Could 3D placental volume and perfusion indices measured at 11–14 weeks predict occurrence of preeclampsia in high-risk pregnant women?

Abstract

Our findings suggest that 3D placental volume measurement and 3DPD assessment of placental vascular indices in the first trimester has the potential to detect women at risk for subsequent development of PE.

Placental volume and other first-trimester outcomes: are there differences between fresh embryo transfer, frozen-thawed embryo transfer and natural conception?

“…Produced by trophoblastic cells, hCG promotes the invasion of cytotrophoblasts and supports foetal and placental growth (Cole, 2010), making consistent our finding of its correlation with PV. Increased uterine artery PI is the expression of increased vascular resistances, which corrupt endovascular trophoblastic invasion (Prefumo et al, 2004;Prefumo et al, 2007), consistently with the negative correlation between PV and PI observed in the present study and in others (Hashish et al, 2015). Overall, PV correlated with these three markers, which supports the hypothesis that PV could be a surrogate marker of trophoblastic invasiveness.…”

B‐flow/spatiotemporal image correlation M‐mode: novel ultrasound method that detects decrease in spiral artery luminal diameter in first trimester in primate model of impaired spiral artery remodeling

“…Although 3D power Doppler of the uteroplacental vascularization can identify some pregnancies at risk for pre-eclampsia [23][24][25][26][27] , its prognostic value early in gestation is limited because power gain, pulse-repetition frequency and other 3D settings compromise imaging. Other Doppler approaches, for example coherent flow power Doppler and superb microvascular imaging, have been employed to quantify placental vascularization and flow 28,29 , but the clinical utility of Doppler is compromised by 'blooming' artifacts, aliasing, signal drop-out and interference by fetal blood flow.…”

Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta

“…The advent of three-dimensional (3-D) ultrasound in the 1990s improved the accuracy with which measurements could be taken and this generated renewed research interest [23][24][25]. It has now been shown that low placental volume (PlaV) at 11-13 weeks is associated with SGA/FGR [23,[26][27][28] and pre-eclampsia [28,29], and that this is independent of PAPP-A and nuchal translucency (NT) measurements [27]. It has also been shown that the predictive accuracy for SGA can be improved by considering PlaV in combination with other known risk factors -including maternal characteristics, PAPP-A levels and placental growth factor levels [30].…”