{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T18:39:24Z","timestamp":1771267164686,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T00:00:00Z","timestamp":1580169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Late\u2010gestation adverse pregnancy outcome is associated with reduced placental villous vascularity but rarely with a frankly abnormal umbilical artery Doppler waveform. The clinical utility of umbilical artery Doppler velocimetry in late gestation is limited by poor understanding of what aspect(s) of placental structure and function the impedance reflects. We hypothesized that placental arterial circulation impedance reflects placental vascularity and arterial function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This was a secondary analysis of data from the FEMINA2 study, a study of pregnancy outcome after reduced fetal movement. Forty\u2010three pregnancies that delivered within 7\u00a0days of ultrasound assessment were examined. Impedance was quantified by pulsatility index (PI) from umbilical, chorionic plate arteries, and intra\u2010placental arteries. Site\u2010specific PI was compared with villous vascularity (CD31 immunostaining) and placental arterial function (wire myography) by regression analysis (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01) where factor analysis suggested potential co\u2010variance (Eigen value\u00a0&gt;\u00a02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pulsatility index decreased with proximity to the placental microvasculature (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). Intra\u2010placental artery PI correlated significantly with vessel number (R<jats:sup>2<\/jats:sup>\u00a0=\u00a00.40, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.0007). No significant relations between umbilical or chorionic plate artery PI and villous vascularity were found (<jats:italic>P<\/jats:italic>\u00a0\u2265\u00a0.11 and <jats:italic>P<\/jats:italic>\u00a0\u2265\u00a0.042). No significant co\u2010variance was suggested between PI at any Doppler sampling site and ex vivo placental arterial function indices. Measurement reliability (intraclass correlation coefficient) was highest in the umbilical artery (PI 0.75 and 0.50 for intra\u2010 and interoperator reliability, respectively) and lowest in the intra\u2010placental arteries (PI 0.55 and 0.41, respectively). Systematic bias in umbilical artery PI was observed between observers, but not at other Doppler sampling sites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>More vascular placentas ex vivo are associated with reduced intra\u2010placental artery Doppler impedance in utero. Although umbilical (but not intra\u2010placental) artery Doppler PI is associated with adverse outcome after reduced fetal movement, this predictive ability does not appear to be through assessment of placental vascularity or chorionic plate arterial function. The inferior reliability of intra\u2010placental artery Doppler, although similar to previously published reliability of umbilical artery Doppler, impairs its ability to detect subtle differences in placental vascularity, and must be significantly improved before it could be considered a clinically useful test.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13807","type":"journal-article","created":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T13:36:35Z","timestamp":1579008995000},"page":"865-874","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Intra\u2010placental arterial Doppler: A marker of fetoplacental vascularity in late\u2010onset placental disease?"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0993-497X","authenticated-orcid":false,"given":"Lucy E.","family":"Higgins","sequence":"first","affiliation":[{"name":"Maternal and Fetal Health Research Center Institute of Human Development University of Manchester Manchester UK"},{"name":"St. Mary's Hospital Central Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Center Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4303-7845","authenticated-orcid":false,"given":"Alexander E. 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Institute of Human Development University of Manchester Manchester UK"},{"name":"St. Mary's Hospital Central Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Center Manchester 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