Re: ovarian artery
From: DuBose, Terry (DuboseTerryJ@uams.edu)
Fri Feb 15 16:34:01 2002
Dr Patrizia, here are several (14) abstracts (bottom of message) that deal
in varying degrees with your question... I hope they help. If you can find
any of the original articles, I am sure their bibliographies will lead to
more literature. And I will watch for more specific information.
Before Doppler was widely available we did a study of 319 women
(cross-sectional data), but we measured the myometrial arcuate vessel
diameters, rather than the blood flow. This was from the double blinded
study that we published in 1985:
Fetal Sonography, Table 16-1, p. 351
Days from LMP- #Exams - Mean vessle diameter (mm) - +/-2SD (mm) - Range (mm)
0-10 days 70 - 2.03 mm - 2.1 mm - 0.0-8.0 mm
11-17 days 61 - 2.73 mm - 2.2 mm - 1.0-7.0 mm
18-30 days 52 - 1.90 mm - 1.26 mm - 0.0-3.3 mm
>30 days, not preg. 45 - 2.01 mm - 2.35 mm - 0.0-5.0 mm
1st Trimester 91 - 2.65 mm - 1.19 mm - 1.0-7.0 mm
Our original research was published:
. DuBose TJ, Hill LW, Cunyus JA, et al; "Sonography of Menstrual Changes
in Arcuate Uterine Blood Vessel Diameters"; J Cardiovascular
Ultrasonography, 1985; 4:243-251.
. DuBose TJ, Hill LW, Hennigan HW; "Sonography of Arcuate Uterine Blood
Vessels"; J Ultrasound Med, 1985; 4:229-233.
"It was believed that longitudinal studies would show significant changes in
the sizes of these vessels. In the longitudinal study through a single
menstrual cycle we found the same arcuate vessel went from a diameter of 3
mm on the 7th LMP day, to just over 5 mm on LMP day 13, and constricted to
less than 2 mm in the premenstrual period on day 24. This represents a
change in diameter of approximately 250% from smallest to largest, which is
an increase of about 625% increase in vessel lumen cross-sectional area or
blood flow, assuming constant flow velocity. (volume flow = velocity X lumen
cross-sectional area). , This very large potential increase of flow is
less than that found by Greiss and Anderson in sheep. They found a
tenfold (1000%) increased flow in sheep uterine arteries from the lowest
flow to the greatest flow at estrous." from: DuBose; FETAL SONOGRAPHY,
Chapter 16: Extrafetal Structures of Pregnancy, W. B. Saunders, 1996, p.
351.
See also: . Resnik R; "ANATOMIC ALTERATIONS IN THE REPRODUCTIVE TRACT",
Chapter 6; Creasy RK & Resnik R, Editors; MATERNAL-FETAL MEDICINE:
Principles and Practice, 2nd edition; W. B. Saunders Company, 1989; p.
137-140.
and
. Greiss FC & Anderson SG; "Uterine vascular changes during the ovarian
cycle"; Am J Obstet Gynecol, 1969; 103:629.
While I still find this subject very interesteing, I have moved on and must
leave that reasearch to others now. Fetal Sonography does contain a large
number of references that may also help you. Hope this helps.
Peace, Terry J. DuBose, M.S., RDMS
Assistant Professor & Director, Diagnostic Medical Sonography Program
CHRP, University of Arkansas for Medical Sciences
Little Rock, Arkansas, USA
501-686-6510
http://www.io.com/~dubose/
http://www.uams.edu/CHRP/dmshome.htm
http://www.obgyn.net/us/panel/panel.htm
-----Original Message-----
From: patrizia [mailto:pellpatri@iol.it]
Sent: Thursday, February 14, 2002 4:50 PM
To: Multiple recipients of list ULTRASOUND
Subject: ovarian artery
Hi colleagues
does anyone tell me where I can find the pulsatility index, resistance index
and systolic peak velocity average values for the ovarian artery in the
proliferative phase?
thank you
Dr Patrizia
Ovid Technologies, Inc. Email Service
------------------------------
Search for: 3 and 4
------------------------------
Citations: 5-18
------------------------------
Database: MEDLINE <1966 to January Week 3 2002>
Search Strategy:
----------------------------------------------------------------------------
----
----------------------------------------------------------------------------
1 Ovary/ or ovarian artery.mp. or Uterus/ (66039)
----------------------------------------------------------------------------
2 Blood Flow Velocity/ or systolic peak velocity.mp. (32527)
3 1 and 2 (752)
4 exp Menstrual Cycle/ or proliferative phase.mp. (36040)
5 3 and 4 (53)
6 from 5 keep 5,7,9,14-22,24-25 (14)
***************************
Citation <1>
Unique Identifier
--
21025656
PubMed Identifier
11152329
Authors
Yokota A. Nakai A. Oya A. Koshino T. Araki T.
Institution
Department of Obstetrics and Gynecology, Tama Nagayama Hospital, Nippon
Medical School, Tokyo, Japan.
Title
Changes in uterine and ovarian arterial impedance during the periovulatory
period in conception and nonconception cycles.
Source
Journal of Obstetrics & Gynaecology Research. 26(6):435-40, 2000 Dec.
Local Messages
Not locally available; ask about Interlibrary Loan
Abstract
OBJECTIVE: To evaluate whether the Doppler velocimetry of uterine and
ovarian arteries during the periovulatory period in conception cycles
differs from that in nonconception cycles. DESIGN: Transvaginal color
Doppler sonography was used to assess uterine and ovarian perfusion in 63
infertile women during the periovulatory period. RESULTS: In the conception
cycles (n = 16), the PI values of uterine arteries at the day of ovulation
were significantly less than those in nonconception cycles (n = 47). There
were no significant differences in the PI values of ovarian arteries between
the conception and nonconception cycles. CONCLUSIONS: In the present study,
the conception cycles showed lower vascular impedance in the uterine during
the periovulatory period than did the nonconception cycles. This endometrial
perfusion presents an accurate noninvasive assay of uterine receptivity that
can be used to predict the successful outcome of implantation and to reveal
unexplained infert!
il!
ity problems.
Citation <2>
Unique Identifier
99217140
PubMed Identifier
10201083
Authors
Engmann L. Sladkevicius P. Agrawal R. Bekir J. Campbell S. Tan SL.
Institution
London Women's Clinic, UK.
Title
The pattern of changes in ovarian stromal and uterine artery blood flow
velocities during in vitro fertilization treatment and its relationship with
outcome of the cycle.
Source
Ultrasound in Obstetrics & Gynecology. 13(1):26-33, 1999 Jan.
Local Messages
Part @ UAMS (Click WebLink)
Abstract
OBJECTIVES: To assess the effect of short-term (2-3 weeks) pituitary
suppression and controlled ovarian stimulation on ovarian and uterine artery
Doppler measurements during the in vitro fertilization (IVF) treatment cycle
and to compare the pattern of these changes between conception and
non-conception cycles as well as between patients with normal and those with
polycystic ovaries. DESIGN: Prospective observational study of women
undergoing IVF treatment. SUBJECTS: Women using the long-treatment buserelin
protocol who did not have uterine fibroids, ovarian cysts or endometrioma.
METHODS: Serial transvaginal color and pulsed Doppler measurements of
ovarian stromal and uterine artery blood flow velocity were carried out in
the early follicular phase of the menstrual cycle, on the day of pituitary
suppression and on the day of administration of human chorionic gonadotropin
(hCG). The main outcome measures were the ovarian stromal and uterine artery
blood flow peak systolic !
ve!
locity (PSV) and pulsatility index (PI). RESULTS: A total of 105 patients
were recruited but six patients were excluded from the analysis because they
had only one stage of the measurements performed. There was a significant
decline in mean ovarian stromal artery PSV after 2-3 weeks of gonadotropin
releasing hormone (GnRH) agonist therapy but no effect on ovarian stromal
artery PI. The mean uterine artery PSV or PI did not change significantly
after 2-3 weeks of GnRH agonist therapy. There was a significantly higher
mean ovarian stromal artery PSV in conception cycles compared to
non-conception cycles in the early follicular phase and on the day of
pituitary suppression, but not on the day of hCG administration. There were
no differences between conception and non-conception cycles in the mean
uterine artery PSV or PI. Women with polycystic ovaries had a higher mean
ovarian artery PSV on all the three occasions of measurement. CONCLUSION:
These data suggest that assessment o!
f !
ovarian blood flow before commencement of gonadotropin stimulation may play
a role in assessing cycles likely to result in pregnancy.
Citation <3>
Unique Identifier
99009586
PubMed Identifier
9793191
Authors
Zaidi J. Jacobs H. Campbell S. Tan SL.
Institution
Department of Obstetrics and Gynaecology, King's College School of
Medicine and Dentistry, Denmark Hill, London.
Title
Blood flow changes in the ovarian and uterine arteries in women with
polycystic ovary syndrome who respond to clomiphene citrate: correlation
with serum hormone concentrations.
Source
Ultrasound in Obstetrics & Gynecology. 12(3):188-96, 1998 Sep.
Local Messages
Part @ UAMS (Click WebLink)
Abstract
OBJECTIVE: Our purpose was to study the hemodynamic changes in the uterine
and intraovarian vessels in women with polycystic ovary syndrome (PCOS) and
to relate the vascular changes to hormonal indices. METHODS: Six women with
a history of previous anovulatory cycles and/or oligomenorrhea and/or
elevated serum luteinizing hormone concentrations in addition to polycystic
ovaries underwent induction of ovulation with clomiphene citrate. Serial
transvaginal ultrasonography was performed on menstrual cycle day 2, daily
from the estimated day of ovulation minus 6, 6-hourly from the estimated day
of ovulation minus 2 or when the mean follicular diameter was greater than
16 mm (whichever was earlier) until 6 h after follicular rupture, and once 7
days after follicular rupture. At each scan, uterine and intraovarian blood
flow was assessed by transvaginal color Doppler ultrasound, and serum
concentrations of follicle stimulating hormone (FSH), luteinizing hormone
(LH), estradiol a!
nd!
progesterone were assessed by fluoroimmunoassay. RESULTS: All six women
demonstrated ultrasonographic features of ovulation. Follicular peak
systolic blood flow velocity (Vmax) and ovarian stromal Vmax in the dominant
ovary increased during the follicular phase of the menstrual cycle and
reached a peak at 36 and 42 h after the onset of the LH surge of 30.7 +/-
4.6 cm/s and 37.0 +/- 3.9 cm/s, respectively. There was no significant
change in the ovarian stromal Vmax of the non-dominant ovary. There was no
significant change in the pulsatility index (PI) in either the follicular or
the ovarian stromal vessels during the menstrual cycle. The changes in
follicular Vmax correlated significantly with changes in serum
concentrations of FSH, LH and progesterone. Uterine artery time-averaged
maximum velocity (TAMX) declined to its lowest levels at LH surge minus 6
days, and thereafter increased. In contrast, the PI increased during the
follicular phase of the cycle, reaching a peak a!
t !
LH surge minus 4 days, and thereafter declined. The changes in uterine
artery PI correlated inversely with serum estradiol and serum progesterone
concentrations. CONCLUSIONS: Women with PCOS have significant differences in
intraovarian and uterine artery hemodynamics, both at the baseline
ultrasound scan and during the clomiphene-induced menstrual cycle, compared
with women with normal ovaries. The intraovarian and uterine artery vascular
differences are likely to be due to a primary disorder within the polycystic
ovary and their different hormonal status. Clomiphene citrate may have an
effect on uterine artery blood flow.
Citation <4>
Unique Identifier
97227570
PubMed Identifier
9132253
Authors
Doren M. Suselbeck B. Schneider HP. Holzgreve W.
Institution
Department of Obstetrics and Gynecology, Westfalische Wilhelms-Universitat
Munster, Germany.
Title
Uterine perfusion and endometrial thickness in postmenopausal women on
long-term continuous combined estrogen and progestogen replacement.
Source
Ultrasound in Obstetrics & Gynecology. 9(2):113-9, 1997 Feb.
Local Messages
Part @ UAMS (Click WebLink)
Abstract
We assessed the resistance index (RI) and pulsatility index (PI), peak and
average systolic velocities in uterine, arcuate and radial arteries, and
endometrial thickness (ET) by transvaginal B mode and color Doppler
sonography in patients on continuous combined hormonal replacement therapy
(HRT) and controls. HRT consisted of 2 mg estradiol, 1 mg estriol and 1 mg
norethisterone acetate daily (n = 33) compared to controls, who received
none of these (n = 21). Age was 61 +/- 6 and 59 +/- 9 years (mean +/-
standard deviation) in the HRT and control groups, respectively. The
duration of HRT was 5 +/- 2 years, with a minimum of 1 year. We found that
the uterine RI and, to a lesser extent, the uterine PI were significantly
lower and the radial peak systolic velocities were significantly higher in
the HRT group compared to controls. The highest uterine PI values were
measured in controls with the shortest life-time exposure to endogenous
estrogens, i.e. late menarcheal age or ear!
ly!
menopause. The endometrial thickness of 2.8 +/- 1.8 mm in the HRT group was
not significantly different from that in the controls (4.2 +/- 5.6 mm). In
conclusion, the alteration in blood flow parameters demonstrated in this
study would suggest that the long-term use of continuous oral estradiol 2
mg, estriol 1 mg and norethisterone acetate 1 mg daily is associated with a
slight increase of flow in the uterine arteries compared to controls matched
for (postmenopausal) age. Endometrial thickness does not increase with
duration of use of continuous combined HRT.
Citation <5>
Unique Identifier
96426131
PubMed Identifier
8828425
Authors
Tan SL. Zaidi J. Campbell S. Doyle P. Collins W.
Institution
Department of Obstetrics and Gynecology, King's College School of Medicine
and Dentistry, London, United Kingdom.
Title
Blood flow changes in the ovarian and uterine arteries during the normal
menstrual cycle.
Source
American Journal of Obstetrics & Gynecology. 175(3 Pt 1):625-31, 1996
Sep.
Local Messages
All @ UAMS
Abstract
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 !
fr!
om 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 ti!
me!
-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.
Citation <6>
Unique Identifier
97135602
PubMed Identifier
8981139
Authors
Lunenfeld E. Schwartz I. Meizner I. Potashnik G. Glezerman M.
Institution
Department of Obstetrics and Gynecology, Soroka University Centre of Kupat
Holim, Israel.
Title
Intraovarian blood flow during spontaneous and stimulated cycles.
Source
Human Reproduction. 11(11):2481-3, 1996 Nov.
Local Messages
Not locally available; ask about Interlibrary Loan
Abstract
This study was undertaken to investigate intraovarian blood flow during
the early follicular, periovulatory and mid-luteal phases, during
spontaneous and stimulated ovarian cycles. Transvaginal ultrasonography with
colour flow imaging was used to measure the pulsatility index in eight
patients with spontaneous cycles, 20 patients undergoing induction of
ovulation with clomiphene citrate and 11 patients undergoing controlled
ovarian hyperstimulation for in-vitro fertilization (IVF)-embryo transfer
with gonadotrophin-releasing hormone analogue, human menopausal
gonadotrophin, human chorionic gonadotrophin. All patients were studied
during the early follicular, periovulatory and mid-luteal phase.
Intraovarian blood flow velocity waveforms were found in 20% of cases at the
early follicular phase, in 56% during the periovulatory phase and in 85%
during the mid-luteal phase (P < 0.001). Pulsatility index at the early
follicular phase was found to be 1.05 +/- 0.22, during the per!
io!
vulatory phase 0.99 +/- 0.22 and during the mid-luteal phase 0.85 +/- 0.22.
The appearance of intraovarian flow velocity waveforms may suggest either
ovarian neovascularization or final follicular maturation or luteinization,
which can be detected or measured by Doppler technology.
Citation <7>
Unique Identifier
96256925
PubMed Identifier
8671225
Authors
Tekay A. Martikainen H. Jouppila P.
Institution
Department of Obstetrics and Gynaecology, University of Oulu, Finland.
Title
Comparison of uterine blood flow characteristics between spontaneous and
stimulated cycles before embryo transfer.
Source
Human Reproduction. 11(2):364-8, 1996 Feb.
Local Messages
Not locally available; ask about Interlibrary Loan
Abstract
The Doppler blood flow characteristics of uterine arteries were evaluated
prospectively in 57 patients undergoing embryo transfer. A total of 32 women
underwent frozen-thawed (FT) embryo transfer during a spontaneous menstrual
cycle (FT-embryo transfer), and 25 patients underwent in-vitro fertilization
treatment (IVF-embryo transfer). The endometrial thickness, pulsatility
index (PI), maximum peak systolic velocity (MPSV), minimum diastolic
velocity (MDV) and flow velocity waveform type of the uterine artery blood
flow were assessed with transvaginal colour Doppler ultrasonography before
embryo transfer. The mean (SD) endometrial thickness was 9.2 (2.0) mm in
FT-embryo transfer patients and 12 (3.4) mm in IVF-embryo transfer patients
(P < 0.0003). There were no conception cycles in which the uterine arteries
bilaterally had a flow velocity waveform with an absent end-diastolic flow.
Compared to spontaneous cycles, the median PI was statistically lower and
the MDV was highe!
r !
in IVF cycles. In contrast, no difference was found in the median MPSV
values between the two groups. There was no difference in Doppler
velocimetry measurements between the conception and non-conception cycles in
either the FT-embryo transfer or the IVF-embryo transfer groups. In
conclusion, an inadequate uterine blood flow impaired implantation, while
optimum uterine blood perfusion did not necessarily lead to conception.
Citation <8>
Unique Identifier
96372423
PubMed Identifier
8776238
Authors
Tekay A. Jouppila P.
Institution
Department of Obstetrics and Gynecology, University of Oulu, Finland.
Title
Intraobserver reproducibility of transvaginal Doppler measurements in
uterine and intraovarian arteries in regularly menstruating women.
Source
Ultrasound in Obstetrics & Gynecology. 7(2):129-34, 1996 Feb.
Local Messages
Part @ UAMS (Click WebLink)
Abstract
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 measure!
me!
nts 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.
Citation <9>
Unique Identifier
96422544
PubMed Identifier
8825161
Authors
Cacciatore B. Tiitinen A.
Institution
Department of Obstetrics and Gynecology, Helsinki University Central
Hospital, Finland.
Title
Does ovarian stimulation affect uterine artery impedance?.
Source
Journal of Assisted Reproduction & Genetics. 13(1):15-8, 1996 Jan.
Local Messages
Not locally available; ask about Interlibrary Loan
Abstract
PURPOSE: We evaluated the effect of induction of ovulation on uterine
perfusion. METHODS: In 42 infertile women transvaginal color Doppler was
performed at days 16-21 of a spontaneous ovulatory cycle and prior to embryo
transfer in an in vitro fertilization (IVF) cycle. Indication for treatment
was mainly tubal or unexplained infertility. RESULTS: Uterine artery
pulsatility index was significantly (P < 0.001) lower in IVF than in natural
cycles, 3.24 +/- 0.72 2.64 +/- 0.53 (mean +/- SD), with a mean reduction of
18%. The reduction was higher, although not significantly, in the women who
conceived (20%) than in those who did not (15%), and in those with a basal
PI > 3.0 (20%) as opposed to those with normal values (16%). The percentage
reduction correlated with patient age and with estradiol concentration,
number of follicles, and oocytes recruited. CONCLUSIONS: Induction of
superovulation reduces impedance to flow in the uterine circulation. The
amplitude of this effect ap!
pe!
ars to be regulated partially by patient age and by effectiveness of ovarian
stimulation.
Citation <10>
Unique Identifier
95263786
PubMed Identifier
7745069
Authors
Zaidi J. Jurkovic D. Campbell S. Collins W. McGregor A. Tan SL.
Institution
Department of Obstetrics and Gynaecology, King's College School of
Medicine and Dentistry, London, UK.
Title
Luteinized unruptured follicle: morphology, endocrine function and blood
flow changes during the menstrual cycle.
Source
Human Reproduction. 10(1):44-9, 1995 Jan.
Local Messages
Not locally available; ask about Interlibrary Loan
Abstract
A case of spontaneous luteinized unruptured follicle syndrome is presented
with full documentation of hormonal, morphological and haemodynamic changes.
Changes in uterine blood flow were also noted. Growth of the leading
follicle was slow during the follicular phase of the cycle. After the
luteinizing hormone (LH) surge, growth of the follicle was more rapid.
Concurrently, the follicle developed internal echogenicity with ultrasonic
evidence of separation of the granulosa cell layer. The follicle was no
longer visible 144 and 132 h after the LH rise and peak respectively. There
was no primary progesterone rise associated with either the LH rise or peak,
but a secondary progesterone rise occurred 42 h after the onset of the LH
surge. Peri-follicular blood flow velocity was detected for the first time
on cycle day 5 and appeared to rise after the onset of the LH surge.
Peri-follicular blood flow velocity appeared to reduce after the LH surge to
values associated with the fol!
li!
cular phase. These observations are consistent with an association of a
primary granulosa cell defect with luteinized unruptured follicle syndrome
which would account for the initial slow follicular growth, absent primary
progesterone rise and reduction in blood flow in the wall of the follicle
after the LH surge.
Citation <11>
Unique Identifier
96033121
PubMed Identifier
8582954
Authors
Zaidi J. Jurkovic D. Campbell S. Pittrof R. McGregor A. Tan SL.
Institution
Academic Department of Obstetrics and Gynaecology, King's College Hospital
School of Medicine and Dentistry, Denmark Hill, London, UK.
Title
Description of circadian rhythm in uterine artery blood flow during the
peri-ovulatory period.
Source
Human Reproduction. 10(7):1642-6, 1995 Jul.
Local Messages
Not locally available; ask about Interlibrary Loan
Abstract
Uterine artery blood flow was assessed by transvaginal colour and pulsed
Doppler ultrasound prospectively in six women during the peri-ovulatory
period. All patients had regular ovulatory menstrual cycles and a mid-luteal
serum progesterone consistent with spontaneous ovulation in the preceding
cycle. Each patient underwent serial transvaginal ultrasound examination and
Doppler assessment of blood flow in the uterine arteries. When the mean
follicular diameter was > 16 mm or day -2 from the estimated day of
ovulation was reached, patients were scanned at 6 hourly intervals at 0600,
1200, 1800 and 2400 h until follicular rupture. The pulsatility index (PI)
and time averaged maximum velocity (TAMX) were calculated as Doppler indices
of impedance to blood flow and velocity respectively. A venous blood sample
was taken at each visit for subsequent hormonal analysis. The mean uterine
artery PI showed a marked daily fluctuation with a nadir occurring most
commonly at 0600 h. A c!
om!
parison between the mean PI values at 0600 and 1800 h showed significantly
lower results at 0600 h in both dominant (P < 0.05) and nondominant (P <
0.02) uterine arteries. Furthermore, mean uterine artery TAMX showed daily
fluctuations with peak values most commonly occurring at 0600 h with the
nadir occurring during the afternoon and late evening. There was no temporal
relationship between the fluctuations in PI and changes in luteinizing
hormone, follicle stimulating hormone, oestradiol or progesterone
concentrations. These observations suggest that there is a circadian rhythm
in uterine artery blood flow during the peri-ovulatory period which appears
to be independent from the hormonal changes.
Citation <12>
Unique Identifier
96122347
PubMed Identifier
8537472
Authors
Sumiala S. Pirhonen J. Tuominen J. Maenpaa J.
Institution
Department of Obstetrics and Gynecology, University of Turku, Finland.
Title
Increased uterine and ovarian vascular resistance following Filshie clip
sterilization: preliminary findings obtained with color Doppler
ultrasonography.
Source
Journal of Clinical Ultrasound. 23(9):511-6, 1995 Nov-Dec.
Local Messages
All @ UAMS; Part @ ACH(Click WebLink) & LRVA(10 years)
Abstract
The effect of Filshie clip sterilization on uterine and ovarian
circulation was studied with color Doppler ultrasonography in 16 women
before and twice after the operation. As a whole, the vascular resistance
was slightly raised in the largest uterine artery and in the fundal parts of
the uterine arteries; likewise in the ovarian arteries 2 days after
sterilization. The resistance in the uterine arteries approached the
presterilization level at 3 months after the operation, although these
changes were not statistically significant. Two women had pelvic pain in the
first days after the procedure, and they were compared with the symptom-free
patients. Two days after sterilization, the patients with pain had
significantly higher vascular resistance in all parts of the uterine
arteries as compared to the symptom-free patients. After 3 months the
difference had decreased in the largest uterine arteries and in the middle
parts of the uterine arteries, but in the fundal parts the!
r!
esistance was still higher than before sterilization. Vascular resistance in
the ovarian arteries was increased in both groups, although the elevation
was more pronounced in patients with pain. These preliminary findings imply
that sterilization may cause an increase in the local vascular resistance,
which is measurable by color Doppler sonography.
Citation <13>
Unique Identifier
96035010
PubMed Identifier
7552803
Authors
Zaidi J. Jurkovic D. Campbell S. Okokon E. Tan SL.
Institution
Department of Obstetrics and Gynaecology, King's College School of
Medicine and Dentistry, University of London, UK.
Title
Circadian variation in uterine artery blood flow indices during the
follicular phase of the menstrual cycle.
Source
Ultrasound in Obstetrics & Gynecology. 5(6):406-10, 1995 Jun.
Local Messages
Part @ UAMS (Click WebLink)
Abstract
We investigated for the presence of circadian variation in uterine artery
blood flow indices during the late follicular phase of the menstrual cycle.
Twenty women with regular menstrual cycles underwent transvaginal color
Doppler assessment of blood flow in the uterine arteries on two occasions
precisely 12 h apart on the same day in the follicular phase. Ultrasound
examinations were performed between 06.00 and 10.00 and repeated between
18.00 and 22.00. Indices of uterine artery blood flow included the
pulsatility index (PI) and the time-averaged maximum velocity (TAMX). The
changes in PI and TAMX were related to variations in serum concentrations of
estradiol and luteinizing hormone (LH). We noted a significantly higher PI
and lower TAMX in the evening compared to the morning values, p < 0.001 and
p = 0.01, respectively. There was no significant change in estradiol or LH
concentrations between morning and evening (p > 0.05). There appears to be a
circadian rhythm in uter!
in!
e artery blood flow occurring independently of these hormonal parameters.
The circadian changes in PI and TAMX may be larger than the previously
described effects of hormones on these parameters. The accurate
interpretation of uterine artery blood flow indices should take these
time-related fluctuations into account.
Citation <14>
Unique Identifier
95373042
PubMed Identifier
7645123
Authors
Sladkevicius P. Valentin L.
Institution
Department of Obstetrics and Gynaecology, Lund University, Malmo General
Hospital, Sweden.
Title
Reproducibility of Doppler measurements of blood flow velocity in the
uterine and ovarian arteries in premenopausal women.
Source
Ultrasound in Medicine & Biology. 21(3):313-9, 1995.
Local Messages
Part @ UAMS (Click WebLink)
Abstract
Intra- and interobserver reproducibility of Doppler measurements of the
pulsatility index (PI) and time-averaged maximum velocity (TAMXV) in the
uterine and ovarian arteries were evaluated in examinations of healthy
premenopausal women. Each woman underwent reproducibility measurements once
in the late follicular phase and once in the midluteal phase. Intraobserver
repeatability was assessed in examinations of 12 women, three replicate
Doppler measurements being made by one observer in the same vessel.
Interobserver agreement was assessed by comparing the results of Doppler
measurements made by two investigators in 11 women. The intraclass
correlation coefficient (Intra-CC) was 0.78 for the TAMXV in the dominant
uterine artery in the follicular phase and 0.82 for the PI in the wall of
the dominant follicle. For all other measurements the Intra-CC was < 0.75,
indicating poor reproducibility. The interclass correlation coefficient
(Inter-CC) was > 0.75 (0.79 to 0.88) for the!
P!
I and TAMXV in the dominant uterine artery in the follicular phase and for
the PI of both uterine arteries in the luteal phase. For all other
measurements the Inter-CC was < 0.75.
