In vivo placental MRI shape and textural features predict fetal growth restriction and postnatal outcome

Dahdouh, Sonia; Andescavage, Nickie; Yewale, Sayali; Yarish, Alexa; Lanham, Diane C.; Bulas, Dorothy; Plessis, Adré J. du; Limperopoulos, Catherine

doi:10.1002/jmri.25806

Cited by 40 publications

(34 citation statements)

References 34 publications

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“…MRI gives additive information about the textural features and shape of the placenta. Placentas in IUGR pregnancies tend to be more oval and thicker than placentas of healthy fetuses, which are more circular [25]. Our morphologic measurements support these observations.…”

Section: Discussionsupporting

confidence: 80%

Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction

et al. 2019

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Objective: To investigate the placental and umbilical cord histopathology in intrauterine growth restriction (IUGR) and their relation to second-trimester maternal hematological parameters. Materials and Methods: Patients were selected for the IUGR group based on estimated fetal weight below the 10th percentile. Patients were recruited into the control group randomly. Patients were followed up with ultrasound, and blood samples were taken between the 20th and 24th gestational weeks. After delivery and formalin fixation, weight and volume of the placenta were recorded and histologic samples were processed. Results: Maternal platelet count strongly correlates with placental weight (r = 0.766). On the other hand, neonatal weight correlates with placental volume (r = 0.572) rather than with placental weight (r = 0.469). Umbilical arterial lumen cross-sectional area correlates with birth weight (r = 0.338). Conclusions: Maternal hematological parameters do not seem to affect neonatal outcome. Our main findings are the correlation of maternal platelet count with placental weight, the correlation of placental volume with birth weight being stronger than the correlation of placental weight with birth weight, and the correlation of umbilical artery lumen cross-sectional area with neonatal weight. Mild histopathologic alterations might occur in normal pregnancies; however, sufficient fetal nutrition can be maintained. This compensatory function of the placenta seems to be insufficient when two or more pathologies are present, which is characteristic for IUGR.

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Section: Discussionsupporting

confidence: 80%

Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction

et al. 2019

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“…However, a heavier placenta does not represent more efficient transport of oxygen and nutrients [68]. Another study demonstrated that the weight and size of the placenta is associated with coronary disease and life expectancy [69,70]. Nevertheless, the human placental compensatory mechanism can only reach a certain point.…”

Section: Discussionmentioning

confidence: 99%

The placental transcriptome of the first-trimester placenta is affected by in vitro fertilization and embryo transfer

Zhao¹,

Zheng²,

Liu³

et al. 2019

Reprod Biol Endocrinol

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Background: The placenta is a highly specialized temporary organ that is related to fetal development and pregnancy outcomes, and epidemiological data demonstrate an increased risk of placental abnormality after in vitro fertilization and embryo transfer (IVF-ET). Methods: This study examines alterations in the transcriptome profile of first-trimester placentas from IVF-ET pregnancies and analyzes the potential mechanisms that play a role in the adverse perinatal outcomes associated with IVF-ET procedures. Four human placental villi from first-trimester samples were obtained through fetal bud aspiration from patients subjected to IVF-ET due to oviductal factors. An additional four control human placental villi were derived from a group of subjects who spontaneously conceived a twin pregnancy. We analyzed their transcriptomes by microarray. Then, RT-qPCR and immunohistochemistry were utilized to analyze several dysregulated genes to validate the microarray results. Biological functions and pathways were analyzed with bioinformatics tools. Results: A total of 3405 differentially regulated genes were identified as significantly dysregulated (> 2-fold change; P < 0.05) in the IVF-ET placenta in the first trimester: 1910 upregulated and 1495 downregulated genes. Functional enrichment analysis of the differentially regulated genes demonstrated that the genes were involved in more than 50 biological processes and pathways that have been shown to play important roles in the first trimester in vivo. These pathways can be clustered into coagulation cascades, immune response, transmembrane signaling, metabolism, cell cycle, stress control, invasion and vascularization. Nearly the same number of up-and downregulated genes participate in the same biological processes related to placental development and maintenance. Procedures utilized in IVF-ET altered the expression of first-trimester placental genes that are critical to these biological processes and triggered a compensatory mechanism during early implantation in vivo. Conclusion: These data provide a potential basis for further analysis of the higher frequency of adverse perinatal outcomes following IVF-ET, with the ultimate goal of developing safer IVF-ET protocols.

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“…This technique has been applied widely to the fetal brain, and extensions of this technique, although made substantially more complicated by non‐rigid motion, are being used for other abdominal organs . For placenta size, shape, and thickness estimation, these techniques are likely to represent the best way to acquire data . 3D reconstruction of structural MRI data has already been shown to have potential in surgical planning for laser division in TTTS, and as imaging and reconstruction techniques improve is likely to play an increasingly important role.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…FGR can be challenging to diagnose as placental function cannot currently be directly measured. Surrogate markers, such as abnormal fetal growth trajectory or abnormal blood flow to the placenta, are used with varying success. At present, there is no treatment for FGR, or the associated condition pre‐eclampsia; however, trials are exploring several new therapeutic avenues, including sildenafil, esomeprazole, metformin, pravastatin, and vascular endothelial growth factor maternal gene therapy .…”

Section: Introductionmentioning

confidence: 99%

Placental MRI and its application to fetal intervention

et al. 2019

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Objective Magnetic resonance imaging (MRI) of placental invasion has been part of clinical practice for many years. The possibility of being better able to assess placental vascularization and function using MRI has multiple potential applications. This review summarises up‐to‐date research on placental function using different MRI modalities. Method We discuss how combinations of these MRI techniques have much to contribute to fetal conditions amenable for therapy such as singletons at high risk for fetal growth restriction (FGR) and monochorionic twin pregnancies for planning surgery and counselling for selective growth restriction and transfusion conditions. Results The whole placenta can easily be visualized on MRI, with a clear boundary against the amniotic fluid, and a less clear placental‐uterine boundary. Contrasts such as diffusion weighted imaging, relaxometry, blood oxygenation level dependent MRI and flow and metabolite measurement by dynamic contrast enhanced MRI, arterial spin labeling, or spectroscopic techniques are contributing to our wider understanding of placental function. Conclusion The future of placental MRI is exciting, with the increasing availability of multiple contrasts and new models that will boost the capability of MRI to measure oxygen saturation and placental exchange, enabling examination of placental function in complicated pregnancies.

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In vivo placental MRI shape and textural features predict fetal growth restriction and postnatal outcome

Abstract: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:449-458.

Cited by 40 publications

References 34 publications

Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction

Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction

The placental transcriptome of the first-trimester placenta is affected by in vitro fertilization and embryo transfer

Placental MRI and its application to fetal intervention

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