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Doppler Findings (doppler + finding)
Selected AbstractsPregnancy outcome and fibrinolytic, endothelial and coagulation markers in women undergoing uterine artery Doppler screening at 23 weeksJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 6 2009B. J. HUNT Summary.,Background:,Pre-eclampsia (PET) and/or fetal growth restriction (FGR) remain a major cause of maternal and fetal morbidity and mortality. In pregnancy, fibrinolysis is controlled by the maternal endothelium and placenta, both of which are central to the pathogenesis of PET/FGR. Clinically, uterine artery Doppler screening at 23 weeks is used to predict PET/FGR. An abnormal uterine artery Doppler finding is defined as early diastolic bilateral uterine artery notching (BN) in the waveform. However, about 50% of mothers with BN do not develop PET/FGR. Objectives:,We investigated fibrinolytic changes and uterine artery Doppler findings in the second trimester, and related them to pregnancy outcome; in particular assessing whether fibrinolytic markers could discriminate between normal and abnormal outcome in mothers with BN. Patients/methods:,Plasma levels of tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), plasminogen activator inhibitor-2 (PAI-2), plasmin-,2 antiplasmin (PAP), D-dimers and markers of endothelial dysfunction were measured with Doppler ultrasound at 23 weeks. Results:,Those with BN had decreased PAP and D-dimer levels, and raised PAI-1 and thrombomodulin levels. Mothers with BN and PET/FGR had significantly increased t-PA levels and reduced PAI-2 levels. Conclusions:,BN at 23 weeks of gestation is associated with increased PAI-1 levels. Within the BN group, mothers who developed PET/FGR had increased t-PA levels and decreased PAI-2 levels, although there was no net change in fibrinolysis as measured by D-dimer levels. No single fibrinolytic marker is helpful in determining pregnancy outcome in those with BN, but t-PA and PAI-2 are worthy of study in a multifactorial algorithm. [source] Conservative management of an extensive renal graft subcapsular hematoma arising during living donor nephrectomy.JOURNAL OF CLINICAL ULTRASOUND, Issue 3 2010Role of Doppler sonographic posttransplant follow-up Abstract We report a case of subcapsular hematoma (SH) of a kidney graft arising during minimal-incision living-donor nephrectomy. SH covered at least two-thirds of the cortical surface. Capsulotomy was not done because it was deemed too risky. In the immediate postoperative period, a rapid deterioration of graft function was observed associated with Doppler sonographic evidence of graft compression. However, in the following days, spontaneous resolution of SH and progressive improvement of Doppler findings was observed, which preceded full recovery of graft function. Conservative management seemed a valid approach of this complication in this case where Doppler sonography proved essential for the follow-up. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2010 [source] Doppler sonography of the superior mesenteric artery in children with recurrent abdominal painJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2008Asli Koktener MD Abstract Purpose. Abdominal pain is one of the most common conditions in childhood and adolescence. The aim of this study was to evaluate the superior mesenteric artery (SMA) Doppler findings in children with recurrent abdominal pain. Method. Duplex Doppler sonographic measurements were performed in 20 patients with recurrent abdominal pain and in 34 controls. Results. The mean blood flow velocities, blood flow volume, and diameter of the SMA were significantly lower in patients with recurrent abdominal pain than in controls. Conclusion. Insufficient development and/or vasoconstriction of the SMA vascular bed may be involved in recurrent abdominal pain, but further studies on larger groups are needed to test this hypothesis. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008. [source] Pregnancy outcome and fibrinolytic, endothelial and coagulation markers in women undergoing uterine artery Doppler screening at 23 weeksJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 6 2009B. J. HUNT Summary.,Background:,Pre-eclampsia (PET) and/or fetal growth restriction (FGR) remain a major cause of maternal and fetal morbidity and mortality. In pregnancy, fibrinolysis is controlled by the maternal endothelium and placenta, both of which are central to the pathogenesis of PET/FGR. Clinically, uterine artery Doppler screening at 23 weeks is used to predict PET/FGR. An abnormal uterine artery Doppler finding is defined as early diastolic bilateral uterine artery notching (BN) in the waveform. However, about 50% of mothers with BN do not develop PET/FGR. Objectives:,We investigated fibrinolytic changes and uterine artery Doppler findings in the second trimester, and related them to pregnancy outcome; in particular assessing whether fibrinolytic markers could discriminate between normal and abnormal outcome in mothers with BN. Patients/methods:,Plasma levels of tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), plasminogen activator inhibitor-2 (PAI-2), plasmin-,2 antiplasmin (PAP), D-dimers and markers of endothelial dysfunction were measured with Doppler ultrasound at 23 weeks. Results:,Those with BN had decreased PAP and D-dimer levels, and raised PAI-1 and thrombomodulin levels. Mothers with BN and PET/FGR had significantly increased t-PA levels and reduced PAI-2 levels. Conclusions:,BN at 23 weeks of gestation is associated with increased PAI-1 levels. Within the BN group, mothers who developed PET/FGR had increased t-PA levels and decreased PAI-2 levels, although there was no net change in fibrinolysis as measured by D-dimer levels. No single fibrinolytic marker is helpful in determining pregnancy outcome in those with BN, but t-PA and PAI-2 are worthy of study in a multifactorial algorithm. [source] Selective intrauterine growth restriction in monochorionic diamniotic twin pregnanciesPRENATAL DIAGNOSIS, Issue 8 2010Dan V. Valsky Abstract Selective intrauterine growth restriction (sIUGR) occurs in 10 to 15% of monochorionic (MC) twins, and it is associated with a substantial increase in perinatal mortality and morbidity. Clinical evolution is largely influenced by the existence of intertwin placental anastomoses: pregnancies with similar degrees of fetal weight discordance are associated with remarkable differences in clinical behavior and outcome. We have proposed a classification of sIUGR into three types according to umbilical artery (UA) Doppler findings (I-normal, II-absent/reverse end-diastolic flow, III-intermittent absent/reverse end-diastolic flow), which correlates with distinct clinical behavior, placental features and may assist in counseling and management. In terms of prognosis, sIUGR can roughly be divided in two groups: type I cases, with a fairly good outcome, and types II and III, with a substantial risk for a poor outcome. Management of types II and III may consist in expectant management until deterioration of the IUGR fetus is observed, with the option of cord occlusion if this occurs before viability. Alternatively, active management can be considered electively, including cord occlusion or laser coagulation. Both therapies seem to increase the chances of intact survival of the larger fetus, while they entail, or increase the chances of, intrauterine demise of the IUGR fetus. Copyright © 2010 John Wiley & Sons, Ltd. [source] When is fetoscopic release of amniotic bands indicated?PRENATAL DIAGNOSIS, Issue 5 2009Review of outcome of cases treated in utero, selection criteria for fetal surgery Abstract Objectives The objectives are to analyze the outcomes of fetal interventions for fetal limb abnormalities associated with amniotic band syndrome (ABS), to compare the outcome with the known natural history, and to establish selection criteria for fetal intervention. Material and Methods In a Medline search, six cases of prenatal fetoscopic interventions for ABS were found. An unpublished case was added. Results Review of the seven cases of treated ABS in utero suggests that abnormal, but present blood flow at Doppler distal to the area constricted by the band may optimally identify cases suitable for fetal surgery. We propose a prenatal classification in stages of cases of ABS based on ultrasound and Doppler findings. Premature rupture of membranes (PROM) occurred in five patients (71%). The median gestational age (GA) at delivery was 34.8 weeks (range 32 to 39). The median time between procedure and PROM was 6 weeks (range 4 days to 14.3 weeks). The median time between procedure and delivery was 11.8 weeks (range 5,17). Conclusion The use of a uniform prenatal classification of cases of ABS may allow a more precise correlation of prenatal findings and postnatal outcome. Copyright © 2009 John Wiley & Sons, Ltd. [source] Correlation between biomagnetic and Doppler findings of the uterine artery in normal and preeclamptic pregnanciesPRENATAL DIAGNOSIS, Issue 1 2005P. Anastasiadis Abstract Objectives To elucidate the hemodynamics of the uterine artery in normal and abnormal pregnancies by use of Doppler ultrasound and SQUID biomagnetometry. Method Two hundred and three women (gestational age 28,42 weeks) were included in the study. Forty-three of them had preeclampsia and/or intrauterine growth restriction and 160 were normal. Uterine artery waveform measurements were evaluated by use of pulsatility index (PI) (normal value PI<1.45). Biomagnetic signals of uterine arteries were recorded and analyzed with Fourier analysis. The biomagnetic signals were distributed according to spectral amplitudes as high (140,300 fT/,Hz), low (50,110 fT/,Hz) and borderline (111,139 fT/,Hz). Results There was a statistically significant difference between normal and abnormal pregnancies concerning the waveform amplitudes (p < 0.001) and the PI index (p < 0.001). Specifically, we noticed high biomagnetic amplitudes in most normal pregnancies (92.5%) and low biomagnetic amplitudes in most preeclamptic cases (90.7%). Conclusions Our study results indicated that biomagnetic measurements of uterine artery might prove to be useful in the evaluation of the fetal well being, especially in cases of preeclampsia and intrauterine growth restriction. Copyright © 2005 John Wiley & Sons, Ltd. [source] Randomised comparison of uterine artery Doppler and aspirin (100 mg) with placebo in nulliparous women: the Essai Régional Aspirine Mère,Enfant study (Part 2)BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2003Damien Subtil Objective To assess the effectiveness of a pre-eclampsia prevention strategy based on routine uterine artery Doppler flow velocity waveform examination during the second trimester of pregnancy, followed by a prescription for 100 mg aspirin in the case of abnormal Doppler findings. Design Multicentre randomised controlled trial. Setting Eleven centres in the north of France and one in Belgium. Population One thousand and eight hundred and fifty-three nulliparous women recruited between 14 and 20 weeks of gestation. Methods Randomisation either to undergo a uterine Doppler examination between 22 and 24 week of gestation or to take a placebo. Women with abnormal Doppler waveforms received 100 mg of aspirin daily from Doppler examination through 36 weeks. Main outcome measures Pre-eclampsia was defined as hypertension (, 140 and/or 90 mmHg) associated with proteinuria (, 0.5 g/L). Results One thousand two hundred and fifty-three women (67%) were randomised into the systematic Doppler group and 617 (33%) into the placebo group. Of the 1175 patients in the Doppler group who underwent this examination, 239 (20.3%) had abnormal uterine artery Doppler and received a prescription for aspirin. Despite the aspirin prescription, the frequency of pre-eclampsia did not differ between the systematic Doppler group and the placebo group (28 of 1237 [2.3%] vs 9 of 616 [1.5%]; RR = 1.55, 95% CI 0.7,3.3). Furthermore, the groups did not differ in the frequency of children who were very small for their gestational age (,3rd centile) or for perinatal deaths. Compared with patients with normal Doppler findings, those with abnormal Doppler were at high risk of pre-eclampsia (RR = 5.5, 95% CI 2.5,12.2) and of giving birth to a small-for-gestational-age child (RR = 3.6, 95% CI 1.6,8.1). Conclusion Despite its sensitivity in screening for pre-eclampsia, routine uterine Doppler in the second trimester cannot be recommended for nulliparous patients. [source] Comparison of orbital colour Doppler findings with computed tomography angiographyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2000Bill Gillies ABSTRACT Colour Doppler imaging (CDI) of orbital vessels is non- invasive but may be fallacious, while computed tomography (CT) angiography displays a visual outline of orbital vessels. We compared clinical findings of the two methods in 33 patients with a wide variety of clinical conditions. It was not possible to visualize the central retinal arteries with CT angiography, but it was possible to show the intracranial carotid, which CDI could not. Changes in the ophthalmic arteries on CDI usually showed changes in calibre on CT angiography. Patients with unexplained or gross visual loss often showed marked abnormalities on CT scanning, not entirely consistent with the clinical picture. Several patients showed marked ectasia of the intracranial carotid along with variable clinical findings. Findings on CT angiography complement and augment those on CDI, and are likely to be more clinically valuable in the future. [source] Assessment of coronary morphology and flow in a patient with guillain-barré syndrome and st-segment elevationCLINICAL CARDIOLOGY, Issue 3 2001Nikolaos Dagres M.D. Abstract Patients with Guillain-Barré syndrome often have cardiac disturbances as a manifestation of autonomic dysfunction. Such abnormalities consist of arrhythmias and disturbances of heart rate and blood pressure. We report a case of a patient with Guillain-Barré syndrome who developed ST-segment elevation in the inferolateral leads, suggestive of an acute coronary syndrome. Cardiac catheterization revealed angiographically normal coronary arteries. Intracoronary ultrasound was also normal. Intracoronary Doppler flow measurements revealed an elevated baseline coronary flow velocity of up to 41 cm/s and decreased coronary flow reserve, particularly in the left circumflex artery. Myopericarditis as cause of the electrocardiographic changes could be ruled out by echocardiography and endomyocardial biopsy. We postulate that the intracoronary Doppler findings are caused by autonomic dysfunction with decrease of coronary resistance and redistribution of the transmural myocardial blood flow. [source] | ||||||||||