Placental volume and three‐dimensional power Doppler analysis in prediction of pre‐eclampsia and small for gestational age between Week 11 and 13 weeks and 6 days of gestation

Abstract

Objective To assess three-dimensional placental volume measurement and three-dimensional power Doppler (3D-PD) indices between 10 weeks and 6 days and 13 weeks and 6 days in predicting pregnancy-induced hypertension (PIH) and small for gestational age (SGA).Methods Three hundred and eight women undergoing fetal nuchal translucency measurement were prospectively assessed using three-dimensional ultrasound in order to measure placental volume and 3D-PD indices: vascularization index (VI), flow index (FI) and vascularization flow index (VFI), using the VOCAL software. The outcome was scored as normal, PIH, SGA or both.Results Eight women developed PIH and ten delivered SGA; and 17 developed PIH or SGA. The age, gestational age at the examination or delivery, number of the pregnancy and the nuchal translucency, were similar in all groups. The placental volume, FI and VFI were similar between the groups. The VI was significantly lower when PIH developed (7.86 ± 3.92 vs. 12.02 ± 7.09 in the normal group, P = 0.035). The crown-rump length (CRL) was significantly smaller in the group where either PIH or SGA developed compared to normal outcome (54.29 ± 6.50 and 59.04 ± 8.89, respectively, P = 0.02). ConclusionPlacental volume is not appropriate for early prediction of PIH or SGA, whereas the VI may be of some potential in detection of PIH. The significance of small CRL in these patients should be further tested.

Value of Placental Volume and Vascular Flow Indices as Predictors of Early and Late Preeclampsia at First Trimester

“…This technology may allow a more direct evaluation of the abnormal placentation process thought to herald the development of preeclampsia. In agreement with the observations of other authors [4-8], we have shown that women with preeclampsia have significantly lower placental volume and vascularization indices at first trimester [9]. However, the use of 3D ultrasound parameters as risk factors for preeclampsia has been little studied, with discrepancies in the results published to date.…”

“…Dar et al [6] suggested that measurement of vascularization index, flow index, and vascularization flow index in early pregnancy may provide an effective first-trimester screening method for preeclampsia, but their series was small. Odibo et al [7] and Odeh et al [8] indicated that placental volume vascular indices as independent risk factors for preeclampsia had limited value, but no distinction was made between early and late preeclampsia.…”

PlGF/sFlt‑1 as Early Detection Biomarker for Preeclampsia

“…Dengan kemajuan terbaru dalam 3D USG daya Doppler, evaluasi yang lebih kuat dari vaskularisasi dan aliran darah plasenta dapat dilakukan. 25 Penelitian yang dilakukan Odeh 26 menyatakan, 3D Power Doppler dari plasenta pada trimester pertama bisa memprediksi masalah pada kehamilan tetapi tidak dapat mendeteksi perbedaan indeks aliran darah pada wanita yang mengalami PE dan volume plasenta tidak sesuai untuk memprediksi PE pada tahap awal. Blood Pressure and Mean Arterial Pressure (MAP) Perubahan kecil dalam tekanan darah adalah penanda risiko berkembangnya PE.…”

Angiographie Doppler 3D placentaire : applications actuelles et à venir

“…Une corrélation positive était confirmée entre les indices 3D et la sévérité de RCIU [45]. Au 1 er trimestre, tous les paramètres vasculaires du placenta mesurés par Doppler 3D en cas de RCIU restaient similaires avec ceux mesurés chez les témoins [39,40,46]. Une étude concernant une population ayant une concentration de protéine plasmatique placentaire de type A (PAPP-A) basse [47] retrouvait un volume placentaire significativement diminué dans cette population par rapport aux valeurs de références.…”