Evidence map›Paper›PMID 33965347›Full record

ArticleEBioMedicine2021

Wave reflections in the umbilical artery measured by Doppler ultrasound as a novel predictor of placental pathology.

Lindsay S Cahill, Greg Stortz, Anjana Ravi Chandran, Natasha Milligan, Shiri Shinar, Clare L Whitehead, Sebastian R Hobson, Viji Ayyathurai, Anum Rahman, Rojan Saghian and 16 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EBioMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 28 citations in OpenAlex.

  1. Morning Blood Pressure and Adverse Pregnancy Outcomes in High-Risk Pregnancies.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  2. Article
  3. Placental biomarker and fetoplacental Doppler abnormalities are strongly associated with placental pathology in pregnancies with small-for-gestational-age fetus: prospective study.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2025
    Article
  4. Article
  5. Article
  6. Article
  7. A Multiscale Mathematical Model for the Fetal Blood Circulation of the Second Half of Pregnancy.International journal for numerical methods in biomedical engineering · 2024
    Article
  8. Review
  9. Article
  10. Review
  11. Peripheral cord insertion is associated with adverse pregnancy outcome only when accompanied by clinically significant placental pathology.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2023
    Article
  12. Recent research on the influence of intrauterine growth restriction on the structure and function of the nervous system.Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2021
    Article
  13. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

26 authors at 6 institutions in 4 countries.

Lindsay S CahillMouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Chemistry, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada. Electronic address: lcahill@mun.ca.
Greg StortzTranslational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Anjana Ravi ChandranDepartment of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada.
Natasha MilliganDivision of Cardiology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
Shiri ShinarDepartment of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada.
Clare L WhiteheadDepartment of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada; Pregnancy Research Centre, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Australia.
Sebastian R HobsonDepartment of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada.
Viji AyyathuraiDepartment of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada.
Anum RahmanMouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
Rojan SaghianMouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.
Karl J JobstDepartment of Chemistry, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada.
Cyrethia McShaneCenter for Fetal Therapy, Johns Hopkins Medicine, Baltimore, MD, USA.
Dana Block-AbrahamCenter for Fetal Therapy, Johns Hopkins Medicine, Baltimore, MD, USA.
Viola SeravalliCenter for Fetal Therapy, Johns Hopkins Medicine, Baltimore, MD, USA; Department of Health Sciences, Division of Obstetrics and Gynecology, University of Florence, Italy.
Melissa LaurieCenter for Fetal Therapy, Johns Hopkins Medicine, Baltimore, MD, USA.
Sarah MillardCenter for Fetal Therapy, Johns Hopkins Medicine, Baltimore, MD, USA.
Cassandra DelpCenter for Fetal Therapy, Johns Hopkins Medicine, Baltimore, MD, USA.
Denise WolfsonCenter for Fetal Therapy, Johns Hopkins Medicine, Baltimore, MD, USA.
Ahmet A BaschatCenter for Fetal Therapy, Johns Hopkins Medicine, Baltimore, MD, USA.
Kellie E MurphyDepartment of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
Lena SerghidesToronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Immunology and Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Eric MorgenDepartment of Pathology, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
Christopher K MacgowanTranslational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
W Tony ParksDepartment of Pathology, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
John C KingdomDepartment of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
John G SledMouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
Mount Sinai Hospital · CAJohns Hopkins University · USHospital for Sick Children · CAUniversity of Toronto · CAMemorial University of Newfoundland · CAUniversity Health Network · CA

Funding

Environmental factors in placental pathology: a new diagnostic method based on umbilical vessel wave mechanicsU01HD087177 · NICHD · HOSPITAL FOR SICK CHLDRN (TORONTO) · PI SLED, JOHN G · 2015 to 2015
$2.5M
NICHD NIH HHS U01 HD087177
6 · The paper itself

Abstract

backgroundThe umbilical artery (UA) Doppler pulsatility index is used clinically to detect elevated feto-placental vascular resistance. However, this metric is confounded by variation in fetal cardiac function and is only moderately predictive of placental pathology. Our group developed a novel ultrasound methodology that measures wave reflections in the UA, thereby isolating a component of the Doppler signal that is specific to the placenta. The present study examined whether wave reflections in the UA are predictive of placental vascular pathology.

methodsStandard clinical Doppler ultrasound of the UAs was performed in 241 pregnant women. Of these, 40 women met narrowly defined preset criteria for the control group, 36 had maternal vascular malperfusion (MVM) and 16 had fetal vascular malperfusion (FVM). Using a computational procedure, the Doppler waveforms were decomposed into a pair of forward and backward propagating waves.

findingsCompared to controls, wave reflections were significantly elevated in women with either MVM (p<0.0001) or FVM pathology (p = 0.02). In contrast, the umbilical and uterine artery pulsatility indices were only elevated in the MVM group (p<0.0001) and there were no differences between women with FVM and the controls.

interpretationThe measurement of wave reflections in the UA, combined with standard clinical ultrasound parameters, has the potential to improve the diagnostic performance of UA Doppler to detect placental vascular pathology. Identifying women with FVM pathology is particularly challenging prenatally and future investigations will determine if women at risk of this specific placental disease could benefit from this novel diagnostic technique.

Indexed as

AdolescentAdultFemaleHumansPlacentaPlacenta DiseasesPlacental CirculationPregnancyUltrasonography, Doppler, PulsedUmbilical ArteriesDoppler ultrasoundFetal vascular malperfusionMaternal vascular malperfusionPlacentaUmbilical arteryWave reflection

Identifiers

PMID33965347
PMCPMC8176120
OpenAlexW3158427490

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.