Estimation of forming uteroplacental blood flow in patients with threatened miscarriage in the presence of progesterone deficiency in the first trimester of pregnancy

Objective. To define the relationship of forming uteroplacental blood flow in first-trimester threatened miscarriage in the presence of normal and low blood progesterone levels. Subjects and methods. The investigation enrolled 91 primigravidas at 8-12 weeks’ gestation. 64 pregnant patients with threatened miscarriage formed Group 1; 27 with uncomplicated pregnancy were included in Group 2. Blood progesterone levels were determined in both groups. According to the findings, Group 1 was divided into two subgroups: 1A) 21 patients with a blood progesterone level lower than the 25th percentile; 1B) 43 with normal (from the 25th to 75th percentile) and elevated (more than the 75th percentile) blood progesterone levels. To estimate uteroplacental blood flow, all the patients underwent real-time three-dimensional transvaginal Doppler ultrasonography. Results. In the presence of blood progesterone def iciency versus blood flow ultrasound parameters and curve values, the patients with normal progesterone levels were recorded to have a significant increase in the blood flow curve values in the spiral arteries (p=0.0001) and corpus luteum vessels (0.0001). There was also a decrease in chorionic volume (p=0.026) and vascularization index (0.028), and corpus luteum volume (p=0.025). The groups showed no differences in the blood flow curve values in the uterine and ovarian arteries. Conclusion. The status of the mother-placenta-fetus system is determined by the blood flow curve indicators (resistance index, pulsatility index) of the spiral and corpus luteum arteries, and by chorionic volume and vascularization and corpus lutetium volume. The blood flow that is impaired in the spiral arteries and altered in the yolk sac artery may be considered to be a major Doppler sign of threatened miscarriage and possible complications of a gestational process in later periods.

progesterone, miscarriage threat, spiral arteries, chorion, yellow body, Doppler, three-dimensional ultrasound