Uterine artery Doppler velocimetry, calcium and lipids in pregnant women of advanced age

The studies presented in this thesis were conducted in a cohort of healthy pregnant women of 35 years and older. who presented themselves for late f1rst trimester prenatal diagnosis. This provided the opportunity to collect data on the uteroplacental circulation, as well as various other characteristics in early pregnancy. The main objective of the work presented was to document uterine artery flow velocity waveforms in the first and second trimester of pregnancy and to relate them to pregnancy complications and maternal age. Uteroplacental Doppler studies in both normal and complicated pregnancies are evaluated by a review of the published results. In the interpretation of these studies, it is important to take into account the large methodological differences across studies. which include differences in study design, study populations, insonation sites along the uteroplacental vascular tree, indices used to describe the flow velocity waveforms obtained and definitions of normal and abnormal flow velocity waveforms. Most studies performed in normal pregnancies report a major drop in flow velocity waveform indices, i.e., vascular resistance, in the first half of pregnancy, which is believed to coincide with morphological changes in the uteroplacental spiral arteries as the result of trophoblast invasion. Studies assessing the predictive ability of uteroplacental Doppler flow velocity waveforms have yielded a large range in predictive values for the various complications, partly due to differences in choice of study populations

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