Obstet Gynecol Sci.  2015 Nov;58(6):453-460. 10.5468/ogs.2015.58.6.453.

Uterine blood flow indices, antinuclear autoantibodies and unexplained recurrent miscarriage

• Pietropolli A
• Bruno V
• Capogna MV
• Bernardini S
• Piccione E
• Ticconi C

• KMID: 2314060
• DOI: http://doi.org/10.5468/ogs.2015.58.6.453

Abstract

OBJECTIVE
To study the correlation between 2D and 3D uterine flow indexes and the presence or the absence of antinuclear antibodies (ANA) in women with unexplained recurrent miscarriage (uRM).
METHODS
Fifty-two subjects (26 uRM and 26 control women) underwent 2D Doppler measurement of pulsatility index and resistance index of the uterine arteries in both the follicular and midluteal phase of the cycle. Additionally, 3D ultrasonography determination of vascularisation index, flow index, and vascularisation flow index was carried out with the aid of the VOCAL technique. Serum assay for the presence of ANA was performed in all women.
RESULTS
Pulsatility index of ANA+ uRM women was higher than that of ANA- uRM women and control ANA+ and ANAwomen, both in the follicular and in the midluteal phase of the cycle. Vascularisation index in ANA- uRM women was significantly higher than that in ANA+ control women. Flow index in uRM ANA+ women was significantly lower than that of each of the other groups.
CONCLUSION
ANA might be involved in uRM by determining an impairment in uterine blood flow hemodynamic, particularly in uterine blood flow intensity and uterine artery impedance.

Keyword

3D Doppler; Antinuclear autoantibodies; Recurrent miscarriage; Uterine artery blood flow; VOCAL

MeSH Terms

Abortion, Habitual*
Antibodies, Antinuclear
Autoantibodies*
Electric Impedance
Female
Hemodynamics
Humans
Pregnancy
Ultrasonography
Uterine Artery
Antibodies, Antinuclear
Autoantibodies

Figure

• 

  Fig. 1 Two-dimentional ultrasound analysis of uterine flux indexes. Flow and vascularization indexes in unexplained recurrent miscarriage (RM) women antinuclear antibodies (ANA)- (n=26) and ANA+ (n=26), and in controls woman ANA- (n=26) and ANA+ (n=26). In each women flow indexes (pulsatility index and resistance index) values were obtained in the follicular and in the mid-luteal phase. (A) Pulsatility index in follicular phase, (B) pulsatility index in mid-luteal phase, (C) resistivity index in follicular phase, and (D) resistivity index in mid-luteal phase. Data are expressed as mean±standard deviation. *One-way analysis of variance P<0.01, F=2.958; *SNK P<0.05 vs. all other groups.

• 

  Fig. 2 Three-dimentional ultrasound analysis of uterine vascularization indexes. Flow and vascularization indexes in unexplained recurrent miscarriage (RM) women antinuclear antibodies (ANA)- (n=26) and ANA+ (n=26), as well as in control women ANA- (n=26) and ANA+ (n=26), measured in the midluteal phase of the cycle. (A) Vascularisation index, (B) flow index, and (C) vascularisation flow index. Data are expressed as means±SD for parametric values (B) and as median (range) for the non parametric ones (A,C). *One-way analysis of variance P=0.01, *SNK P<0.05 vs. all other groups. **KRUSKAL-WALLIS statistic 9.498, P<0.05, **Dunn P<0.001 for RM women ANA- vs. control women ANA+.

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