Is evaluation of placenta with real-time sonoelastography during the second trimester of pregnancy an effective method for the assessment of spontaneous preterm birth risk?

Albayrak, Eda; Doğru, Hatice Yılmaz; Özmen, Zafer; Altunkaş, Ayşegül; Kalaycı, Tuğçe Özlem; İnci, Mehmet Fatih; Server, Sadık; Sönmezgöz, Fitnet; Aktaş, Fatma; Demir, Osman

doi:10.1016/j.clinimag.2016.04.006

Cited by 13 publications

(9 citation statements)

References 23 publications

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“…Moreover, they have employed a diverse range of elastography techniques: strain elastography [ 19 , 26 , 30 ], ARFI [ 20 , 28 , 32 – 34 ], or SWE [ 21 , 22 , 25 , 27 , 29 ]. The orders of magnitude of the measurements sometimes differed from one study to another.…”

Section: Discussionmentioning

confidence: 99%

Measurement of shear wave speed dispersion in the placenta by transient elastography: A preliminary ex vivo study

Simon¹,

Callé²,

Perrotin³

et al. 2018

PLoS ONE

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BackgroundPlacental elasticity may be modified in women with placental insufficiency. Shear wave elastography (SWE) can measure this, using acoustic radiation force, but the safety of its use in pregnant women has not yet been demonstrated. Transient elastography (TE) is a safer alternative, but has not yet been applied to the placenta. Moreover, the dispersion of shear wave speed (SWS) as a function of frequency has received relatively little study for placental tissue, although it might improve the accuracy of biomechanical assessment.ObjectiveTo explore the feasibility and reproducibility of TE for placental analysis, to compare the values of SWS and Young’s modulus (YM) from TE and SWE, and to analyze SWS dispersion as a function of frequency ex vivo in normal placentas.Materials and methodsTen normal placentas were analyzed ex vivo by an Aixplorer ultrasound system as shear waves were generated by a vibrating plate and by using an Aixplorer system.The frequency analysis provided the value of the exponent n from a fractional rheological model applied to the TE method. We calculated intra- and interobserver agreement for SWS and YM with 95% prediction intervals, created Bland-Altman plots with 95% limits of agreement, and estimated the intraclass correlation coefficient (ICC).Main resultsThe mean SWS was 1.80 m/s +/- 0.28 (standard deviation) with the TE method at 50 Hz and 1.82 m/s +/-0.13 with SWE (P = 0.912). No differences were observed between the central and peripheral regions of placentas with either TE or SWE. With TE, the intraobserver ICC for SWS was 0.68 (0.50–0.82), and the interobserver ICC for SWS 0.65 (0.37–0.85). The mean parameter n obtained from the fractional rheological model was 1.21 +/- 0.12, with variable values of n for any given SWS.ConclusionsTE is feasible and reproducible on placentas ex vivo. The frequency analysis of SWS provides additional information about placental elasticity and appears to be able to distinguish differences between placental structures.

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Section: Discussionmentioning

confidence: 99%

Measurement of shear wave speed dispersion in the placenta by transient elastography: A preliminary ex vivo study

Simon¹,

Callé²,

Perrotin³

et al. 2018

PLoS ONE

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“…Furthermore, it is difficult to maintain constant palpation among operators, and readings between patients can be difficult to compare. In Albayrak et al study, fat-to-placenta strain ratio was reported from SE instead and showed a large variability in his results, range from 0.2 to 14.0 for normal placenta (Albayrak et al, 2016 ). On top of palpation inconsistency, this large variability of the readings could also be due to person-to-person variability of fat tissue stiffness, which acted as the reference tissue.…”

Section: Placenta Ultrasound Elastographymentioning

confidence: 98%

“…The stiffness of a targeted tissue is expressed as strain ratio, the strain of targeted tissue to the strain of reference tissue. In several implementations, maternal fat tissues were used as the reference tissue (Cimsit et al, 2015b ; Albayrak et al, 2016 ). A major difficulty, however, is reproducibility.…”

Section: Placenta Ultrasound Elastographymentioning

confidence: 99%

A Review of Biomechanics Analysis of the Umbilical–Placenta System With Regards to Diseases

2021

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Placenta is an important organ that is crucial for both fetal and maternal health. Abnormalities of the placenta, such as during intrauterine growth restriction (IUGR) and pre-eclampsia (PE) are common, and an improved understanding of these diseases is needed to improve medical care. Biomechanics analysis of the placenta is an under-explored area of investigation, which has demonstrated usefulness in contributing to our understanding of the placenta physiology. In this review, we introduce fundamental biomechanics concepts and discuss the findings of biomechanical analysis of the placenta and umbilical cord, including both tissue biomechanics and biofluid mechanics. The biomechanics of placenta ultrasound elastography and its potential in improving clinical detection of placenta diseases are also discussed. Finally, potential future work is listed.

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“…Placental strain ratio, when measured with real-time sonoelastography, was found negatively correlated with gestational age at birth and it was suggested to be an effective predictor for PB [ 45 ].…”

Section: Ultrasound Markersmentioning

confidence: 99%

Prediction of Preterm Birth: Maternal Characteristics, Ultrasound Markers, and Biomarkers: An Updated Overview

Kaplan

Özgü-Erdinç

2018

Journal of Pregnancy

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There is not a single or combined screening method for preterm birth with high sensitivity which will truly identify the women at risk for preterm birth while also with high specificity to prevent unnecessary interventions and high treatment costs. Measurement of cervical length is the most cost-effective method that is used in clinical practice. Bedside tests have also been developed for detecting markers like fetal fibronectin, insulin-like growth factor binding protein-1 (IGFBP-1), interleukin-6, and placental alpha-macroglobulin-1. Taking the maternal history, health condition, and sociodemographical factors into consideration is recommended. Ultrasound markers apart from cervical length measurements as uterocervical angle and placental strain ratio are studied. Investigations on metabolomics, proteomics, and microRNA profiling have brought a new aspect on this subject. Maybe in the future, with clear identification of women at true risk for preterm birth, development of more effective preventive strategies will not be unfeasible.

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Is evaluation of placenta with real-time sonoelastography during the second trimester of pregnancy an effective method for the assessment of spontaneous preterm birth risk?

Cited by 13 publications

References 23 publications

Measurement of shear wave speed dispersion in the placenta by transient elastography: A preliminary ex vivo study

Measurement of shear wave speed dispersion in the placenta by transient elastography: A preliminary ex vivo study

A Review of Biomechanics Analysis of the Umbilical–Placenta System With Regards to Diseases

Prediction of Preterm Birth: Maternal Characteristics, Ultrasound Markers, and Biomarkers: An Updated Overview

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