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Özbay K, Semiz A. Assessment of Uterine Blood Flow in Mild Primary Dysmenorrhea. J Pain Res 2024; 17:2071-2077. [PMID: 38887385 PMCID: PMC11182353 DOI: 10.2147/jpr.s456239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 06/05/2024] [Indexed: 06/20/2024] Open
Abstract
Purpose We aimed to assess uterine and arcuate artery Doppler indices in patients with mild primary dysmenorrhea. Patients and Methods A total of 55 patients were included, consisting of women without dysmenorrhea (n=26, group A) and women with mild primary dysmenorrhea (n=29, group B). Doppler measurements of the uterine and arcuate arteries were performed in both groups on the 1st-2nd days and 21st-24th days (midluteal phase) of the menstrual cycle using transvaginal ultrasound and compared between the groups. The severity of dysmenorrhea was assessed using visual analog scale scores. Results Doppler measurements of the uterine and arcuate arteries performed on the 1st-2nd days of the menstrual cycle and the midluteal phase were similar between the groups (p>0.05). There was a significant decrease in the intragroup measurements of uterine and arcuate arteries performed on the first day of menstruation and the luteal phase in both groups (p<0.01). Conclusion Doppler findings of the uterine and arcuate arteries did not differ between patients with and without mild primary dysmenorrhea. The etiology of primary dysmenorrhea mainly involves ischemia and vasoconstriction, but mild primary dysmenorrhea appears to be associated with a different etiology other than decreased tissue perfusion.
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Affiliation(s)
- Koray Özbay
- Department of Obstetrics and Gynecology, Memorial Şişli Hospital, Istanbul, Turkey
| | - Altuğ Semiz
- Department of Obstetrics and Gynecology, Memorial Şişli Hospital, Istanbul, Turkey
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Naeh A, Berezowsky A, Yaniv SS, Berger H, Agrawal S, Ray JG. Persistence of abnormal uterine artery flow postpartum: case-control study. Pregnancy Hypertens 2022; 29:21-22. [DOI: 10.1016/j.preghy.2022.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/26/2022] [Indexed: 11/30/2022]
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Maged AM, Shoab AY, Dieb AS. Antepartum and postpartum uterine artery impedance in women with pre-eclampsia: a case control study. J OBSTET GYNAECOL 2019; 39:633-638. [DOI: 10.1080/01443615.2018.1563054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ahmed M. Maged
- Department of Obstetrics and Gynecology, KasrAlAini Hospital Cairo University, Cairo, Egypt
| | - Amira Y. Shoab
- Department of Obstetrics and Gynecology, KasrAlAini Hospital Cairo University, Cairo, Egypt
| | - Amira S. Dieb
- Department of Obstetrics and Gynecology, KasrAlAini Hospital Cairo University, Cairo, Egypt
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Duncan JR, Tobiasz AM, Bursac Z, Rios-Doria EV, Schenone MH, Mari G. Uterine artery flow velocity waveforms before and after delivery in hypertensive disorders of pregnancy near term. Hypertens Pregnancy 2018; 37:131-136. [PMID: 30019974 DOI: 10.1080/10641955.2018.1493495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To compare the uterine artery pulsatility index (UtAPI-AP) before labor and immediate postpartum (UtAPI-PP) in hypertensive disorders of pregnancy (HTNP) and normotensives near term. METHODS Pregnancies ≥36 weeks admitted for labor induction in our institution from October 2015 to October 2017 were included. We excluded active labor, multiple gestations, fetal demise, and those with inadequate uterine artery sampling. Our primary outcome was to compare the UtAPI-AP and UtAPI-PP between subjects with HTNP (gestational hypertension, preeclampsia with and without severe features) and normotensive participants. Our secondary outcomes were to compare the UtAPI-AP and UtAPI-PP by subgroups (severe HNTP, non-severe HTNP, and controls) and the UtAPI-PP in participants while on MgSO4 and after its discontinuation. A linear regression model was applied to test the above associations. A P < .05 was considered significant. RESULTS We included 108 women (HTNP = 71; controls = 37). The UtAPI-AP was higher in the HTNP group (.85 ± .3 vs. .71 ± .2; P < .001); however, the UtAPI-PP was not different between groups (1.11 ± .3 vs. 1.16 ± .4; P = .46). The UtAPI-AP was higher in the severe HTNP group than controls (P = .004), but there was no significant difference in the UtAPI-PP between subgroups. Our results remained unchanged after adjusting for confounders. The UtAPI while on MgSO4 and after its discontinuation was similar (P = >.99). CONCLUSION The increased UtAPI in patients with HTNP resolves soon after delivery. MgSO4 does not seem to have an effect on the UtAPI postpartum.
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Affiliation(s)
- Jose Ramon Duncan
- a Department of Obstetrics and Gynecology , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Ana Marie Tobiasz
- a Department of Obstetrics and Gynecology , University of Tennessee Health Science Center , Memphis , TN , USA.,b Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , Sanford Health , Bismarck , ND , USA
| | - Zoran Bursac
- c Department of Preventive Medicine , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Eric Vincent Rios-Doria
- a Department of Obstetrics and Gynecology , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Mauro Humberto Schenone
- a Department of Obstetrics and Gynecology , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Giancarlo Mari
- a Department of Obstetrics and Gynecology , University of Tennessee Health Science Center , Memphis , TN , USA
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Paliulyte V, Drasutiene GS, Ramasauskaite D, Bartkeviciene D, Zakareviciene J, Kurmanavicius J. Physiological Uterine Involution in Primiparous and Multiparous Women: Ultrasound Study. Obstet Gynecol Int 2017; 2017:6739345. [PMID: 28555159 PMCID: PMC5438840 DOI: 10.1155/2017/6739345] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 04/13/2017] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To examine the uterine involution period after uncomplicated delivery in primiparous and multiparous women. METHODS Longitudinal prospective study. Repeated parameters were measured and endometrial contents and diastolic notch were observed. Measurements of primiparous and multiparous women were carried out after labour on the 1st, 3rd, 10th, 30th, 42nd, and 60th postpartum days. The analysis was performed using SPSS version 21. RESULTS The median uterus parameters are bigger in multiparous group in physiological puerperium, but the decreasing trend is the same. The endometrial cavity on the 10th day was significantly wider in multiparous women and mainly echo-negative view of the uterine cavity was observed. The evaluation of the uterine angle deviation changes from an extremely retroverted position to a more anteverted position. RI of the uterine artery in both groups was low immediately after labour and significantly increased one month postpartum. Notching of the uterine artery undergoes changes, but diastolic notch does not appear in all postpartum women even after two months following labour. CONCLUSIONS The puerperium period after normal vaginal delivery depends on parity. The trend of involution in primiparous and multiparous women follows a similar pattern, yet, it lasts longer in the multiparous women. Ultrasound of uterine is certainly a useful tool after labour and may be important in facilitating an early detection of postpartum uterine complications.
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Affiliation(s)
- V. Paliulyte
- Clinic of Obstetrics and Gynaecology of Vilnius University, Centre of Obstetrics and Gynecology, Vilnius University Hospital Santariskiu Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania
| | - G. S. Drasutiene
- Clinic of Obstetrics and Gynaecology of Vilnius University, Centre of Obstetrics and Gynecology, Vilnius University Hospital Santariskiu Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania
| | - D. Ramasauskaite
- Clinic of Obstetrics and Gynaecology of Vilnius University, Centre of Obstetrics and Gynecology, Vilnius University Hospital Santariskiu Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania
| | - D. Bartkeviciene
- Clinic of Obstetrics and Gynaecology of Vilnius University, Centre of Obstetrics and Gynecology, Vilnius University Hospital Santariskiu Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania
| | - J. Zakareviciene
- Clinic of Obstetrics and Gynaecology of Vilnius University, Centre of Obstetrics and Gynecology, Vilnius University Hospital Santariskiu Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania
| | - J. Kurmanavicius
- Department of Obstetrics, University Hospital Zurich, Zurich, Switzerland
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Uterine blood flow in sheep and goats during the peri-parturient period assessed by transrectal Doppler sonography. Anim Reprod Sci 2017; 176:32-39. [DOI: 10.1016/j.anireprosci.2016.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 11/03/2016] [Accepted: 11/17/2016] [Indexed: 11/21/2022]
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Uterine artery pulsatility index in hypertensive pregnancies: When does the index normalize in the puerperium? Obstet Gynecol Sci 2016; 59:463-469. [PMID: 27896248 PMCID: PMC5120065 DOI: 10.5468/ogs.2016.59.6.463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/16/2016] [Accepted: 09/03/2016] [Indexed: 11/08/2022] Open
Abstract
Objective To investigate whether the uterine artery pulsatility index (UtA PI) of hypertensive pregnancies is higher than that of normal pregnancies in the puerperium, as well as in the antepartum period. Methods The UtA PI was measured in hypertensive (group 1) and normal pregnancies (group 2) during antepartum, immediate postpartum or late postpartum periods. Using the transvaginal approach, the bilateral uterine artery indices were measured. Results One hundred twenty-two women were enrolled: group 1, hypertensive disease in pregnancy (11 cases in antepartum, 13 cases in immediate postpartum and 10 cases in late postpartum period); group 2, normal pregnancies (32 cases in antepartum, 29 cases in immediate postpartum and 27 cases in late postpartum). In antepartum and immediate postpartum periods, the mean UtA PI and the proportion of cases with an early diastolic notch were higher in group 1 than in group 2 (antepartum mean UtA PI, 1.14 in group 1 vs. 0.68 in group 2, P<0.001; early diastolic notch, 46% vs. 9%, P<0.05; immediate postpartum mean UtA PI, 1.30 vs. 1.08, P<0.05; early diastolic notch, 85% vs. 48%, P<0.05). In late postpartum period, the mean value of UtA PI of group 1 was still higher than that of group 2, although the proportion of cases with an early diastolic notch was not different (mean UtA PI, 1.43 vs. 1.20, P<0.05; early diastolic notch, 60% vs. 52%, P=0.73). Conclusion The UtA PI in hypertensive pregnancies was still higher than normal pregnancies in puerperal periods, suggesting that more than several weeks are required to resolve increased uterine artery vascular impedance.
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Baron J, Hershkovitz R, Baumfeld Y, Imterat M, Sciaky-Tamir Y, Mastrolia SA, Schwarzman P, Weintraub AY. Postpartum uterine artery blood flow impedance following cesarean section or vaginal delivery. JOURNAL OF CLINICAL ULTRASOUND : JCU 2016; 44:278-283. [PMID: 26666505 DOI: 10.1002/jcu.22315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 10/06/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE To compare uterine arteries (UtA) blood flow after cesarean section (CS) or vaginal delivery (VD). METHODS We performed a prospective case-control study comparing UtA blood flow impedance in patients who delivered by CS or VD. The UtA pulsatility index (PI) was measured with Doppler ultrasound during post partum using a transabdominal convex probe. Maternal and gestational age, parity, gravidity, and delay between delivery and Doppler measurement were noted. RESULTS We examined 106 postnatal patients, of whom 35 had CS delivery and 71 had VD. The median delay from delivery to Doppler measurement was 35 hours for the CS group and 32 hours for the VD group. The mean PI following CS and VD was 1.62 ± 0.45 and 1.42 ± 0.47, respectively. Using a linear model, the regression coefficients for mean, right, and left PI were not significantly different depending on the mode of delivery. There was no difference between emergency and elective CS. CONCLUSIONS Early postpartum UtA blood flow impedance is not significantly different after CS or VD. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound 44:278-283, 2016.
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Affiliation(s)
- Joel Baron
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Reli Hershkovitz
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yael Baumfeld
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Clinical Research Center, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Majdi Imterat
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yael Sciaky-Tamir
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Salvatore A Mastrolia
- Department of Obstetrics and Gynecology, Azienda Ospedaliero-Universitaria Policlinico di Bari, University of Bari, Bari, Italy
| | - Polina Schwarzman
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Adi Y Weintraub
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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