Early Path Medical Consultation Services
Pathology Services Working for Safer Pregnancies

Abstracts
Uterine Artery Blood Flow

1
Blood flow changes in the ovarian and uterine arteries during the normal menstrual cycle
American Journal of Obstetrics & Gynecology 1996 Sep;175(3 Pt 1):625-31

Tan SL, Zaidi J, Campbell S, Doyle P, Collins W
Department of Obstetrics and Gynecology, King's College School of Medicine and Dentistry, London, United Kingdom.

OBJECTIVE: Our purpose was to study the hemodynamic changes in the uterine and intraovarian vessels
during the normal menstrual cycle and to relate the vascular changes to hormonal index values.
STUDY DESIGN: Seven women who had bilateral tubal patency, a normal pelvis on laparoscopy, and regular ovulatory cycles underwent serial transvaginal ultrasonography on menstrual cycle day 2, daily from estimated day of ovulation-6, hourly from estimated day of ovulation-2, or when the mean follicular diameter was > 16 mm (whichever was earlier) until 6 hours after follicular rupture and once 7 days after follicular rupture. At each scan uterine and intraovarian blood flow was assessed with transvaginal color Doppler ultrasonography and serum concentrations of follicle-stimulating hormone, luteinizing hormone, estradiol, and progesterone assessed by fluoroimmunoassay.
RESULTS: In one case there was evidence of a luteinized unruptured follicle and the patient was therefore excluded from analysis. In the other six women there was spontaneous ovulation at a mean of 39 hours after the onset of the luteinizing hormone surge. On the side with the dominant follicle, follicular and ovarian stromal peak systolic blood flow velocity rose significantly during the menstrual cycle with no significant change in pulsatility index. The changes in blood flow velocity correlated significantly with changes in serum follicle-stimulating hormone, luteinizing hormone and progesterone concentrations. There were no significant changes in either blood flow velocity or pulsatility index in the contralateral ovary. Uterine artery time-averaged maximum velocity on the side of the developing ovarian follicle increased during the menstrual cycle with no significant change in the contralateral vessel. Uterine artery pulsatility index on the side of the developing follicle declined during the midluteal phase and was significantly lower than on the contralateral side. The changes in time-averaged maximum velocity correlated with the changes in serum estradiol and progesterone concentrations.
CONCLUSION: The vascular changes in the wall of the dominant ovarian follicle and ovarian stroma during the menstrual cycle are consistent with activity of angiogenic-like factors. The decline in uterine artery resistance during the midluteal phase may reflect optimal vascularity for implantation of the blastocyst.

2
Intra-observer reproducibility of transvaginal Doppler measurements in uterine and intraovarian arteries in regularly menstruating women
Ultrasound in Obstetrics & Gynecology 1996 Feb;7(2):129-34

Tekay A, Jouppila P
Department of Obstetrics and Gynecology, University of Oulu, Finland.

The intraobserver reproducibility of the pulsatility index (PI), resistance index (RI) and maximum peak systolic velocity (MPSV) measurements in uterine and intraovarian arteries was assessed in ten regularly menstruating women by means of transvaginal pulsed Doppler ultrasound. Three different sources of variation in repeat measurements, i.e. beat-to-beat, between-frame and temporal variability, were studied using the coefficient of variation (CV) and intra-class correlation coefficients. Beat-to-beat and between-frame variabilities in all Doppler parameters were negligible. The following figures were obtained from the assessment of temporal variability. The uterine artery PI and MPSV measurements had a CV of 10% and 15%, respectively. Intra-class correlation coefficients for these parameters were 0.99 and 0.88, respectively. In the intraovarian arteries, the CV was between 15 and 19% for the PI and between 8 and 12% for the RI. The CV values for intraovarian MPSV measurements were 14 and 16%. In contrast, the intra-class correlation coefficients for the intraovarian MPSV measurements showed considerable variation, from 0.63 to 0.68. Uterine artery Doppler velocimetry proved to be a reliable method. The PI and RI measurements in the intraovarian arteries were also reproducible. In contrast, the inconsistency observed in velocity measurements in the intraovarian arteries raises some doubt as to the reliability of these measurements.

DISCLAIMER: This communication is for educational purposes only and it is not to be used as a substitute for a consultation with your physician. Should you contact Dr. Salafia's office, any responses to you will be based on the information you provide and no attempt will be made to confirm or verify any such information, including any laboratory data you may submit. Questions regarding actual symptoms of illness or health conditions should be addressed to a local health care practitioner who can physically examine and take responsibility for your care throughout the course of your condition/illness, which Dr. Salafia, being a physician licensed to practice medicine only in the State of New York, cannot and will not do. You should NOT use this information to diagnose or treat a health problem; rather, you should consult a qualified health care provider who examines you in person and who is licensed to practice in the state where you are located.

Copyright © 2000-2004 EarlyPath. All rights reserved.