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  • 1
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To assess the elaboration of placental stem villous vessels from pregnancies complicated by intrauterine growth restriction (IUGR) with absent end–diastolic flow velocity detected prior to delivery in the umbilical artery.Design Comparison between IUGR and control groups of the distribution, in 15 pm increments of 600 randomly chosen stem vessel profiles (post-fixation diameter 10-160 pm) identified by immunohistochemical localisation of a-smooth muscle actin in the vessel media.Setting Clinical teaching hospital and university anatomy department.Subjects Paraffin-fixed blocks obtained from placentas of eight pregnancies complicated by IUGR and eight gestational age-matched controls.Results The distribution of the stem villous vessels in the IUGR placentas, as assessed by the mean vessel diameter in each case, did not differ from the controls (mean vessel diameter 31.8 μm [SD 2.41 vs 29.6 pm [2.3]; P= 0.13). In five IUGR cases a-smooth muscle actin positive cells (myofibroblasts) were identified within the stroma of nonmuscularised peripheral (mature intermediate and terminal) villi, but in none of the controls.Conclusions Our data do not support the theory that IUGR with absent end-diastolic flow velocity in the umbilical artery is due to a selective loss of small stem villous vessels. The increased impedance in this condition may be conferred more distally within the nonmuscularised capillaries of the peripheral villi.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 104 (1997), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To investigate gestational and postural changes in diameter and blood flow in the proximal deep leg veins during pregnancy.Design A longitudinal, prospective observational study.Setting The ultrasound department of a teaching maternity hospital.Population Twenty-four healthy women with uncomplicated singleton pregnancies.Methods Real-time and duplex Doppler ultrasound assessments of the vessel diameter, flow velocity and respiratory flow fluctuation in the proximal deep leg veins of women serially measured from the first trimester of pregnancy to six weeks postnatally.Main outcome measures The effects of increasing gestation and the adoption of the left lateral position on the above parameters.Results An increase in vessel diameter and a fall in flow velocity with increasing gestation was observed. However, no change in venous flow variation was observed. Delivery had reverse effects. Flow velocity was slower in the left than the right legs, but on adoption of the left lateral position an increase in flow velocity and venous flow variation was observed in both legs during pregnancy.Conclusions These data are consistent with the observed increase in incidence and pattern of deep venous thrombosis in pregnancy and may aid interpretation of duplex Doppler ultrasound examinations for deep venous thrombosis in pregnancy. Postural changes should be part of this evaluation. The gravid uterus may not be the sole cause for postural changes in deep venous flow velocity.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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