Placental Elasticity (KPA) Assessment by Shearwave Elastography in early detection of hypotrophic fetuses.

Abstract

Aim: To see the predictability of the shear wave elastography assessment of placental elasticity (kpa) for early detection of hypotrophic fetuses Design: Cross sectional comparative.300 single tone pregnancies previously diagnosed as normal and hypotrophic fetuses were included, the placental elasicity assessed by shear wave elastography of both groups and compared. Methods: We took biometric measurements and Doppler indicis of the uterine, umbilical, and middle cerebral arteries in both groups and screened them for grayscale and colour doppler ultrasonography. The placental elasticity was measured by Shear wave elastography in these groups .The comparison of strain ratios between these groups were done. Statistical analysis was carried out using the Mann-Whitney test. By plotting ROC curves, cut-off values for elasticity were analysed. On Shear wave elastography measurements, the sensitivity and specificity and diagnostic accuracy of hypotrophic fetuses were planned and developed. Results: The mean placental elasticity in hypotrophic fetuses and normal group was 28.71 ± 7.28 and 5.64 ± 1.53 respectively while the median placental elasticity in IUGR group was 27 ± 7 and 5.50 ± 2 with statistically higher median in hypotrophic groups, p-value < 0.001. Conclusion: In hypotrophic fetuses, as placental stiffness values are much higher, therefore for early detection of compromised hypotrophic fetuses , as a non-invasive, supplementary tool to gray-scale and Doppler, the Shear-wave elastography can be used. Keywords: Hypotrophic fetuses, Shear-wave elastography, Placental Elasticity (kpa), IUGR, Uterine artery, Umbilical artery, Middle cerebral artery, resistive index, pulsatility index,

Role of shear wave elastography in assessment of placental elasticity in normal and high-risk pregnancies in third trimester

“…Earlier, a few studies were conducted evaluating placental elasticity in separate individual high-risk factors. 5,10 The current results showed significant difference in placental SWV and kPa values of normal and high-risk pregnancies. Hafeda and Zakaria 2 showed SWV of 0.85m/s and 0.89m/s in normal pregnancies in their second and third trimester, respectively, compared to 1.42 in the current study.…”

“…4 There are limited studies available regarding placental elasticity using SWE worldwide and only 2-3 studies have been conducted in Pakistan to date. 5 SWE can aid in the detection of placental insufficiency and to increase the diagnostic accuracy of fundamental grey scale and colour Doppler ultrasounds. This can further help in improving diagnostic accuracy of ultrasonography (USG) in detecting placental insufficiency in high-risk pregnancies.…”