Intervillous and uteroplacental circulation in normal early pregnancy and early pregnancy loss assessed by 3-dimensional power Doppler angiography

Mercé, Luis T.; Barco, María J.; Alcázar, Juan Luis; Sabatel, Rosa; Troyano, J. M.

doi:10.1016/j.ajog.2008.10.020

Cited by 63 publications

(37 citation statements)

References 31 publications

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“…In the present study, some FI measurement presented values above 100, which contradicts the definition of such index (6) . The majority of the studies on 3D power Doppler have evaluated the placental vascularization at the first (6,22) as well as at the second and third gestational trimesters (14,19,23) , observing that the FI values were within the normal variation range between 0 and 100.…”

Section: Discussioncontrasting

confidence: 99%

“…The majority of the studies on 3D power Doppler have evaluated the placental vascularization at the first (6,22) as well as at the second and third gestational trimesters (14,19,23) , observing that the FI values were within the normal variation range between 0 and 100. In previous studies the authors of the present study evaluated the vascularization in other structures such as the region of the middle cerebral artery of the fetus (24) and the embryo itself (3) , observing that for these structures the maximum values of FI were above 100.…”

Section: Discussionmentioning

confidence: 99%

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Reprodutibilidade interobservador dos índices vasculares do Doppler de amplitude tridimensional do embrião entre 7 e 10 semanas e 6 dias de gestação

et al. 2010

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OBJETIVO: Avaliar a reprodutibilidade interobservador dos índices de vascularização do Doppler de amplitude tridimensional (Doppler de amplitude 3D) no primeiro trimestre de gestação. MATERIAIS E MÉTODOS: Realizou-se estudo de reprodutibilidade com 32 gestantes normais entre 7 e 10 semanas e 6 dias. Para o cálculo do volume tridimensional dos embriões utilizou-se o método VOCAL (Virtual Organ Computer-aided AnaLysis) com ângulo de rotação de 12°. Em seguida obtiveram-se, automaticamente, os três índices vasculares do Doppler de amplitude 3D: índice de vascularização (VI), índice de fluxo (FI) e índice de vascularização e fluxo (VFI). Para o cálculo da variabilidade interobservador, um examinador realizou uma segunda medida dos 32 embriões e um segundo examinador realizou uma terceira medida dos mesmos volumes, ambos desconhecendo os resultados do outro. Utilizaram-se, para análise estatística, o coeficiente de correlação intraclasse (CCI) e gráficos de Bland-Altman. RESULTADOS: Observou-se boa reprodutibilidade interobservador dos três índices vasculares. O VI apresentou CCI = 0,9 e média da diferença = -1,1; o FI apresentou CCI = 0,9 e média da diferença = -0,5; e o VFI apresentou CCI = 0,9 e média da diferença = -1,1. CONCLUSÃO: Os índices vasculares do Doppler de amplitude 3D do embrião no primeiro trimestre de gestação foram altamente reprodutíveis, em especial o FI.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reprodutibilidade interobservador dos índices vasculares do Doppler de amplitude tridimensional do embrião entre 7 e 10 semanas e 6 dias de gestação

et al. 2010

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“…Parameters examined have included the heart rate, sac size and volume, yolk sac dimensions, hematoma size, and blood flow characteristics. [8][9][10][11][12][13] Although the clinical implications of these findings are useful in predicting which pregnancies with heartbeats present are likely to fail, they have not addressed the possible structural etiologies associated with embryonic death. Unfortunately, when the embryonic heartbeat ceases, the 2D sonographic texture of the embryo becomes more homogeneous, with a faded ground glass appearance that makes it impossible to identify anatomic landmarks.…”

Section: Discussionmentioning

confidence: 99%

Structural Anomalies in Early Embryonic Death

Bromley

Shipp

Benacerraf

2010

Journal of Ultrasound in Medicine

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Objective. The purpose of this pictorial essay was to determine whether 3-dimensional (3D) surface rendering of a dead first-trimester embryo can provide any information for the loss. Methods. Threedimensional surface rendering was performed on a collection of dead first-trimester embryos with crown-rump lengths between 12 and 27 mm. These were compared with 2-dimensional (2D) images of the same embryos and with 2D images and 3D surface renderings of normally developing embryos. Results. Surface rendering of dead embryos showed a variety of abnormalities in the contour and limb formation. Conclusions. The use of 3D sonography may provide insight into the etiology of firsttrimester embryonic death. Key words: embryonic death; malformation; 3-dimensional sonography. The risk of spontaneous abortion increases with advancing maternal age from 20% at age 35 years to 40% by age 40 years.3 Chromosomal abnormalities account for approximately 50% of all early pregnancy losses, the risk being highest at the earliest gestational ages.4 Structural abnormalities are reported in 16.5% of spontaneously aborted embryos and fetuses examined pathologically at less than 13 weeks' gestation.5 In many patients, no etiology for the pregnancy loss is ever determined. The criteria for identifying an early pregnancy failure have been clearly delineated.7 Often pregnancy losses occur at an early gestational age when the gestational sac is identified but no embryo is seen. The remaining losses are identified when there is an embryonic pole of 5 mm or longer without any cardiac activity. In the event that an embryo is identified, it may be possible to visualize structural abnormalities that potentially could provide insight as to the etiology of the death.

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“…Our group has previously detected differences between normal and pathological placentas in terms of vascular density and blood flow [13] but it was difficult to compare the images because they were limited to a particular area.…”

Section: Introductionmentioning

confidence: 99%

Placental virtual biopsy: 3D-US hemodynamics of normal pregnancy versus gestational diabetes

Troyano-Luque

Ferrer-Roca

Barco-Marcellán

et al. 2013

JBGC

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Objectives: We used three-dimensional ultrasound with trans-abdominal Power-Doppler (3D-US PD) to determine placental vascular evolution in normal pregnancies (NP) and in insulin-dependent Gestational Diabetes Pregnancies (GDP). Study design:We obtained 473 measurements from 43 NP at 20 weeks-40 weeks gestation and 122 measurements from 70 insulin-dependent GDP at 22 weeks-40 weeks. Standardization was achieved recording three successive placental vascular tree volumes, measuring the spherical volume between the chorionic and basal plates always under or near funicular insertion. Parameters analysed were: mean intensity of blood flow (Flow Index, FI); percentage of volume occupied by vessels (Vascularisation Index, VI); and intensity of blood flow in the volume occupied by vessels (Vascularisation-flow index, VFI). Results:In NP, FI increased throughout early pregnancy and decreased before delivery and correlated with fetal parameters. In contrast, in GDP, FI was high from the onset, better correlated with placental parameters, and had a diagnostic cutoff value of 45, which was only found in 7% of NP at the end of the pregnancy. VI was variable and had a low diagnostic value, being related to placental parameters; VI values were significantly lower in NP (17.4 ± 7.4%) than in GDP (21 ± 12%) with a diagnostic cutoff point at 31%. In NP, FI-peak was at 32 weeks, two weeks after the VI-peak, while VFI showed no significant differences. Conclusions:The results showed that placental blood flow (FI) was related to fetal circulation, while the percentage of vessels per volume (VI) was related to maternal circulation. 3D-US PD indicated a diagnosis of GDP for FI > 45 and VI > 30%. We also discuss the values of change in VI that predict changes in fetal FI.

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Intervillous and uteroplacental circulation in normal early pregnancy and early pregnancy loss assessed by 3-dimensional power Doppler angiography

Cited by 63 publications

References 31 publications

Reprodutibilidade interobservador dos índices vasculares do Doppler de amplitude tridimensional do embrião entre 7 e 10 semanas e 6 dias de gestação

Reprodutibilidade interobservador dos índices vasculares do Doppler de amplitude tridimensional do embrião entre 7 e 10 semanas e 6 dias de gestação

Structural Anomalies in Early Embryonic Death

Placental virtual biopsy: 3D-US hemodynamics of normal pregnancy versus gestational diabetes

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