In vivo assessment of failed trophoblastic invasion of the spiral arteriesin pre-eclampsia

Objective To assess the ability of colour/pulsed Doppler ultrasound to dete ct failed physiologic change of the spiral arteries in pregnancies complica ted by pre-eclampsia. Design Prospective matched-pairs case controlled study. Setting Tertiary referral teaching hospital. Sample Sixteen women with severe pre-eclampsia and 16 normotensive controls . Methods Colour/pulsed Doppler assessment of blood flow in the uterine arter ies and spiral arteries in central and peripheral parts of the placental be d. Main outcome measures Impedance to blood flow in the spiral arteries in pre -eclamptic group compared with normotensive controls. Results In women with pre-eclampsia there is significantly higher impedance to blood flow in spiral arteries compared with normotensive women. Conclusions Ultrasound colour/pulsed Doppler based investigation of blood f low in the spiral arteries in ongoing pregnancy can detect failed physiolog ical change of these vessels in pre-eclampsia. This is in concordance with histologic data.