Color doppler study of the subendometrial area [junctional zone] of the uterus in unexplained infertility

A case control study aiming to study endometrial perfusion and receptivity in unexplained infertility as it is simple and is available in many radiological clinics. Thirty-five cases of unexplained infertility and 16 fertile females were submitted, in the midluteal phase of the menstrual cycle; to Color Doppler study of the subendometrial area which is the inner most part of the myometrium, 5 mm outside the echogenic basal layer of the endometrium. Study of vascularization of this area showed that, blood flow was detected in 51.4% of the group of unexplained and 93.8% of the control group. The difference is statistically significant. Mean pulsatility index [P1] in the subendometrial arteries, if detected by color flow mapping was 2.65 +/- 0.37 in unexplained infertility and 1.95 +/- 0.24 in control group. The difference is statistically significant. The mean peak systolic velocity [PSV] in the subendometrial arteries in unexplained infertility was 0.29 +/- 0.0, 02 m/second and in the control group was 0.42 +/- 0.03 m/second. The difference is statisically significant. Our color Doppler study of the uterine arteries showed also that P1, resistance index [RI] are higher and PSV was lower in unexplained infertility than in control ferile group. Our study showed that in midluteal phase of the menstrual cycle in patients with unexplained infertility blood perfusion of the subendometrial area was impaired. Blood perfusion of the endometrium was also impaired as the blood supply to it passes through the subendometrium area. A possible treatment of these patients is uterine perfusion enhancers as sildenafil [Viagra], low dose aspirin and glyceryl trinitrate

Color doppler study of the uteroplacental circulation in early pregnancy complicated by threatened miscarriage

The study involved the presence or absence of blood flow in the intervillous space and the resistance index [RI] of the decidual spiral arteries at the chorion frondosum or the placenta. Forty-six pregnant women [7-11 weeks] with threatened miscarriage and 15 normal pregnant women [7-11 weeks] were submitted to color Doppler study of the uteroplacental circulation. Cases of threatened miscarriage were classified into three subgroups. Subgroup A: blood flow was detected in the intervillous space and mean RI of the spiral arteries was>0.55. This group included 22 cases [47.82%], 11 cases [50%] the spontaneous miscarriage was complete and 11 cases [50%] pregnancy continued to 20 weeks which was the period of follow up. Subgroup B: included 19 cases [41.30%]: no blood flow was detected in the intervillous space but mean RI of the spiral arteries was>0.55. Two cases [10.52%] miscarried and pregnancy coninued to 20 weeks in 17 cases [89.47%]. Subgroup C: 5 cases [10.86%] no blood flow was detected in the intervillous space and mean RI was<0.55. All pregnancies in this subgroup reached 20 weeks. The overall fetal loss by spontaneous miscarriage was 28, 89%. Control group [normal pregnancy]: blood flow was not detected in the intervillous space in all cases and mean RI of spiral arteries was<0.55, all pregnancies continued to 20 weeks. The differences between groups as regard the age, gravidity, parity and previous miscarriages are not statistically significant. The differences between RI of the decidual spiral arteries of the control group and subgroups of miscarriage are statistically significant. The differences between the outcome [incidence of spontaneous fetal loss] of the subgroups A, B and C are staistically significant. color Doppler study of the uteroplacental circulation of threatened miscarriage in the first trimester can predict the outcome of this pregnancy