Placental Volumes Measured by 3-Dimensional Ultrasonography in Normal Pregnancies From 12 to 40 Weeks' Gestation

Paula, Carla Fagundes Silva de; Ruano, Rodrigo; Campos, Juliana Álvares Duarte Bonini; Zugaib, Marcelo

doi:10.7863/jum.2008.27.11.1583

Cited by 53 publications

(61 citation statements)

References 21 publications

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“…A significant contribution of "missed tissue" to the suboptimal reliability of third trimester measures may also be inferred as, using the same technique, (and without extrapolation) other researchers have reported much higher intra-and inter-observer ICCs!0.88 using VOCAL est PV in the first and second trimesters [29,30,37], and between 12 and 40 weeks gestation (majority of measurements obtained <28 weeks gestation) [26] than those demonstrated in this third trimester study. However, other researchers employing robust methodologies have also demonstrated similar reliability (ICC 0.59 with wide limits of agreement) using this technique even in the first trimester [38].…”

Section: Discussionsupporting

confidence: 55%

Third trimester placental volume and biometry measurement: A method-development study

et al. 2016

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a b s t r a c tObjectives: To test the hypothesis that third trimester placental biometry and volume can be measured by two-dimensional (2D) and three-dimensional (3D) ultrasound in utero, determining which method of measurement was most strongly correlated with true placental size ex vivo. Methods: Singleton pregnancies underwent placental ultrasound within seven days of delivery (n ¼ 87, 29 þ3 e41 þ5 weeks). Length and width (linear and curvilinear) and depth were estimated. Placental volume (PV) was estimated using 2D ellipse and shell techniques and 3D rotational (15⁰ and 30⁰ rotation angles) and multiplanar (5 and 10 mm slicing intervals) techniques. Measurements were compared to their true correlates following delivery. Intra-and inter-observer reliabilities of candidate placental size estimates were assessed by intraclass correlation coefficient (ICC). Results: Curvilinear placental length (R s ¼ 0.24, p ¼ 0.031), width (R s ¼ 0.27, p ¼ 0.013) and depth (R s ¼ 0.31, p ¼ 0.0056) correlated well with ex vivo measurements. All methods of PV estimation were related to ex vivo volume (R s ! 0.32, p < 0.01) but not placental weight (p > 0.05); 30 rotational estimation demonstrated the strongest biological correlation (R s ¼ 0.40, p ¼ 0.0004). Intra-and interobserver placental size measurements intraclass correlation coefficients were suboptimal (0.59e0.70 and 0.10e0.58 respectively). Discussion: We have demonstrated that it is possible to obtain information about the size of the third trimester placenta in utero using 2D and 3D ultrasound. However it is essential that the reliability (particularly interobserver reliability) of these estimates is improved prior to prospective studies to determine their predictive value.

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Section: Discussionsupporting

confidence: 55%

Third trimester placental volume and biometry measurement: A method-development study

et al. 2016

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“…Although the human placenta is classified as a discoidal organ [15] placental shape varies between individuals. The shape of an average 'normal' placenta at term has been described as close to circular in cross section, or having an ellipsoidal shape [12,16], and placental volumes estimated in vivo at term are approximately 428 cm 3 [17].…”

Section: Introductionmentioning

confidence: 99%

Multiscale modelling of the feto–placental vasculature

et al. 2015

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One contribution of 11 to a theme issue 'Multiscale modelling in biomechanics: theoretical, computational and translational challenges'. The placenta provides all the nutrients required for the fetus through pregnancy. It develops dynamically, and, to avoid rejection of the fetus, there is no mixing of fetal and maternal blood; rather, the branched placental villi 'bathe' in blood supplied from the uterine arteries. Within the villi, the feto-placental vasculature also develops a complex branching structure in order to maximize exchange between the placental and maternal circulations. To understand the development of the placenta, we must translate functional information across spatial scales including the interaction between macro-and micro-scale haemodynamics and account for the effects of a dynamically and rapidly changing structure through the time course of pregnancy. Here, we present steps towards an anatomically based and multiscale approach to modelling the feto-placental circulation. We assess the effect of the location of cord insertion on feto-placental blood flow resistance and flow heterogeneity and show that, although cord insertion does not appear to directly influence feto-placental resistance, the heterogeneity of flow in the placenta is predicted to increase from a 19.4% coefficient of variation with central cord insertion to 23.3% when the cord is inserted 2 cm from the edge of the placenta. Model geometries with spheroidal and ellipsoidal shapes, but the same volume, showed no significant differences in flow resistance or heterogeneity, implying that normal asymmetry in shape does not affect placental efficiency. However, the size and number of small capillary vessels is predicted to have a large effect on feto-placental resistance and flow heterogeneity. Using this new model as an example, we highlight the importance of taking an integrated multi-disciplinary and multiscale approach to understand development of the placenta.

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“…Объем плаценты служит одним из важных диагностических критериев, опреде-ляемых во время беременности исключительно при помощи ультразвукового исследования [17]. Гипоплазия плаценты может быть обусловлена развитием тяжелых генетических отклонений у плода или ПЭ.…”

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Features of pregnancy with gestational diabetes mellitus and prediction of diabetic fetopathy

et al. 2017

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Gestational diabetes mellitus (GDM) and its consequences for the mother and child represent a serious not only medical, but also an economic problem. The urgency of studying this problem also lies in the fact that the number of pregnant women suffering from this disease is progressively increasing. The aim of the study was to study the risk factors and features of the course of pregnancy and childbirth in women with gestational diabetes mellitus, as well as to improve methods for diagnosing and predicting the development of diabetic fetopathy (DF). The work was carried out in 3 stages: 1 — prospective study of the course of pregnancy and childbirth in 104 women with GDM and in 50 pregnant women without GDM (control group); 2 — determination in the peripheral blood of the pregnant women of both groups of the level of glycemia, C-peptide, insulin, calculation of the insulin resistance index (HOMA-IR) with an assessment of the prognostic significance of these markers in the development of diabetic fetopathy; 3 — prediction of the development of diabetic fetopathy using a mathematical model that includes risk factors, the results of laboratory and instrumental research methods for this pathology. It was found that the violation of carbohydrate metabolism during pregnancy promotes the development of a large number of obstetric complications and in 36.5% of cases leads to the birth of children with diabetic fetopathy, which is manifested to a greater degree by macrosomia (30%), which increases the risk of perinatal complications and worsens the course of the period newborn in the future. An increase in the level of C-peptide was diagnosed in 87% of pregnant women with gestational diabetes, and an increase in the insulin resistance index in 93%, in contrast to the control group, where these indicators were 4 and 6%, respectively (p < 0.05). Using discriminant analysis, it was determined that the threshold for predicting the development of DF should be considered an increase in HOMA-IR above 7 with a confidence of 73%, but the level of C- peptide does not have a predictive value. The mathematical model, including risk factors, data of laboratory and instrumental methods for studying carbohydrate metabolism in the mother and fetus, created using regression analysis, reflects the probability of development of diabetic fetopathy in pregnant women with gestational diabetes with an accuracy of 91.4%, which will help to prevent this complication in at an earlier stage through insulin therapy.

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Placental Volumes Measured by 3-Dimensional Ultrasonography in Normal Pregnancies From 12 to 40 Weeks' Gestation

Abstract: Nomograms of placental volumes according to gestational age and estimated fetal weight were constructed, generating reference values.

Cited by 53 publications

References 21 publications

Third trimester placental volume and biometry measurement: A method-development study

Third trimester placental volume and biometry measurement: A method-development study

Multiscale modelling of the feto–placental vasculature

Features of pregnancy with gestational diabetes mellitus and prediction of diabetic fetopathy

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