Ultrasound evaluation of the placenta in healthy and placental syndrome pregnancies: A systematic review

Schiffer, V.; Haren, Ashlee van; Cubber, Lisa De; Bons, J; Coumans, A.; Kuijk, Sander MJ van; Spaanderman, M.E.A.; Al‐Nasiry, Salwan

doi:10.1016/j.ejogrb.2021.04.042

Cited by 24 publications

(16 citation statements)

References 52 publications

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“…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 ]. Ultrasound is a commonly used obstetric test to identify structural and functional abnormalities of the fetal heart and facilitates the assessment of the effects of HDP on fetal cardiac function [ 11 , 12 ]. This study was to evaluate the ultrasound multiparametric assessment of the impact of HDP on fetal cardiac function and growth and development.…”

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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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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“…While several studies concentrated on ultrasound findings and correlated the amount of calcifications to the outcome of the pregnancy ( 20 , 22 ) and drew a connection to increased stillbirth if the calcifications were seen before the 36th gestational week ( 20 ), these results cannot be compared to our study as they concentrate on calcifications in general and not in preeclampsia in particular. A recent review again showed associations between Grannum 3 calcifications and PE ( 52 ). Although the numbers of examined placentae in the reviewed studies is higher compared to this work, their results are based exclusively on the Grannum classification, which is known to have severe limitations, including observer bias ( 53 ).…”

Section: Discussionmentioning

confidence: 95%

The Role of Inorganics in Preeclampsia Assessed by Multiscale Multimodal Characterization of Placentae

et al. 2022

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Preeclampsia is one of the most dangerous diseases in pregnancy. Because of the hypertensive nature of preeclampsia, placental calcifications are believed to be a predictor for its occurrence, analogous to their role in cardiovascular diseases. However, the prevalence and the relevance of calcifications for the clinical outcome with respect to preeclampsia remains controversial. In addition, the role of other inorganic components present in the placental tissue in the development of preeclampsia has rarely been investigated. In this work, we therefore characterized inorganic constituents in placental tissue in groups of both normotensive and preeclamptic patients (N = 20 each) using a multi-scale and multi-modal approach. Examinations included elemental analysis (metallomics), sonography, computed tomography (CT), histology, scanning electron microscopy, X-ray fluorescence and energy dispersive X-ray spectroscopy. Our data show that tissue contents of several heavy metals (Al, Cd, Ni, Co, Mn, Pb, and As) were elevated whereas the Rb content was decreased in preeclamptic compared to normotensive placentae. However, the median mineral content (Ca, P, Mg, Na, K) was remarkably comparable between the two groups and CT showed lower calcified volumes and fewer crystalline deposits in preeclamptic placentae. Electron microscopy investigations revealed four distinct types of calcifications, all predominantly composed of calcium, phosphorus and oxygen with variable contents of magnesium in tissues of both maternal and fetal origin in both preeclamptic and normotensive placentae. In conclusion our study suggests that heavy metals, combined with other factors, can be associated with the development of preeclampsia, however, with no obvious correlation between calcifications and preeclampsia.

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“…A reviewer (J.dN.T. ), blinded for the subjects' clinical outcome, analyzed histologic slides, documenting individual morphological characteristics of DV as performed elsewhere 6 . In addition, in an analysis of interobserver error, a second reviewer (C.S.‐R.…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, there is potential benefit in the development of predictive markers for these lesions. Abnormalities in placental appearance on ultrasound, namely placental thickness, lacunas and abnormal calcification, have been related to maternal and neonatal complications and/or postpartum placental pathology 5,6 . Additionally, studies have shown that abnormal uterine artery (UtA) Doppler measurements, reflecting a reduced placental perfusion, are associated with an increased risk on developing PS 7 .…”

Section: Introductionmentioning

confidence: 99%

The association between decidual vasculopathy and abnormal uterine artery Doppler measurement

Stevens

Schiffer

Teixeira

et al. 2022

Acta Obstet Gynecol Scand

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Introduction: Placental syndrome is an umbrella term encompassing the clinical phenotypes of preeclampsia and fetal growth restriction, and is associated with high maternal and neonatal morbidity. In women with placental syndrome, histologicl examination of the uteroplacental unit commonly demonstrates pathological lesions, such as decidual vasculopathy. Decidual vasculopathy are pathological changes in

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Ultrasound evaluation of the placenta in healthy and placental syndrome pregnancies: A systematic review

Cited by 24 publications

References 52 publications

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

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

The Role of Inorganics in Preeclampsia Assessed by Multiscale Multimodal Characterization of Placentae

The association between decidual vasculopathy and abnormal uterine artery Doppler measurement

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