Utilizing Two-Dimensional Ultrasound to Develop Normative Curves for Estimated Placental Volume

Abstract

Objective The objective of this study was to use two-dimensional (2D) ultrasound (US) during routine prenatal surveillance to develop normative estimated placental volume (EPV) growth curves.

Study Design Patients ≥ 18 years old with singleton pregnancies were prospectively followed from 11 weeks gestational age (GA) until delivery. At routine US visits, placental width, height, and thickness were measured and EPV calculated using a validated mathematical model.

Results In this study, 423 patients were scanned between 9.7 and 39.3 weeks GA to generate a total of 627 EPV calculations. Readings were clustered at 12 and 20 weeks, times of routine scanning. The mean EPV was 73 ± 47 cc at 12.5 ± 1.5 weeks (n = 444) and 276 ± 106 cc at 20 ± 2 weeks (n = 151). The data best fit a parabolic function as follows: EPV = (0.384GA – 0.00366GA²)³. Tenth and 90th percentile lines were generated with ± 1.28 SE offset. EPV readings below the 10th or above the 90th percentiles tended to be associated with either small or large newborns, respectively.

Conclusion Routine 2D US created EPV growth curves, which may be useful for stratifying patients into prenatal risk groups.

Keywords

placenta - EPV - prenatal care

• References

• 1 Azpurua H, Funai EF, Coraluzzi LM , et al. Determination of placental weight using two-dimensional sonography and volumetric mathematic modeling. Am J Perinatol 2010; 27 (2) 151-155
• 2 Kinare AS, Natekar AS, Chinchwadkar MC , et al. Low midpregnancy placental volume in rural Indian women: A cause for low birth weight?. Am J Obstet Gynecol 2000; 182 (2) 443-448
• 3 Hafner E, Metzenbauer M, Höfinger D , et al. Comparison between three-dimensional placental volume at 12 weeks and uterine artery impedance/notching at 22 weeks in screening for pregnancy-induced hypertension, pre-eclampsia and fetal growth restriction in a low-risk population. Ultrasound Obstet Gynecol 2006; 27 (6) 652-657
• 4 Metzenbauer M, Hafner E, Schuchter K, Philipp K. First-trimester placental volume as a marker for chromosomal anomalies: preliminary results from an unselected population. Ultrasound Obstet Gynecol 2002; 19 (3) 240-242
• 5 Elchalal U, Ezra Y, Levi Y , et al. Sonographically thick placenta: a marker for increased perinatal risk—a prospective cross-sectional study. Placenta 2000; 21 (2–3) 268-272
• 6 Baschat AA, Harman CR. Antenatal assessment of the growth restricted fetus. Curr Opin Obstet Gynecol 2001; 13 (2) 161-168
• 7 Harkness UF, Mari G. Diagnosis and management of intrauterine growth restriction. Clin Perinatol 2004; 31 (4) 743-764 , vi
• 8 Gilbert WM, Danielsen B. Pregnancy outcomes associated with intrauterine growth restriction. Am J Obstet Gynecol 2003; 188 (6) 1596-1599 , discussion 1599–1601
• 9 Center for Disease Control (CDC) Pediatric Growth Charts. Available at: http://www.cdc.gov/growthcharts/ . Accessed April 3, 2013
• 10 Figueras F, Eixarch E, Gratacos E, Gardosi J. Predictiveness of antenatal umbilical artery Doppler for adverse pregnancy outcome in small-for-gestational-age babies according to customised birthweight centiles: population-based study. BJOG 2008; 115 (5) 590-594
• 11 Almog B, Shehata F, Aljabri S, Levin I, Shalom-Paz E, Shrim A. Placenta weight percentile curves for singleton and twins deliveries. Placenta 2011; 32 (1) 58-62
• 12 Thompson JM, Irgens LM, Skjaerven R, Rasmussen S. Placenta weight percentile curves for singleton deliveries. BJOG 2007; 114 (6) 715-720
• 13 Collins SL, Stevenson GN, Noble JA, Impey L. Rapid calculation of standardized placental volume at 11 to 13 weeks and the prediction of small for gestational age babies. Ultrasound Med Biol 2013; 39 (2) 253-260
• 14 Pomorski M, Zimmer M, Florjanski J , et al. Comparative analysis of placental vasculature and placental volume in normal and IUGR pregnancies with the use of three-dimensional Power Doppler. Arch Gynecol Obstet 2012; 285 (2) 331-337