TRANSVAGINAL COLOR DOPPLER IN EARLY-PREGNANCY - RATIONAL AND CLINICALPOTENTIAL

Remarkable hemodynamics changes that occur in the maternal circulation , the continuous growth and development of the fete-placental circulat ion is now studied by transvaginal Doppler. This seems to give more li ght in understanding of the early pregnancy pathophysiology. For the f irst time, it seems that ultrasound might be able to distinguish diffe rent forms of gestational trophoblastic disease. Due to its non-invasi veness and relatively simple and easily performed technique, transvagi nal color Doppler might be of considerable clinical value. The other i mportant point is that study results are available immediately for cli nical judgement. From our study, we can conclude that transvaginal ult rasound with color and pulsed Doppler is potentially valuable diagnost ic tool to differentiate forms of the gestational trophoblastic diseas es. On the basis of Doppler findings, the complete mole can be reliabl y distinguish from the invasive mole or choriocarcinoma. The degree of myometrial invasion can be also assessed. This can be an objective fo undation for therapeutical approach. There is no doubt that studies of maternal-fetal circulation in early pregnancy may help for better und erstanding of physiological and pathophysiological hemodynamic changes . Investigation of maternal (main uterine, arcuate, radial and spiral) arteries; placental (umbilical, chorionic arterioles) vessels and fet al (aorta and intracranial circulation) arteries flow patterns may hel p in order to diagnose abnormal implantation. More studies are necessa ry in order the Doppler technique to be used for clinical judgment in early pregnancy. Safety aspects should also be considered. However, po tentials of these technique are more then obvious.