Comparative analysis of placental vasculature and placental volume in normal and IUGR pregnancies with the use of three-dimensional Power Doppler

Abstract

ObjectivesTo evaluate the differences in placental vascular indices and placental volume between normal and IUGR pregnancies.MethodsA prospective study was conducted on a group of 100 normal and 20 IUGR pregnancies between 22 and 42 weeks of gestation. For the purpose of evaluation of placental volume and placental vascular indices, we applied 3D Power Doppler and VOCAL technique. Only patients with entirely visualized placenta were included in the study.ResultsA comparative analysis of vascularization index (VI), vascularization flow index (VFI), flow index (FI), and placental volume (PV) revealed statistically significant differences between normal and IUGR pregnancies.In normal pregnancies, the volume of the placenta was on average 92.42 cm3 larger than in pregnancies complicated by IUGR. Receiver operating characteristic (ROC) curves were used to evaluate the clinical usefulness of placental vascular indices and placental volume for discriminating IUGR and normal pregnancies. It was concluded that the VI, VFI, PV, FI parameters are the best discriminants, with the cut-off values of 5.30, 2.30, 199, and 36.0, respectively.ConclusionsThe quantitative assessment of placental vasculature and placental volume by means of 3D Power Doppler and VOCAL technique is an adjunctive modality for differentiation between normal and IUGR pregnancies. Our findings further suggest that the vascularization index (VI) and vascularization flow index (VFI) are the best parameters with the most favorable discriminating potential for proper identification of IUGR pregnancies.

Third trimester placental volume and biometry measurement: A method-development study

“…Whether the reliability demonstrated in our study (ICC <0.75) is sufficient to detect relatively subtle differences (e.g. <3 cm difference in placental length and width [5]) in placental size remains to be seen, although both Pomorski et al [39] and Artunc Ulkumen et al [28] were able to detect a 92 cm 3 reduction in VOCAL est PV between third trimester FGR and control pregnancies. This should be the subject of future work in this area, alongside comparative assessment of the clinical utility of these measures against other assessments of in utero placental structure and function including umbilical and uterine artery Doppler impedance and placental hormonal assessment.…”

Future Uses of Three/Four Dimensional Power Doppler Signal in Fetal Medicine

“…O. Odibo et al 2011;Pomorski et al 2011;Rizzo et al 2009). It seems that the evaluation of first trimester placental vascularisation correlates, somehow, with a compromised placentation and therefore could predict some adverse perinatal outcomes of placental origin.…”

Placental Volumetry by 2-D Sonography with a New Mathematical Formula: Prospective Study on the Shell of a Spherical Sector Model

“…The validation of this model was carried out via measuring maximal height, length and thickness of placental series by 2-D sonography and calculation of volumes based on this formula. Correlation analysis of the dataset of estimated placental volumes (EPV) and measured placental volumes (MPV) were conducted utilizing 3-D technique (Odibo et al 2011;Pomorski et al 2012;Rizzo et al 2012) in normal pregnancies. A further aim was to compare the dependence of the placental volumes upon the gestational age.…”