Objective: To explore the relation between total utero-placental (TQ(uta)) and feto-placental (Q(uv)) blood flows and establish longitudinal reference ranges for the TQ(uta)/Q(uv) ratio and the mean uterine artery and umbilical artery pulsatility (UtaPI/UAPI) and resistance index (UtaRI/UARI) ratios.
Design: Prospective longitudinal observational study.
Setting: University hospital in Norway.
Population: Fifty-three low-risk pregnant women.
Methods: Uterine artery and umbilical vein blood flow was measured using Doppler ultrasonography at 4-weekly intervals from 22(+0) to 39(+6) weeks of gestation.
Main outcome measures: Ratios between utero-placental and feto-placental volume blood flows and between indices of uterine and umbilical artery impedance.
Results: The TQ(uta)/Q(uv) ratio had a significant association with the gestational age (p < 0.00001) and decreased with advancing gestation during the second half of pregnancy. The mean UtaPI/UAPI (p = 0.094) and mean UtaRI/UARI (p = 0.323) ratios were not significantly associated with gestational age and remained relatively constant. There was no significant association between TQ(uta) and Q(uv) (p = 0.72), mean UtaPI and UAPI (p = 0.56), or mean UtaRI and UARI (p = 0.57).
Conclusion: The gestational-age-related changes in the utero-placental and feto-placental circulations do not appear to be affected by each other under physiological conditions. We have established longitudinal reference ranges for the utero-placental and feto-placental blood flow and impedance ratios during the second half of pregnancy.