Early pregnancy complications assessed by color doppler and three dimensional ultrasound

Giriş

To investigate the role of 3D and color Doppler ultrasound in the evaluation of the patient with early pregnancy complications.

Yöntem

Seventy five patients whose gestational age ranged from 6 to 14 weeks presented with vaginal bleeding, closed cervix, ultrasound finding of a living embryo and subchorionic hematoma were analyzed with both methods. A total of 150 matched controls were randomly selected from a pool of 1200 pregnant women in the same gestational age who were studied during the one year period at our Department. Subchorionic hematoma was diagnosed as echo-poor or echo-free area between the chorionic membrane and the myometrium. Multiplanar imaging enabled correct imaging of the subchorionic hematoma diameters and volume in each patient. The hematoma size was categorized as a small or large, according to whether it was more or less than 20ml. Color flow Doppler was used to visualize spiral arteries and blood flow velocity waveforms were analyzed by means of pulsed Doppler using resistance index (RI) as the measurement parameter. The patients were evaluated in two weeks" period, at least three times, and both parameters, the hematoma volume and spiral artery RI were statistically analyzed.

Bulgular

 

Hematomas ranged from 9.5 to 78.4 ml. The RI slowly declined during the 8 weeks" period, while hematoma volume showed a week positive correlation. Most spontaneous abortions occurred in the group of the patients with subchorionic hematomas (18.7% vs 6%), documenting a significant difference. Another significant factor was the presence of the hematoma in the corpus of the uterus.

Sonuç

 Three-dimensional ultrasound enables precise localization and volume measurement of the hematoma, while color Doppler evaluation allows dedection of the patients with altered spiral artery blood flow who are at increased risk for spontenous abortion.