[Comparison of transvaginal and transabdominal Doppler flow measurements in uterine vessels in the normal course of pregnancy].

Despite physiological and methodical drawbacks Doppler velocimetry in the arcuate arteries has become a standard for examination during pregnancy. Arcuate arteries are terminal branches of the uterine vaculature and supply only a circumscript area. Local vasoconstriction (due to contractions) and placental infarction may give erroneus results. Measurements in arcuate arteries at the site of placental insertion showed flow patterns different from those in the rest of the uterus. Since continuous wave Doppler systems were mostly applied, the received echoes could have originated from any part along the sound beam. Signals from arteries of the anterior abdominal wall may lead to "false pathological" waveforms. All these drawbacks have been overcome by Doppler velocimetry of the main stem uterine artery on its course through the parametrium by a transvaginal inserted probe that combines a 240 degrees "panorama" sector scanner with a pulsed Doppler system. Both main vessels supplying the uterus, i.e. left and right uterine artery, could be visually identified and pulsed Doppler velocimetry could be applied. This provided us with information about perfusion of the whole organ and showed us also the physiological range of left to right discrepancy in the flow patterns. In 63 pregnant women with a single foetus and an uneventful course of pregnancy we compared transabdominal measurements of the arcuate arteries with transvaginal measurements in both main uterine arteries. In 56 women we found pathological wave forms in the arcuate arteries (A/B ratio greater than 2) despite lack of clinical or transvaginal measured evidence of malnutrition.(ABSTRACT TRUNCATED AT 250 WORDS)