B-Flow/Spatiotemporal Image Correlation M-Mode and Contrast-Enhanced/Microbubble Ultrasonography Quantification of Spiral Artery Distensibility and Placental Intervillous Perfusion in the First Trimester in a Primate Model of Impaired Spiral Artery Remodeling
- PMID: 37749012
- PMCID: PMC10591761
- DOI: 10.1016/j.ultrasmedbio.2023.08.021
B-Flow/Spatiotemporal Image Correlation M-Mode and Contrast-Enhanced/Microbubble Ultrasonography Quantification of Spiral Artery Distensibility and Placental Intervillous Perfusion in the First Trimester in a Primate Model of Impaired Spiral Artery Remodeling
Abstract
Objective: During early human pregnancy, placental trophoblasts remodel spiral arteries into distensible low-resistance vessels to promote placental perfusion. We have established a model of impaired spiral artery remodeling (SAR) by elevating estradiol levels in the first trimester of baboon pregnancy. In the present study, B-flow/spatiotemporal image correlation (STIC) M-mode ultrasonography, a non-Doppler technology for sharp rendering of vessel dimensions, was used to determine whether spiral artery distensibility was altered in SAR-suppressed baboons. Contrast-enhanced ultrasound/microbubble imaging was also performed to determine whether it detected changes in placenta intervillous space perfusion in SAR-suppressed baboons.
Methods: The two imaging procedures were performed in the first trimester in baboons not treated or treated with estradiol to suppress SAR.
Results: Spiral artery distensibility, that is, luminal diameter at systole minus diameter at diastole, and volume flow as quantified by B-flow/STIC M-mode were 26% (p = 0.03) and 55% (p = 0.059) lower, respectively, in SAR-suppressed baboons. However, placental intervillous space flow rate and video intensity plateau levels reflecting blood perfusion, quantified by contrast-enhanced ultrasound/microbubble imaging, were unaltered in SAR-suppressed baboons.
Conclusion: The results indicate that B-flow/STIC M-mode ultrasonography provides a non-invasive method to detect reduced distensibility and, thus, function of spiral arteries across the cardiac cycle in the first trimester in a primate model of impaired SAR. This study represents a first step in determining whether B-flow/STIC M-mode detects a similar defect in SAR early in adverse human pregnancy. This would provide an avenue to develop therapeutic modalities to prevent the devastating consequences of impaired SAR.
Keywords: B-flow; Contrast ultrasound; M-mode; Primate; Spiral artery.
Copyright © 2023 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
Conflict of interest statement
Conflict of interest The authors declare no competing interests.
Similar articles
-
B-flow/spatiotemporal image correlation M-mode ultrasound provides novel method to quantify spiral artery remodeling during normal human pregnancy.Ultrasound Obstet Gynecol. 2024 Mar 13. doi: 10.1002/uog.27636. Online ahead of print. Ultrasound Obstet Gynecol. 2024. PMID: 38477161
-
B-flow/spatiotemporal image correlation M-mode: novel ultrasound method that detects decrease in spiral artery luminal diameter in first trimester in primate model of impaired spiral artery remodeling.Ultrasound Obstet Gynecol. 2022 Mar;59(3):358-364. doi: 10.1002/uog.23753. Ultrasound Obstet Gynecol. 2022. PMID: 34358371 Free PMC article.
-
Early first trimester uteroplacental flow and the progressive disintegration of spiral artery plugs: new insights from contrast-enhanced ultrasound and tissue histopathology.Hum Reprod. 2017 Dec 1;32(12):2382-2393. doi: 10.1093/humrep/dex301. Hum Reprod. 2017. PMID: 29136193 Free PMC article.
-
Utero-placental Doppler ultrasound for improving pregnancy outcome.Cochrane Database Syst Rev. 2010 Sep 8;2010(9):CD008363. doi: 10.1002/14651858.CD008363.pub2. Cochrane Database Syst Rev. 2010. PMID: 20824875 Free PMC article. Review.
-
Uteroplacental circulation development: Doppler assessment and clinical importance.Placenta. 2001 Nov;22(10):795-9. doi: 10.1053/plac.2001.0732. Placenta. 2001. PMID: 11718565 Review.
References
-
- Brosens I A study of the spiral arteries of the decidua basalis in normotensive and hypertensive pregnancies. J Obste Gynaecol Br Commonw 1964;71:222–230. - PubMed
-
- Ramsey EM, Houston ML, Harris JWS. Interactions of the trophoblast and maternal tissues in three closely related primate species. Am J Obstet Gynecol 1976;124:647–652. - PubMed
-
- Khong TY, De Wolf F, Robertson WB, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J Obstet Gynaecol 1986;93:1049–1059. - PubMed
-
- Roberts J, Taylor RN, Goldfien A. Clinical and biochemical evidence of endothelial cell dysfunction in the pregnancy syndrome preeclampsia. Am J Hypertens 1991;4:700–708. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Miscellaneous