{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T15:46:53Z","timestamp":1783784813065,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,12,2]],"date-time":"2023-12-02T00:00:00Z","timestamp":1701475200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To use superb microvascular imaging (SMI) to evaluate longitudinally spiral artery (SA) and uterine artery (UtA) vascular adaptation in normal human pregnancy, and to develop reference ranges for use at various gestational ages throughout pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The data for this study were obtained from the National Institutes of Health (NIH)\u2010funded Human Placenta Project. Women aged 18\u201335\u2009years, with a body mass index &lt;\u200930\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , without  comorbidities, with a singleton gestation conceived spontaneously, and gestational age at or less than 13\u2009+\u20096\u2009weeks were eligible for inclusion. The current analysis was restricted to uncomplicated pregnancies carried to term. Exclusion criteria included maternal or neonatal complications, fetal or umbilical cord anomalies, abnormal placental implantation or delivery &lt;\u200937\u2009weeks. Women who fulfilled the inclusion criteria formed the reference population of the Human Placenta Project study. Each participant underwent eight  ultrasound examinations during pregnancy. The pulsatility index (PI) of both the left and right UtA were obtained twice for each artery and the presence or absence of a notch was noted. Using SMI technology, the total number of SA imaged was recorded in a sagittal placental section at the level of cord insertion. The PI and peak systolic velocity (PSV) were also measured in a total of six SA, including two in the central portion of the placenta, two peripherally towards the uterine fundal portion, and two peripherally towards the lower uterine segment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 90 women fulfilled the study criteria. Maternal UtA\u2010PI decreased throughout the first half of pregnancy from a mean\u2009\u00b1\u2009SD of 1.39\u2009\u00b1\u20090.50 at 12\u201313\u2009weeks' gestation to 0.88\u2009\u00b1\u20090.24 at 20\u201321\u2009weeks' gestation. The mean number of SA visualized in a sagittal plane of the placenta increased from 8.83\u2009\u00b1\u20092.37 in the first trimester to 16.99\u2009\u00b1\u20093.31 in the late\u2010third trimester. The mean SA\u2010PI was 0.57\u2009\u00b1\u20090.12 in the first trimester and decreased progressively during the second trimester, reaching a nadir of 0.40\u2009\u00b1\u20090.10 at 24\u201325\u2009weeks, and  remaining constant until the end of pregnancy. SA\u2010PSV was highest in early pregnancy with a mean of 57.16\u2009\u00b1\u200914.84\u2009cm\/s at 12\u201313\u2009weeks' gestation, declined to a mean of 49.38\u2009\u00b1\u200917.88\u2009cm\/s at 20\u201321\u2009weeks' gestation and continued to trend downward for the remainder of pregnancy, reaching a nadir of 34.50\u2009\u00b1\u200915.08\u2009cm\/s at 36\u201337\u2009weeks' gestation. A statistically significant correlation was noted between SA\u2010PI and UtA\u2010PI (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.5633;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multilevel regression models with natural cubic splines were used to create reference ranges of SA\u2010PSV and SA\u2010PI for given gestational ages.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      From early gestation, we have demonstrated the ability to image and quantify SA blood flow in normal pregnancy, and have developed reference ranges for use at various gestational ages throughout pregnancy. \u00a9 2023 The Authors.\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.26312","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T11:31:49Z","timestamp":1689852709000},"page":"860-866","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Longitudinal assessment of spiral and uterine arteries in normal pregnancy using novel ultrasound tool"],"prefix":"10.1002","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2752-4061","authenticated-orcid":false,"given":"R.","family":"Horgan","sequence":"first","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology Eastern Virginia Medical School  Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Sinkovskaya","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology Eastern Virginia Medical School  Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Saade","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology University of Texas Medical Branch  Galveston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0658-138X","authenticated-orcid":false,"given":"E.","family":"Kalafat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Koc University School of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M.","family":"Rice","sequence":"additional","affiliation":[{"name":"George Washington University Biostatistics Center Milken Institute School of Public Health  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Heeze","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology Eastern Virginia Medical School  Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Abuhamad","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology Eastern Virginia Medical School  Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.08.009"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.2006.089"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.01892"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2011.01.008"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10149"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.4036145"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.577"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1822"},{"key":"e_1_2_8_10_1","article-title":"Initial experience with a novel microvascular flow imaging technique","author":"Machado P","year":"2014","journal-title":"Toshiba Medical Systems Corporation"},{"key":"e_1_2_8_11_1","article-title":"Seeing the Unseen: New Techniques in Vascular Imaging","author":"Hata J.","year":"2018","journal-title":"Toshiba Medical Systems Corporation"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.16.07004"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.4048\/jbc.2016.19.2.210"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/RUQ.0000000000000156"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23760"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23698"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-985X.00091"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0258(20001115)19:21<2943::AID-SIM559>3.0.CO;2-5"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0301-5629(85)90132-2"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8907"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1023535"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13257"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2009.28.12.1623"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2021.01.004"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03150-0"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26312","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.26312","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T07:18:57Z","timestamp":1773386337000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.26312"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/uog.26312"],"URL":"https:\/\/doi.org\/10.1002\/uog.26312","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12]]},"assertion":[{"value":"2023-01-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}