{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T18:56:00Z","timestamp":1773341760118,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01 HD 93946"],"award-info":[{"award-number":["R01 HD 93946"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>During human pregnancy, placental extravillous trophoblasts replace vascular smooth muscle and elastic tissue within the walls of the uterine spiral arteries, thereby remodeling them into distensible low\u2010resistance vessels to promote placental perfusion. The present study determined whether B\u2010flow\/spatiotemporal image correlation (STIC) M\u2010mode ultrasonography provides an <jats:italic>in\u2010vivo<\/jats:italic> imaging method able to digitally quantify spiral artery luminal distensibility as a physiological index of spiral artery remodeling during the advancing stages of normal human pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective, longitudinal, observational study was conducted to quantify spiral artery distensibility (i.e. vessel luminal diameter at systole minus diameter at diastole) by B\u2010flow\/STIC M\u2010mode ultrasonography during the first, second and third trimesters in 290 women exhibiting a normal pregnancy. Maternal serum levels of placental growth factor (PlGF) and soluble fms\u2010like tyrosine kinase\u20101 (sFlt\u20101), growth factors that modulate important events in spiral artery remodeling, were quantified in a subset of the women in the first, second and third trimesters of pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median (interquartile range (IQR)) spiral artery distensibility increased progressively between the first (0.17 (0.14\u20130.21)\u2009cm), second (0.23 (0.18\u20130.28)\u2009cm) and third (0.26 (0.21\u20130.35)\u2009cm) trimesters of pregnancy (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001 for all). Median (IQR) spiral artery volume flow increased progressively between the first (2.49 (1.38\u20134.99)\u2009mL\/cardiac cycle), second (3.86 (2.06\u20136.91)\u2009mL\/cardiac cycle) and third (7.79 (3.83\u201314.98)\u2009mL\/cardiac cycle) trimesters (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 for all). In accordance with the elevation in spiral artery distensibility, the median (IQR) ratio of serum PlGF\/sFlt\u20101\u2009\u00d7\u200910<jats:sup>3<\/jats:sup> levels increased between the first (7.2 (4.5\u201310.0)), second (22.7 (18.6\u201342.2)) and third (56.2 (41.9\u201392.5)) trimesters (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 for all).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study shows that B\u2010flow\/STIC M\u2010mode ultrasonography provides an <jats:italic>in\u2010vivo<\/jats:italic> imaging technology to quantify digitally the structural and physiological expansion of the walls of the spiral arteries during the cardiac cycle as a consequence of their transformation into compliant vessels during advancing stages of normal human pregnancy. \u00a9 2024 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.27636","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T09:07:08Z","timestamp":1710320828000},"page":"322-329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["B\u2010flow\/spatiotemporal image correlation M\u2010mode ultrasound provides novel method to quantify spiral artery remodeling during normal human pregnancy"],"prefix":"10.1002","volume":"64","author":[{"given":"O. 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J.","family":"Pepe","sequence":"additional","affiliation":[{"name":"Department of Physiological Sciences Eastern Virginia Medical School  Norfolk VA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2827-9739","authenticated-orcid":false,"given":"E. 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