Subscribe to RSS
Factors Associated with Placental Vascularization Measured by 3D Power Doppler Ultrasonographic Sphere Biopsy between 11 and 14 Weeks of GestationFunding The study was supported by grants from the Fetal Medicine Foundation (Charity No: 1037116).
17 December 2017
10 January 2018
19 February 2018 (online)
Objective Preeclampsia is associated with placental vascularization disorders. Ultrasonographic sphere biopsy (USSB) of the placenta can estimate the vascularization of the placenta and potentially the risk of preeclampsia. We aimed to explore the factors related to placental vascularization measured with USSB in the first trimester.
Study Design A prospective cohort was conducted in women recruited at 11 to 14 weeks. Three-dimensional acquisition of the placenta with power Doppler was undertaken along with crown-rump length (CRL). Using USSB of the full placental thickness at its center, vascularization index, flow index, and vascular flow index were measured. Pearson's correlation coefficients and multivariate linear regression were used to correlate the vascularization indices with CRL and maternal characteristics.
Results A total of 5,612 women were recruited at a mean gestational age of 12.8 ± 0.6 weeks. We observed that vascularization indices increase with CRL. After adjustment, we observed that maternal age, ethnicity other than Caucasian, and body mass index were associated with lower vascularization indices, while diabetes, smoking, and assisted reproduction technology were not. We observed that parous women without history of preeclampsia had greater vascularization indices compared with nulliparous women.
Conclusion Placental vascularization indices assessed by USSB fluctuate with gestational age, ethnicity, maternal age, body mass index, and previous pregnancy history.
- 1 World Health Organization International Collaborative Study of Hypertensive Disorders of Pregnancy. Geographic variation in the incidence of hypertension in pregnancy. Am J Obstet Gynecol 1988; 158 (01) 80-83
- 2 Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol 2009; 33 (03) 130-137
- 3 Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet 2010; 376 (9741): 631-644
- 4 Brosens I, Pijnenborg R, Vercruysse L, Romero R. The “Great Obstetrical Syndromes” are associated with disorders of deep placentation. Am J Obstet Gynecol 2011; 204 (03) 193-201
- 5 Ogge G, Chaiworapongsa T, Romero R. , et al. Placental lesions associated with maternal underperfusion are more frequent in early-onset than in late-onset preeclampsia. J Perinat Med 2011; 39 (06) 641-652
- 6 Hata T, Tanaka H, Noguchi J, Hata K. Three-dimensional ultrasound evaluation of the placenta. Placenta 2011; 32 (02) 105-115
- 7 Gebb J, Dar P. Colour Doppler ultrasound of spiral artery blood flow in the prediction of pre-eclampsia and intrauterine growth restriction. Best Pract Res Clin Obstet Gynaecol 2011; 25 (03) 355-366
- 8 Effendi M, Demers S, Giguère Y. , et al. Association between first-trimester placental volume and birth weight. Placenta 2014; 35 (02) 99-102
- 9 Hafner E, Metzenbauer M, Stümpflen I, Waldhör T, Philipp K. First trimester placental and myometrial blood perfusion measured by 3D power Doppler in normal and unfavourable outcome pregnancies. Placenta 2010; 31 (09) 756-763
- 10 Hafner E, Metzenbauer M, Stümpflen I, Waldhör T. Measurement of placental bed vascularization in the first trimester, using 3D-power-Doppler, for the detection of pregnancies at-risk for fetal and maternal complications. Placenta 2013; 34 (10) 892-898
- 11 Dar P, Gebb J, Reimers L, Bernstein PS, Chazotte C, Merkatz IR. First-trimester 3-dimensional power Doppler of the uteroplacental circulation space: a potential screening method for preeclampsia. Am J Obstet Gynecol 2010; 203 (03) 238.e1-238.e7
- 12 Markey S, Demers S, Girard M, Tétu A, Gouin K, Bujold E. Reliability of first-trimester ultrasonic biopsy for the evaluation of placental and myometrial blood perfusion and the prediction of preeclampsia. J Obstet Gynaecol Can 2016; 38 (11) 1003-1008
- 13 Snijders RJ, Noble P, Sebire N, Souka A, Nicolaides KH. ; Fetal Medicine Foundation First Trimester Screening Group. UK multicentre project on assessment of risk of trisomy 21 by maternal age and fetal nuchal-translucency thickness at 10-14 weeks of gestation. Lancet 1998; 352 (9125): 343-346
- 14 Pomorski M, Zimmer M, Fuchs T. , et al. Quantitative assessment of placental vasculature and placental volume in normal pregnancies with the use of 3D Power Doppler. Adv Med Sci 2014; 59 (01) 23-27
- 15 Gonzalez Gonzalez NL, Gonzalez Davila E, Castro A, Padron E, Plasencia W. Effect of pregestational diabetes mellitus on first trimester placental characteristics: three-dimensional placental volume and power Doppler indices. Placenta 2014; 35 (03) 147-151
- 16 Rizzo G, Capponi A, Pietrolucci ME, Aiello E, Arduini D. First trimester placental volume and three dimensional power Doppler ultrasonography in type I diabetic pregnancies. Prenat Diagn 2012; 32 (05) 480-484
- 17 Persson M, Cnattingius S, Wikström AK, Johansson S. Maternal overweight and obesity and risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes. Diabetologia 2016; 59 (10) 2099-2105
- 18 Moran M, Mulcahy C, Daly L, Zombori G, Downey P, McAuliffe FM. Novel placental ultrasound assessment: potential role in pre-gestational diabetic pregnancy. Placenta 2014; 35 (08) 639-644
- 19 Rizzo G, Capponi A, Pietrolucci ME, Arduini D. Effects of maternal cigarette smoking on placental volume and vascularization measured by 3-dimensional power Doppler ultrasonography at 11+0 to 13+6 weeks of gestation. Am J Obstet Gynecol 2009; 200 (04) 415.e1-415.e5
- 20 Vachon-Marceau C, Demers S, Markey S. , et al. First-trimester placental thickness and the risk of preeclampsia or SGA. Placenta 2017; 57: 123-128