Spiral artery blood flow during pregnancy: a systematic review and meta-analysis

Downstream remodeling of the spiral arteries (SpA) decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta under all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by u...

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Bibliographic Details
Published in:BMC pregnancy and childbirth 2020-11, Vol.20 (1), p.680-680, Article 680
Main Authors: Schiffer, Veronique, Evers, Laura, de Haas, Sander, Ghossein-Doha, Chahinda, Al-Nasiry, Salwan, Spaanderman, Marc
Format: Article
Language:English
Subjects:
Adaptation
Arteries - diagnostic imaging
Bias
Blood Flow Velocity
Doppler
Female
Gestational age
Hemodynamics
Humans
Hypertension
Investigations
Meta-analysis
Placenta
Placenta - blood supply
Placental Circulation - physiology
Pregnancy
Pregnancy Trimester, First
Pregnancy Trimester, Second
Remodeling
Spiral artery
Systematic review
Ultrasonic imaging
Ultrasonography, Doppler
Uterus - blood supply
Vascular Resistance - physiology
Veins & arteries
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Summary:Downstream remodeling of the spiral arteries (SpA) decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta under all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by ultra-sonographic measurements and evaluated when this process is completed. A systematic review and meta-analysis of spiral artery flow (pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV)) was performed. English written articles were obtained from Pubmed, EMBASE and Cochrane Library and included articles were assessed on quality and risk of bias. Weighted means of Doppler indices were calculated using a random-effects model. In healthy pregnancies, PI and RI decreased from 0.80 (95% CI: 0.70-0.89) and 0.50 (95% CI: 0.47-0.54) in the first trimester to 0.50 (95% CI: 0.45-0.55, p 
ISSN:1471-2393
1471-2393
DOI:10.1186/s12884-020-03150-0