Can conventional biomedical investigative technology unfold the complexities of uteroplacental system in pregnancy? A critical study

摘要

Haemodynamic changes in the uteroplacental vessels in normal and hypertensive pregnancy still remain unknown and complex, the reason being the difficulty in conducting in-vivo and in-vitro studies. A proper understanding of the flow and pressure changes may lead to solutions of many complex problems related to pregnancy. In-vitro and invasive techniques may interfere with pregnancy and alter the haemodynamic profile. The most ideal technique therefore is a noninvasive and in-vivo study. A theoretical model is useful to understand the complex flow mechanics but, howsoever advanced a theoretical model it may be, it can not provide answers to all the questions unless an accurate validation using the most appropriate technology, that is Doppler velocimetry in the case of pregnancy, is possible. The present study to monitor pressure and flow velocity profiles under different experimental conditions has led the authors to suggest that pressure recordings are in general ineffective in predicting the onset as well as the severity of the disease process which therefore shifts the spectrum to an alternative sensitive indicator. Doppler velocimetry remains as the most sensitive technique with a very high predictability index, but measurement beyond the site of pathology as understood is not possible. The aim is either to obtain a definite signal from the peripheral site or derive maximum information from the signals recorded from any of the proximal sites. It is possible through an advancement of the Doppler instrumentation or signal processing and analysis which should be the key area of future research.