Placental volume, vasculature and calcification in pregnancies complicated by pre-eclampsia and intra-uterine growth restriction
- PMID: 26461962
- DOI: 10.1016/j.ejogrb.2015.07.023
Placental volume, vasculature and calcification in pregnancies complicated by pre-eclampsia and intra-uterine growth restriction
Abstract
Objective: Pre-eclampsia (PET) and intrauterine growth restriction (IUGR), often associated with impaired placental function, are among the most common conditions contributing to increased perinatal mortality and morbidity. This study investigates if three dimensional power Doppler (3DPD) of the placenta and computerised analysis of placental calcification is different between PET/IUGR and normal pregnancies.
Study design: This was a prospective cohort study involving 50 women with pre-eclampsia and/or IUGR, or with IUGR only from 24 to 40 weeks' gestation. 3DPD ultrasound was used to calculate placental volume, vascularisation index (VI), flow index (FI) and vascularisation-flow index (VFI). Following each scan the percentage of placental calcification was also calculated, by computer analysis. Results were compared with normal (control) values, and findings correlated with maternal and fetal Doppler parameters and placental histology.
Results: Volume, VI, and VFI are not influenced by gestational age in PET/IUGR pregnancies. FI was found to increase with gestational age (p=0.009) and was lower than normal in the total study group from 24 to 30 weeks (p=0.006). In the pregnancies affected by PET, whether or not IUGR was present, all three indices were lower than normal values between 24 and 30 weeks (VI: p=0.038, FI: p=0.004, VFI: p=0.015). Vascularisation and flow indices were less than the normal 50th centile in the majority of cases of utero-placental insufficiency (p=0.047), and vascularisation and vascularisation flow indices were lower in cases of accelerated placental maturation (p=0.016 and 0.041 respectively). Placental volume greater than the 50th centile between 24 and 30 weeks was associated with the presence of infarction on histology (p=0.021). Flow index (p=0.002) and vascularisation flow index (p=0.036) were lower in the presence of bilateral uterine artery notches. Calcification, similar to the control group, was related to an increasing UAPI (p=0.041) and MCA PI <5th centile (p=0.010).
Conclusions: The study findings suggest that there may be a role for 3DPD placental assessment of volume, vascularisation and blood flow and computer analysis of placental calcification in the identification and management of PET/IUGR pregnancy.
Keywords: Calcification of calcification; Intrauterine growth restriction; Placental vasculature; Placental volume; Pre-eclampsia.
Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Similar articles
-
Value of placental volume and vascular flow indices as predictors of intrauterine growth retardation.Eur J Obstet Gynecol Reprod Biol. 2017 May;212:13-19. doi: 10.1016/j.ejogrb.2017.03.005. Epub 2017 Mar 6. Eur J Obstet Gynecol Reprod Biol. 2017. PMID: 28327375
-
Evaluation of the predictive value of placental vascularisation indices derived from 3-Dimensional power Doppler whole placental volume scanning for prediction of pre-eclampsia: A systematic review and meta-analysis.Placenta. 2017 Mar;51:89-97. doi: 10.1016/j.placenta.2017.01.005. Epub 2017 Jan 5. Placenta. 2017. PMID: 28089506 Review.
-
Utero-placental vascularisation in normal and preeclamptic and intra-uterine growth restriction pregnancies: third trimester quantification using 3D power Doppler with comparison to placental vascular morphology (EVUPA): a prospective controlled study.BMJ Open. 2016 Mar 31;6(3):e009909. doi: 10.1136/bmjopen-2015-009909. BMJ Open. 2016. PMID: 27033959 Free PMC article. Clinical Trial.
-
Placental vascular indices (VI, FI and VFI) in intrauterine growth retardation (IUGR). A pooled analysis of the literature.Prenat Diagn. 2015 Nov;35(11):1065-72. doi: 10.1002/pd.4646. Epub 2015 Aug 3. Prenat Diagn. 2015. PMID: 26126703 Review.
-
First-trimester uterine artery Doppler indices in the prediction of small-for-gestational age pregnancy and intrauterine growth restriction.Ultrasound Obstet Gynecol. 2009 May;33(5):524-9. doi: 10.1002/uog.6368. Ultrasound Obstet Gynecol. 2009. PMID: 19382287
Cited by
-
Impact of Co-Occurrence of Obesity and SARS-CoV-2 Infection during Pregnancy on Placental Pathologies and Adverse Birth Outcomes: A Systematic Review and Narrative Synthesis.Pathogens. 2023 Mar 27;12(4):524. doi: 10.3390/pathogens12040524. Pathogens. 2023. PMID: 37111410 Free PMC article. Review.
-
Retrospective validation of ultrasound characteristics at 19-24 weeks as predictive tools for selective intrauterine growth restriction in monochorionic diamniotic twin pregnancies: a diagnostic study.Ann Transl Med. 2022 Jul;10(14):760. doi: 10.21037/atm-22-3089. Ann Transl Med. 2022. PMID: 35965827 Free PMC article.
-
Actions of Esomeprazole on the Maternal Vasculature in Lean and Obese Pregnant Mice with Impaired Nitric Oxide Synthesis: A Model of Preeclampsia.Int J Mol Sci. 2022 Jul 25;23(15):8185. doi: 10.3390/ijms23158185. Int J Mol Sci. 2022. PMID: 35897759 Free PMC article.
-
Antenatal diagnosis of chorioamnionitis: A review of the potential role of fetal and placental imaging.Prenat Diagn. 2022 Jul;42(8):1049-1058. doi: 10.1002/pd.6188. Epub 2022 Jun 17. Prenat Diagn. 2022. PMID: 35670265 Free PMC article. Review.
-
Towards Transabdominal Functional Photoacoustic Imaging of the Placenta: Improvement in Imaging Depth Through Optimization of Light Delivery.Ann Biomed Eng. 2021 Aug;49(8):1861-1873. doi: 10.1007/s10439-021-02777-0. Epub 2021 Apr 28. Ann Biomed Eng. 2021. PMID: 33909192 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous