Uterine-umbilical artery doppler velocimetry and pregnancy outcome in SLE patients: relation to disease manifestations and activity

To evaluate the uterine-umbilical artery Doppler velocimetry and determine its relation to pregnancy outcome and disease manifestations in SLE patients. Blood flow velocity waveforms of the umbilical and uterine arteries were studied by color Doppler ultrasound in 36 pregnant SLE patients referred from the Rheumatology Department for follow up and delivery in the Obstetrics Department. Resistance index [RI] and pulsality index [PI] were measured at the 1st week and then every 4 weeks from the 20th and 30th weeks till delivery. The mean age was 27.33 +/- 4.03 years and disease duration of 5.72 +/- 2.57 years. The nulliparity rate and history of previous abortions were higher in those with poor fetal outcome [50% and 62.5%, respectively]. Lupus anticoagulants and anticardiolipin were obviously higher in those with a poor outcome [25% and 37.5%, respectively] with a higher association with APS in spite of anticoagulation. The SLEDAI was higher in those with a poor fetal outcome and the difference reached significance at the 24th week gestation [12.13]. Eight [22.22%] of the patients had abnormal fetal outcome: 5 IUGR [13.89%], 1 IUFD [2.78%] and 2 [5.55%] with missed abortion. Uterine and umbilical artery Doppler abnormalities were higher in those with poor obstetric outcomes and were earlier revealed by the uterine. Uterine artery Doppler seems to be an earlier prognostic factor for adverse outcomes compared to umbilical in SLE patients at high risk, allowing antepartum intensive care and optimal timing of delivery to early confirm a good pregnancy outcome

role of endometrial-subendometrial blood flow distribution assessed by power doppler in the prediction of pregnancy in women with unexplained infertility undergoing intrauterine insemination

The aim of this study was to investigate the role of endometrial-subendometrial blood flow assessed by power Doppler in the prediction of pregnancy in patients with unexplained infertility undergoing intrauterine insemination in clomiphene citrate induced cycles. Prospective clinical study. University teaching hospital. One hundred thirty five patients with unexplained infertility undergoing intrauterine insemination in clomiphene citrate induced cycles were recruited. Transvaginal ultrasound was performed on the day of Human chorionic gonadotrophin [HCG] administration to determine the uterine artery resistance index [RI] and pulsatility index [PI] by pulsed Doppler and to detect the blood flow in endometrial-subendometrial area by power Doppler. Pregnancy occurred in twenty one patients [21/129] [16%]. The [RI] and [PI] were similar in pregnant group and non pregnant group. Pregnancy occurred in 31% of patients with endometrial and subendometrial flow [7/22], in 19% of patients with subendometrial flow only [13/68] and in 2.5% of patients with absent endometrial and subendometrial flow [1/39]. The detection of the blood flow in the endometrial-subendometrial area by power Doppler may be a useful marker in prediction of pregnancy in patients with unexplained infertility undergoing intrauterine insemination