Systematic review on first trimester three‐dimensional placental volumetry predicting small for gestational age infants

Farina, Antonio

doi:10.1002/pd.4754

Cited by 23 publications

(24 citation statements)

References 29 publications

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“…In particular, higher first trimester maternal nutritional scores were associated with increased PAPP-A concentrations, lower UtA mean PI, and decreased placental volumes at the first trimester screening ultrasound, whereas no associations were detected with free β-HCG. The obtained measurements of placental volume were comparable with previous data and small variations could be firstly dependent on the mean gestational age at the ultrasound scan, as the placenta more than doubles its volume starting from 11 to 14 weeks [ 14 , 15 ]. The analysis on birth outcomes additionally showed a positive association between the maternal nutritional score and gestational age at birth ( p = 0.05).…”

Section: Discussionsupporting

confidence: 83%

Associations between First Trimester Maternal Nutritional Score, Early Markers of Placental Function, and Pregnancy Outcome

et al. 2020

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This study investigated the associations between maternal adherence to a healthy diet, first trimester placental markers, and pregnancy outcome. Singleton spontaneous pregnancies were enrolled at 11+0–13+6 gestational weeks in a prospective cohort study. A nutritional score (0–10) measuring the adherence to a healthy diet was calculated. A transabdominal ultrasound scan for placental marker assessment was performed (uterine artery (UtA) doppler, placental volume). Biochemical placental markers were recorded (Pregnancy Associated Plasma Protein A (PAPP-A), free β- Human Chorionic Gonadotropin (HCG)). Birth outcomes were obtained from medical records. Associations between the maternal nutritional score, first trimester placental markers, and pregnancy outcome were investigated by using multi-adjusted general linear models. In total, 112 pregnancies were enrolled with a median nutritional score of 7 (range 3–10). Median gestational age at birth was 277 days (range 203–296). The nutritional score was positively associated with PAPP-A concentrations, whereas a negative association was detected with the UtA mean pulsatility index and placental volume. A positive association was detected between nutritional score and gestational age at birth. This study demonstrates that a first trimester nutritional score as a measure of adherence to a healthy diet is significantly associated with early biochemical and ultrasound markers of placental development, with further association with gestational age at birth.

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Section: Discussionsupporting

confidence: 83%

Associations between First Trimester Maternal Nutritional Score, Early Markers of Placental Function, and Pregnancy Outcome

et al. 2020

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“…55,56 A recent systematic review of 5 studies (302/5411 pregnancies with a subsequent diagnosis of SGA) using 3-dimensional placental volume to predict SGA birth showed inadequate screening test characteristics (sensitivity 25%, specificity 90%). 57 The method has similar performance characteristics to second-trimester UtAD to screen for FGR. 58…”

Section: Placental Infarctionmentioning

confidence: 89%

A placenta clinic approach to the diagnosis and management of fetal growth restriction

Kingdom

Audette

Hobson

et al. 2018

American Journal of Obstetrics and Gynecology

128

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Effective detection and management of fetal growth restriction is relevant to all obstetric care providers. Models of best practice to care for these patients and their families continue to evolve. Since much of the disease burden in fetal growth restriction originates in the placenta, the concept of a multidisciplinary placenta clinic program, managed primarily within a maternal-fetal medicine division, has gained popularity. In this context, fetal growth restriction is merely one of many placenta-related disorders that can benefit from an interdisciplinary approach, incorporating expertise from specialist perinatal ultrasound and magnetic resonance imaging, reproductive genetics, neonatal pediatrics, internal medicine subspecialties, perinatal pathology, and nursing. The accurate diagnosis and prognosis for women with fetal growth restriction is established by comprehensive clinical review and detailed sonographic evaluation of the fetus, combined with uterine artery Doppler and morphologic assessment of the placenta. Diagnostic accuracy for placenta-mediated fetal growth restriction may be enhanced by quantification of maternal serum biomarkers including placenta growth factor alone or combined with soluble fms-like tyrosine kinase-1. Uterine artery Doppler is typically abnormal in most instances of early-onset fetal growth restriction and is associated with coexistent preeclampsia and underlying maternal vascular malperfusion pathology of the placenta. By contrast, rare but potentially more serious underlying placental diagnoses, such as massive perivillous fibrinoid deposition, chronic histiocytic intervillositis, or fetal thrombotic vasculopathy, may be associated with normal uterine artery Doppler waveforms. Despite minor variations in placental size, shape, and cord insertion, placental function remains, largely normal in the general population. Consequently, morphologic assessment of the placenta is not currently incorporated into current screening programs for placental complications. However, placental ultrasound can be diagnostic in the context of fetal growth restriction, for example in Breus' mole and triploidy, which in turn may enhance diagnosis and management. Several examples are illustrated in our figures and supplementary videos. Recent advances in the ability of multiparameter screening and intervention programs to reduce the risk of severe preeclampsia will likely increase efforts to deliver similar improvements for women at risk of fetal growth restriction. Placental pathology is important because the underlying pathologies associated with fetal growth restriction have a wide range of recurrence risks. Rare conditions such as massive perivillous fibrinoid deposition or chronic histolytic intervillositis may recur in >50% of subsequent pregnancies. Postpartum care in a placenta-focused program can provide effective counseling for modifiable maternal risk factors, and can assist in planning future pregnancy care based on the pathologic basis of fetal growth restriction.

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“…Previous studies have examined the association of first trimester PV with placental‐related pregnancy complications and have presented rather conflicting results . Plasencia et al found that PV is smaller in FGR pregnancies even after adjustment for maternal weight and fetal crown‐rump length (CRL).…”

Section: Introductionmentioning

confidence: 99%

“…3 Previous studies have examined the association of first trimester PV with placental-related pregnancy complications and have presented rather conflicting results. [4][5][6][7][8][9][10][11] Plasencia et al 5 found that PV is smaller in FGR pregnancies even after adjustment for maternal weight and fetal crown-rump length (CRL). In line with these results, two other studies confirmed an association between PV measurement at 11 to 14 gestational weeks and birth weight (BW).…”

Section: Introductionmentioning

confidence: 99%

Placental volume at 11 to 14 gestational weeks in pregnancies complicated with fetal growth restriction and preeclampsia

et al. 2018

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Systematic review on first trimester three‐dimensional placental volumetry predicting small for gestational age infants

Cited by 23 publications

References 29 publications

Associations between First Trimester Maternal Nutritional Score, Early Markers of Placental Function, and Pregnancy Outcome

Associations between First Trimester Maternal Nutritional Score, Early Markers of Placental Function, and Pregnancy Outcome

A placenta clinic approach to the diagnosis and management of fetal growth restriction

Placental volume at 11 to 14 gestational weeks in pregnancies complicated with fetal growth restriction and preeclampsia

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