Transvaginal color Doppler in early pregnancy: rational and clinical potential

Abstract

Remarkable hemodynamics changes that occur in the maternal circulation, the continuous growth and development of the feto-placental circulation is now studied by transvaginal Doppler. This seems to give more light in understanding of the early pregnancy pathophysiology. For the first time, it seems that ultrasound might be able to distinguish different forms of gestational trophoblastic disease. Due to its non-invasiveness and relatively simple and easily performed technique, transvaginal color Doppler might be of considerable clinical value. The other important point is that study results are available immediately for clinical judgement. From our study, we can conclude that transvaginal ultrasound with color and pulsed Doppler is potentially valuable diagnostic tool to differentiate forms of the gestational trophoblastic diseases. On the basis of Doppler findings, the complete mole can be reliably distinguish from the invasive mole or choriocarcinoma. The degree of myometrial invasion can be also assessed. This can be an objective foundation for therapeutical approach. There is no doubt that studies of maternal-fetal circulation in early pregnancy may help for better understanding of physiological and pathophysiological hemodynamic changes. Investigation of maternal (main uterine, arcuate, radial and spiral) arteries; placental (umbilical, chorionic arterioles) vessels and fetal (aorta and intracranial circulation) arteries flow patterns may help in order to diagnose abnormal implantation. More studies are necessary in order the Doppler technique to be used for clinical judgment in early pregnancy. Safety aspects should also be considered. However, potentials of these technique are more then obvious.