Spiral arteries remodelling and uterine artery hemodynamics changes peripartum Adaption of spiral arteries based on the needs of the baby and quality assessment of the uterine artery before, during and after delivery.
Conditions
Interventions
Uterine artery Doppler measurements (resistance index, pulsatility index, systolic/diastolic ratio) 
before delivery, during delivery and postpartum, which will take approximately 3-5 minutes. Before and during delivery, the transition of spiral arteries into the intervillous space 
will be identified using colour Doppler. 
Postpartum CEUS, using SonoVue™, administered via the already in place intravenous infusion system. A bolus of 2,4 mL is given followed by a 10mL 
sodium chloride (0.9%) flush, after which potential persisting spiral arteries will be examined using GE Healthcare Voluson E8 ultrasound. This measurement takes several minutes, based on the average
Sponsors
Máxima MC
Eligibility
Age
18 Years to 64 Years
Inclusion criteria
Inclusion criteria: Pregnant patient at a minimum age of 18 yearsSingleton pregnancy at term (=37 weeks gestation)Planning to deliver at the Máxima Medical Centre Able to provide informed consentIntravenous access present at the time of delivery
Exclusion criteria
Exclusion criteria: Multiple gestation pregnancyContra-indications to CEUS, e.g. known allergy for constituents of SonoVue™ Planning on breastfeedingMedical emergency during or after delivery, which makes CEUS impossible or undesirable No intravenous access present at the time of deliveryBody Mass Index >40 kg/m2. Pre-eclampsia requiring medicationFetal growth restriction < p3
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The main study parameters is are to assess the visibility of spiral arteries and the feasibility of CEUS to visualizing and characterizing the persistence of maternal uterine spiral arteries. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary objectives are to evaluate uterine artery Doppler parameters before delivery, during delivery and within 4 hours postpartum to be able to describe peripartum changes in uterine artery hemodynamics, to subsequently correlate CEUS findings at 4 hours postpartum with uterine artery Doppler parameters. Before and during delivery, the transition of spiral arteries into the intervillous space will be identified using colour Doppler. | — |
Countries
Netherlands
Contacts
Public ContactE.M.L. Dekker
Máxima MC
Outcome results
None listed