy was not associated with fetal Doppler abnormalities or placental parameters and only modestly so with lower cerebroplacental ratio (p = 0.036). Conclusions Histologic decidual vasculopathy is associated with abnormal uterine artery Doppler, independent of clinical phenotype during pregnancy.https://doi.org/10.1111/aogs.14345decidual vasculopathyfetal growth restrictionplacental syndromepreeclampsiaultrasounduterine artery Doppler |
| spellingShingle | Droïma Stevens Veronique Schiffer Carmen Severens‐Rijvers Johnny deNobrega Teixeira Ashlee vanHaren Marc Spaanderman Salwan Al‐Nasiry The association between decidual vasculopathy and abnormal uterine artery Doppler measurement Acta Obstetricia et Gynecologica Scandinavica decidual vasculopathy fetal growth restriction placental syndrome preeclampsia ultrasound uterine artery Doppler |
| title | The association between decidual vasculopathy and abnormal uterine artery Doppler measurement |
| title_full | The association between decidual vasculopathy and abnormal uterine artery Doppler measurement |
| title_fullStr | The association between decidual vasculopathy and abnormal uterine artery Doppler measurement |
| title_full_unstemmed | The association between decidual vasculopathy and abnormal uterine artery Doppler measurement |
| title_short | The association between decidual vasculopathy and abnormal uterine artery Doppler measurement |
| title_sort | association between decidual vasculopathy and abnormal uterine artery doppler measurement |
| topic | decidual vasculopathy fetal growth restriction placental syndrome preeclampsia ultrasound uterine artery Doppler |
| url | https://doi.org/10.1111/aogs.14345 |
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