Factors Associated with Placental Vascularization Measured by 3D Power Doppler Ultrasonographic Sphere Biopsy between 11 and 14 Weeks of Gestation

Demers, Suzanne; Boutin, Amélie; Dembickaja, Regina; Campanero, Mercedes; Nicolaides, Kypros H.

doi:10.1055/s-0038-1632369

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…While the placenta might be regarded as the most intuitive target for vascular imaging for assessment of PE risk, 8 it is far less accessible to high-resolution imaging of the vasculature than is the eye, where the retinal microvasculature can be visualized optically. This is especially true given recent advances in ocular imaging, such as optical coherence tomography angiography (OCT-A).…”

Section: Introductionmentioning

confidence: 99%

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Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia

Silverman

Urs

Wapner

et al. 2020

Trans. Vis. Sci. Tech.

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Purpose Pre-eclampsia (PE) is a serious complication of pregnancy characterized by high blood pressure, proteinuria, compromised fetal blood supply, and potential organ damage. The superficial location of the eye makes it an ideal target for characterization hemodynamics. Our aim was to discern the impact of PE on ocular blood flow. Methods 18 MHz plane-wave ophthalmic ultrasound scanning was performed on subjects with PE (n = 26), chronic or gestational hypertension (n = 8), and normal controls (n = 19) within 72 hours of delivery. Duplicate three-second long scans of the posterior pole including the optic nerve were acquired at 6000 images/sec for evaluation of the central retinal artery and vein and the short posterior ciliary arteries. The choroid was scanned at 1000 images/sec. Doppler analysis provided values of pulsatile flow velocity and resistance indexes. Results End diastolic velocity was higher, and pulsatility and resistive indexes were significantly lower in the choroid, central retinal artery and short posterior ciliary arteries in PE than in controls. Blood pressure was elevated in PE with respect to controls and was negatively correlated with resistance. Conclusions Although vasoconstriction is considered characteristic of PE, we found reduced resistance in the orbital vessels and choroidal arterioles, implying vasodilation at this level. Future studies incorporating optical coherence tomography angiography for characterization of the retina and choriocapillaris in conjunction with plane-wave ultrasound scanning, particularly in late pregnancy, might address this conundrum. Translational Relevance Use of plane-wave ultrasound scanning for evaluation ocular blood flow in women at risk for PE may offer an avenue towards early detection and clinical intervention.

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Section: Introductionmentioning

confidence: 99%

“…We developed plane-wave ultrasound scanning for imaging of the eye and reported imaging and measurement of blood-flow in the major vessels and choroid. 8 , 12 …”

Section: Introductionmentioning

confidence: 99%

Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia

Silverman

Urs

Wapner

et al. 2020

Trans. Vis. Sci. Tech.

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Three‐dimensional power Doppler ultrasonography indicates that increased placental blood perfusion during the third trimester is associated with the risk of macrosomia at birth

Zhou

Xiong

Ren

et al. 2020

J of Clinical Ultrasound

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Purpose: To investigate the association between placental blood perfusion and the occurrence of macrosomia at birth. Methods: This was a prospective cohort study including women with singleton pregnancies that aimed to measure placental blood perfusion using three-dimensional (3D) power Doppler ultrasonography in the second and third trimester. We acquired three indices of placental blood flow, including vascularization index (VI), flow index (FI), vascularization flow index (VFI), along with routine two-dimensional (2D) biometric measurements, including abdominal circumference (AC) and estimated fetal weight (EFW). Pregnancy outcomes were divided into two groups: newborns with a normal birth weight and those with macrosomia. We then compared all of the recorded variables between these two groups. We also determined the predictive efficiency of each variable using receiver-operating characteristic (ROC) curves. Results: The placental 3D power Doppler indices, including VI and FI, were significantly higher in the third trimester of pregnancies developing macrosomia, but not during the second trimester, as compared to those with a normal birth weight. ROC curves analysis for third-trimester VI and FI suggested a slight ability to predict macrosomia; this was also the case for AC and EFW. Interestingly, VI showed high sensitivity and low specificity, while FI showed low sensitivity and high specificity; this was also the case for AC and EFW. Conclusions: Three-dimensional power Doppler ultrasound indices were significantly higher during the third-trimester for pregnancies developing macrosomia. However, these indices had only moderate ability to predict macrosomia.

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Correlation of Ocular Plane‐Wave Doppler With Optical Coherence Tomography Angiography in Preeclampsia

Silverman,

Urs,

Wapner

et al. 2023

J of Ultrasound Medicine

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ObjectivesPreeclampsia (PE) is a severe complication of pregnancy characterized by hypertension, proteinuria and compromised fetal blood supply. The eye, like other end organs, is affected by this systemic condition, but unlike in other organs, ocular media transparency allows high‐resolution optical visualization of the vascular structure of the retina. Our aim was to assess how ultrasound‐determined ocular blood‐flow correlates with vascular structure of the retina and choriocapillaris determined by optical coherence tomography angiography (OCTA).MethodsPlane‐wave ultrasound and OCTA were performed on both eyes of 40 consecutive subjects consisting of normal controls (n = 11), mild PE (n = 5), severe PE (n = 17) and chronic or gestational hypertension (n = 7) within 72 hours following delivery. From ultrasound, we measured pulsatile flow velocity and resistance indices in the central retinal artery (CRA) and vein, the short posterior ciliary arteries (SPCAs) and choroid. From OCTA, we measured vascular density (VD) in the superficial, deep retina and choriocapillaris. We determined differences in Doppler and OCTA parameters among groups and correlations between ultrasound and OCTA.ResultsIn severe PE, flow resistance was reduced with respect to controls. Flow velocity and resistance in the and SPCA were moderately correlated with VD in the choriocapillaris and peripapillary retina, but VD in PE did not differ significantly from controls.ConclusionsAlthough OCTA parameters were moderately correlated with Doppler ultrasound, OCTA did not demonstrate significant differences between PE and controls postpartum.

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Factors Associated with Placental Vascularization Measured by 3D Power Doppler Ultrasonographic Sphere Biopsy between 11 and 14 Weeks of Gestation

Abstract: Placental vascularization indices assessed by USSB fluctuate with gestational age, ethnicity, maternal age, body mass index, and previous pregnancy history.

Cited by 4 publications

References 19 publications

Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia

Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia

Three‐dimensional power Doppler ultrasonography indicates that increased placental blood perfusion during the third trimester is associated with the risk of macrosomia at birth

Correlation of Ocular Plane‐Wave Doppler With Optical Coherence Tomography Angiography in Preeclampsia

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