Estimated Placental Volume and Gestational Age

Abstract

Objective The objective of this study was to validate estimated placental volume (EPV) across a range of gestational ages (GAs).

Study Design Three hundred sixty-six patients from 2009 to 2011 received ultrasound scans between 11 + 0 and 38 + 6 weeks GA to assess EPV. An EPV versus GA best fit curve was generated and compared with published normative curves of EPV versus GA in a different population. A subanalysis was performed to explore the relationship between EPV and birth weight (BW).

Results Analysis of EPV versus GA revealed a parabolic curve with the following best fit equation: EPV = (0.372 GA − 0.00364 GA²)³. EPV was weakly correlated with BW, and patients with an EPV in the bottom 50th percentile had 2.42 times the odds of having a newborn with a BW in the bottom 50th percentile (95% confidence interval: 1.27–4.68). Microscopic evaluation of two placentas corresponding to the smallest EPV outliers revealed significant placental pathology.

Conclusion Placental volume increases throughout gestation and follows a predictable parabolic curve, in agreement with the existing literature. Further validation is required, but EPV may have the potential for clinical utility as a screening tool in a variety of settings.

Keywords

placenta - volume - ultrasound - birth weight

• References

• 1 Thame M, Osmond C, Wilks R, Bennett FI, Forrester TE. Second-trimester placental volume and infant size at birth. Obstet Gynecol 2001; 98 (02) 279-283
• 2 Arleo EK, Troiano RN, da Silva R, Greenbaum D, Kliman HJ. Utilizing two-dimensional ultrasound to develop normative curves for estimated placental volume. Am J Perinatol 2014; 31 (08) 683-688
• 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 (06) 652-657
• 4 Harkness UF, Mari G. Diagnosis and management of intrauterine growth restriction. Clin Perinatol 2004; 31 (04) 743-764
• 5 Gilbert WM, Danielsen B. Pregnancy outcomes associated with intrauterine growth restriction. Am J Obstet Gynecol 2003; 188 (06) 1596-1599 , discussion 1599–1601
• 6 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 (03) 240-242
• 7 Baschat AA, Harman CR. Antenatal assessment of the growth restricted fetus. Curr Opin Obstet Gynecol 2001; 13 (02) 161-168
• 8 Wolf H, Oosting H, Treffers PE. A longitudinal study of the relationship between placental and fetal growth as measured by ultrasonography. Am J Obstet Gynecol 1989; 161 (05) 1140-1145
• 9 Hayslett JP. Functional adaptation to reduction in renal mass. Physiol Rev 1979; 59 (01) 137-164
• 10 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 (02) 151-155
• 11 Abramowicz JS, Sheiner E. In utero imaging of the placenta: importance for diseases of pregnancy. Placenta 2007; 28 (Suppl A): S14-S22
• 12 Gowland P. Placental MRI. Semin Fetal Neonatal Med 2005; 10 (05) 485-490
• 13 Kubik-Huch RA, Wildermuth S, Cettuzzi L. , et al. Fetus and uteroplacental unit: fast MR imaging with three-dimensional reconstruction and volumetry--feasibility study. Radiology 2001; 219 (02) 567-573
• 14 Burton GJ, Woods AW, Jauniaux E, Kingdom JC. Rheological and physiological consequences of conversion of the maternal spiral arteries for uteroplacental blood flow during human pregnancy. Placenta 2009; 30 (06) 473-482
• 15 Duncan KR, Sahota DS, Gowland PA. , et al. Multilevel modeling of fetal and placental growth using echo-planar magnetic resonance imaging. J Soc Gynecol Investig 2001; 8 (05) 285-290