Top

Published in:

Open Access 01-02-2012 | Maternal-Fetal Medicine

Comparative analysis of placental vasculature and placental volume in normal and IUGR pregnancies with the use of three-dimensional Power Doppler

Authors: Michal Pomorski, Mariusz Zimmer, Jerzy Florjanski, Joanna Michniewicz, Artur Wiatrowski, Tomasz Fuchs, Ewa Milnerowicz-Nabzdyk

Published in: Archives of Gynecology and Obstetrics | Issue 2/2012

Abstract

Objectives

To evaluate the differences in placental vascular indices and placental volume between normal and IUGR pregnancies.

Methods

A prospective study was conducted on a group of 100 normal and 20 IUGR pregnancies between 22 and 42 weeks of gestation. For the purpose of evaluation of placental volume and placental vascular indices, we applied 3D Power Doppler and VOCAL technique. Only patients with entirely visualized placenta were included in the study.

Results

A comparative analysis of vascularization index (VI), vascularization flow index (VFI), flow index (FI), and placental volume (PV) revealed statistically significant differences between normal and IUGR pregnancies.

In normal pregnancies, the volume of the placenta was on average 92.42 cm³ larger than in pregnancies complicated by IUGR. Receiver operating characteristic (ROC) curves were used to evaluate the clinical usefulness of placental vascular indices and placental volume for discriminating IUGR and normal pregnancies. It was concluded that the VI, VFI, PV, FI parameters are the best discriminants, with the cut-off values of 5.30, 2.30, 199, and 36.0, respectively.

Conclusions

The quantitative assessment of placental vasculature and placental volume by means of 3D Power Doppler and VOCAL technique is an adjunctive modality for differentiation between normal and IUGR pregnancies. Our findings further suggest that the vascularization index (VI) and vascularization flow index (VFI) are the best parameters with the most favorable discriminating potential for proper identification of IUGR pregnancies.

Abramowicz JS, Sheiner E (2007) In utero imaging of the placenta: importance for diseases of pregnancy. Placenta 28(Suppl A):14–22CrossRef

Abramowicz JS, Sheiner E (2008) Ultrasound of the placenta: a systematic approach. Part I: imaging. Placenta 29:225–240PubMedCrossRef

Abramowicz JS, Sheiner E (2008) Ultrasound of the placenta: a systematic approach. Part II: functional assessment (Doppler). Placenta 29:921–929PubMedCrossRef

de Paula CF, Ruano R, Campos JA, Zugaib M (2009) Quantitative analysis of placental vasculature by three-dimensional Power Doppler ultrasonography in normal pregnancies from 12 to 40 weeks of gestation. Placenta 30:142–148PubMedCrossRef

Guiot C, Gaglioti P, Oberto M, Piccoli E, Rosato R, Todros T (2008) Is three-dimensional Power Doppler ultrasound useful in the assessment of placental perfusion in normal and growth-restricted pregnancies? Ultrasound Obstet Gynecol 31(2):171–176PubMedCrossRef

Mercé LT, Barco MJ, Bau S, Kupesic S, Kurjak A (2005) Assessment of placental vascularization by three-dimensional Power Doppler “vascular biopsy” in normal pregnancies. Croat Med J 46:765–771PubMed

Mercé LT, Barco MJ, Bau S (2004) Reproducibility of the study of placental vascularization by three-dimensional Power Doppler. J Perinat Med 32:228–233PubMedCrossRef

Yu CH, Chang CH, Ko HC, Chen WC, Chang FM (2003) Assessment of placental fraction moving blood volume using quantitative three-dimensional Power Doppler ultrasound. Ultrasound Med Biol 29:19–23PubMedCrossRef

Lai PK, Wang YA, Welsh AW (2010) Reproducibility of regional placental vascularity/perfusion measurement using 3D Power Doppler. Ultrasound Obstet Gynecol 36:202–209PubMedCrossRef

10.

Negrini R, de Silva Bussamra LC, da Silva Valladão de Freitas L, Araujo Júnior E, Piato S, Nardozza LM, Moron AF, Aoki T (2010) Assessment of placental blood flow between 22 and 34 weeks of gestation by 3D-sonography Power Doppler vascular indices. Arch Gynecol Obstet 284:53–57

11.

Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK (1985) Estimation of fetal weight with the use of head, body and femur measurements—a prospective study. Am J Obstet Gynecol 151:333–337PubMed

12.

Pomorski M (2010) Assessment of placental vascularisation in normal and complicated pregnancies with the use of Power Doppler ultrasonography. Dissertation. Wroclaw Medical University

13.

Martins WP, Raine-Fenning NJ, Ferriani RA, Nastri CO (2010) Quantitative three-dimensional Power Doppler angiography: a flow-free phantom experiment to evaluate the relationship between color gain, depth and signal artifact. Ultrasound Obstet Gynecol 35:361–368PubMedCrossRef

14.

Madazli R, Somunkiran A, Calay Z, Ilvan S, Aksu MF (2003) Histomorphology of the placenta and the placental bed of growth restricted foetuses and correlation with the Doppler velocimetries of the uterine and umbilical arteries. Placenta 24:510–516PubMedCrossRef

15.

Vedmedovska N, Rezeberga D, Teibe U, Melderis I, Donders GG (2010) Microscopic lesions of placenta and Doppler velocimetry related to fetal growth restriction. Arch Gynecol Obstet. doi:10.1007/s00404-010-1781-x

16.

Mitra SC, Seshan SV, Riachi LE (2000) Placental vessel morphometry in growth retardation and increased resistance of the umbilical artery Doppler flow. J Matern Fetal Med 9:282–286PubMedCrossRef

17.

Mu J, Kanzaki T, Tomimatsu T, Fukuda H, Fujii E, Takeuchi H et al (2002) Investigation of intraplacental villous arteries by Doppler flow imaging in growth-restricted fetuses. Am J Obstet Gynecol 186:297–302PubMedCrossRef

18.

de Paula CF, Ruano R, Campos JA, Zugaib M (2008) Placental volumes measured by 3-dimensional ultrasonography in normal pregnancies from 12 to 40 weeks’ gestation. J Ultrasound Med 27:1583–1590PubMed

19.

Hafner E, Philipp T, Schuchter K, DiIlinger-Paller B, Philipp K, Bauer P (1998) Second-trimester measurement of placental volume by three-dimensional ultrasound to predict small-for-gestational-age infants. Ultrasound Obstet Gynecol 12:97–102PubMedCrossRef

20.

Hafner E, Metzenbauer M, Dillinger-Paller B, Hoefinger D, Schuchter K, Sommer-Wagner H et al (2001) Correlation of first trimester placental volume and second trimester uterine artery Doppler flow. Placenta 22:729–734PubMedCrossRef

21.

Hafner E, Metzenbauer M, Hoefinger D, Munkel M, Gassner R, Schuchter K et al (2003) Placental growth from the first to the second trimester of pregnancy in SGA-foetuses and pre-eclamptic pregnancies compared to normal fetuses. Placenta 24:336–342PubMedCrossRef

Title: Comparative analysis of placental vasculature and placental volume in normal and IUGR pregnancies with the use of three-dimensional Power Doppler
Authors: Michal Pomorski
Mariusz Zimmer
Jerzy Florjanski
Joanna Michniewicz
Artur Wiatrowski
Tomasz Fuchs
Ewa Milnerowicz-Nabzdyk
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 2/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-011-1968-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparative analysis of placental vasculature and placental volume in normal and IUGR pregnancies with the use of three-dimensional Power Doppler

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2012

Robotic-assisted laparoscopic myomectomy versus abdominal myomectomy: a comparative analysis of surgical outcomes and costs

The management of stage III and IV endometriosis

Weekly paclitaxel in heavily pretreated ovarian cancer patients: does this treatment still provide further advantages?

Adjusted risk for trisomy 21 after the anomaly scan. How accurate is the Fetal Medicine Foundation algorithm?

Increased serum asymmetric dimethylarginine levels in hyperemesis gravidarum

Pregnancy outcomes by mode of delivery among breech births