First trimester placental volume is reduced in hypertensive disorders of pregnancy associated with small for gestational age fetus

Stampalija, Tamara; Quadrifoglio, Mariachiara; Casati, D.; Zullino, Sara; Maggi, Valeria; Martino, Daniela Di; Rosti, E.; Mastroianni, C.; Signorelli, V.; Ferrazzi, E.

doi:10.1080/14767058.2019.1636026

Cited by 6 publications

(4 citation statements)

References 43 publications

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“…Previous studies investigated the role of 3DPD for early detection of impaired placental vasculature and volume together with the u PI and others added some serum markers a PAPP A but conflicting results were found [16,17,18] . In line with our findings, some studies found that firsttrimester placental volume is strongly associated with fetal growth and placental growth and observed a correlation between placental volume and the risk of preeclampsia and IUGR [19,20,21] . Other studies detected no significantly placental vascular indices in complicated pregnancy.…”

Section: Discussionsupporting

confidence: 91%

US Doppler and Power Doppler Prediction of Recurrent Fetal Growth Restriction. Prospective Cohort Study

Souidan

Salam

2022

Evidence Based Women's Health Journal

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Background: Intrauterine growth restriction(IUGR) has been defined as the rate of fetal growth that is below normal in light of the growth potential of a specific infant as per the race and gender of the fetus. A woman with a prior pregnancy complicated by IUGR has nearly a 20% risk of recurrence. Defects in placental vascular development can cause embryonic death, can negatively affect fetal growth and can confer a higher risk of disease in the postnatal life. Objective: study aimed to assess the role of first trimester uterine artery Doppler pulsatility index, placental volume and placental vascularization assessed in prediction of recurrence of third trimester intrauterine growth restriction. Methods: In this Prospective longitudinal observational study,two hundred pregnant women with singleton pregnancy from 11 up to 13 weeks with history of intrauterine growth restriction in a previous pregnancy underwent ultrasound assessment of gestational age, ultrasound assessment of uterine artery pulsatility index, placental volume by 3D ultrasound and placental vascularization by 3D power Doppler (3DPD). Results: Placental volume, vascularization index, flow index(F.I), vascularization flow index, and Uterine artery pulsatility index were significantly lower in IUGR with PET(pre eclampatic toxemia) group and IUGRgroup versus normal group, (p-value<0.001).Further, placental volume and F.I were significantly lower in IUGR and PET group compared to IUGR only group. Conclusions: The 1st trimester placental volume, uterine artery Doppler, and, placental vascular indices are useful parameters for prediction of recurrence of IUGR.

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Section: Discussionsupporting

confidence: 91%

US Doppler and Power Doppler Prediction of Recurrent Fetal Growth Restriction. Prospective Cohort Study

Souidan

Salam

2022

Evidence Based Women's Health Journal

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“…In support of the correlation between neonatal weight and placental weight at birth, Ouyang et al ( 22 ) confirmed that the percentile of placental weight at delivery could be used to determine the cause of fetal intrauterine growth restriction. In support of our findings on the association between eventual placental volume and neonatal weight at birth, reduced placental volume as early as the first trimester has been demonstrated in hypertensive disorders of pregnancy associated with SGA fetuses ( 13 ). Furthermore, placental volume less than the 10th percentile in the first trimester could be a useful predictor for SGA neonates ( 23 ).…”

Section: Discussionsupporting

confidence: 89%

“…SGA is defined when a newborn's birth weight is less than two standard deviations or below the 10th percentile of the mean for GA based on defined standards (local birth weight standards) for males and females (12)(13)(14). Preterm birth is commonly defined as live birth occurring before the 37th week of pregnancy (14).…”

Section: Study Design and Populationmentioning

confidence: 99%

Placental morphological features of small for gestational age preterm neonates born to mothers with pregnancy-induced hypertension

Zhang,

Zeng

2023

Front. Pediatr.

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IntroductionSmall for gestational age (SGA) neonates are often born to mothers with pregnancy-induced hypertension (PIH). Here, we aimed to explore the morphometric characteristics of the placenta during the perinatal period associated with SGA risk in mothers with PIH and identify the risk factors related to SGA.MethodsThe medical records of 134 neonates born between 28- and 32-weeks’ gestation to PIH mothers were retrospectively analyzed. Placental morphology and umbilical cord (UC) length were compared between the SGA and appropriate for gestational age (AGA) groups.ResultsThe placenta of the SGA group had a shorter major (15.00 vs. 18.00 cm; z = −6.04, p < 0.01) and minor placenta axes (13.00 vs. 15.00 cm; z = −4.59, p < 0.01), lower weight (300.00 vs. 420.00 g; z = −7.21, p < 0.01), smaller volume (282.00 vs. 396.00 cm3; z = −5.00, p < 0.01), and smaller area (141.00 vs. 212.00 cm2; z = −5.96, p < 0.01) than the AGA group. The UC was significantly shorter (39.00 vs. 44.00 cm; z = −3.68, p < 0.01). Short placental major axis [p = 0.03; odds ratio (OR): 2.16; 95% confidence interval (CI): 1.84 − 2.63] and low placental weight (p < 0.01; OR: 2.68; 95% CI: 2.66 − 2.70) were independent risk factors for SGA in premature newborns of PIH mothers.DiscussionA major axis shorter than 15.5 cm or placental weight lower than 347.50 g at birth was related to a greater risk of SGA infants born to PIH mothers. As a predictor in prenatal ultrasound, the major axis is more helpful for precise prenatal pre-evaluation of vulnerable SGA preterm neonates with PIH mothers.

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“…The 2018 guidelines for the classification, diagnosis, and management of HDP issued by the International Society for the Study of Hypertension in Pregnancy classify HDP as hypertension in pregnancy and preeclampsia [ 5 ]. HDP contributes to maternal cardiac damage and predisposes to impaired placental circulation and symptoms of ischemia and hypoxia [ 6 ], leading to abnormal fetal cardiac function and fetal growth restriction [ 7 , 8 ]. Medical ultrasonography is an ultrasound-based diagnostic medical imaging technique that enables the visualization of muscles and internal organs, including their size, structure, and pathological lesions [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Multiparametric Assessment of the Impact of Hypertensive Disorders of Pregnancy on Fetal Cardiac Function and Growth and Development

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective.To evaluate the ultrasound multiparametric assessment of the impact of hypertensive disorders of pregnancy (HDP) on fetal cardiac function and growth and development. Methods. In this prospective study, 98 cases of HDP treated in our institution were recruited into a study group, and 100 pregnant women with healthy singleton pregnancies were included in a control group. All eligible patients were also assigned to either study group A (HDP fetuses with growth restriction) or study group B (HDP fetuses with normal growth). Fetal echocardiography was performed on all eligible participants to obtain hemodynamic and cardiac function parameters for the evaluation of fetal growth and development, and the impact of HDP on fetal heart function and growth and development was analyzed. Results. HDP fetuses were associated with smaller head circumference, biparietal diameter, femoral length, and abdominal circumference versus healthy fetuses. The study group had a higher resistance index (RI) and pulsatility index (PI) of umbilical artery (UA), ductus venous (DV), pulmonary vein (PV), and lower RI and PI of aortic isthmus (AoI) than the control group. The study group showed higher left and right ventricular isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT), and myocardial performance index (MPI) values and lower mitral and tricuspid E wave and E/A values than the control group. The systolic blood pressure was positively correlated with PI, RI of UA, DV, and PV, and left and right ventricular IVCT, IVRT, and MPI and negatively correlated with PI and RI of AoI and mitral and tricuspid E wave and E/A values of HDP fetuses. The peak systolic/diastolic flow rate (S/D), PI, and RI of umbilical blood flow in study group A were higher than those in study group B. Umbilical blood flow S/D showed the highest AUC and specificity for predicting fetal growth restriction, and PI had the highest sensitivity for predicting fetal growth restriction. Conclusion. HDP compromises fetal cardiac function and growth, and ultrasound multiparametric assessment provides accurate detection of fetal cardiac function and hemodynamics changes. The patient’s condition can be monitored through the assessment of ultrasound parameters of fetal growth and development.

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First trimester placental volume is reduced in hypertensive disorders of pregnancy associated with small for gestational age fetus

Cited by 6 publications

References 43 publications

US Doppler and Power Doppler Prediction of Recurrent Fetal Growth Restriction. Prospective Cohort Study

US Doppler and Power Doppler Prediction of Recurrent Fetal Growth Restriction. Prospective Cohort Study

Placental morphological features of small for gestational age preterm neonates born to mothers with pregnancy-induced hypertension

Ultrasound Multiparametric Assessment of the Impact of Hypertensive Disorders of Pregnancy on Fetal Cardiac Function and Growth and Development

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