3D fractional moving blood volume (3D-FMBV) demonstrates decreased first trimester placental vascularity in pre-eclampsia but not the term, small for gestation age baby.

Sally L. Collins,Lawrence Impey,Gordon N. Stevenson,J. Alison Noble,Alec W. Welsh,Stefan Gebhardt

doi:10.1371/journal.pone.0178675

Sally L. Collins, Lawrence Impey + Show 4 more

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https://doi.org/10.1371/journal.pone.0178675

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Journal: PloS one	Publication Date: Jun 1, 2017
Citations: 16	License type: CC BY 4.0

Affiliation: John Radcliffe Hospital, University of Oxford, UNSW Sydney

Abstract

ObjectiveTo undertake an observational study to see whether first trimester placental vascularity, measured with a standardized power Doppler index: 3D-FMBV, is different in pregnancies which either develop pre-eclampsia or lead to term, normotensive small for gestational age (SGA) babies.MethodsWomen were scanned between 11 and 13+6 weeks. The placental volume (sPlaV) was estimated using our previously validated semi-automated tool. Estimates of 3D-FMBV were generated from the raw power Doppler signal for the whole utero-placental interface, UPI (FMBV-UPI) and 5mm into the placenta (FMBV-IVS). Differences in the placental volume and FMBV for pregnancies developing pre-eclampsia and resulting in term, normotensive SGA babies were compared with term, normotensive, appropriate for gestational age (AGA), controls.ResultsResults were available for 143 women. The placental volume (sPlaV) was reduced in both pre-eclampsia (p = 0.007) and term, normotensive SGA (p = 0.001) when compared with term normotensive AGA controls. 3D-FMBV estimates were significantly lower for pregnancies developing pre-eclampsia (FMBV-UPI, p = 0.03, FMBV-IVS, p = 0.01) but not for the normotensive SGA pregnancies (FMBV-UPI, p = 0.16, FMBV-IVS, p = 0.27).ConclusionPregnancies destined to develop pre-eclampsia are more likely to have small placentas with significantly reduced vascularity at 11–13 weeks. Those pregnancies which were normotensive throughout but resulted in an SGA baby delivered at term, had significantly smaller placentas but with similar vascularity to normotensive AGA pregnancies.

Highlights

Pre-eclampsia and small for gestation age (SGA) babies, defined as
The placental volume was reduced in both pre-eclampsia (p = 0.007) and term, normotensive SGA (p = 0.001) when compared with term normotensive appropriate for gestational age (AGA) controls. 3D-fractional moving blood volume (FMBV) estimates were significantly lower for pregnancies developing pre-eclampsia (FMBV-utero-placental interface (UPI), p = 0.03, FMBV-intervillous space (IVS), p = 0.01) but not for the normotensive SGA pregnancies (FMBV-UPI, p = 0.16, FMBV-IVS, p = 0.27)
Pregnancies destined to develop pre-eclampsia are more likely to have small placentas with significantly reduced vascularity at 11–13 weeks. Those pregnancies which were normotensive throughout but resulted in an SGA baby delivered at term, had significantly smaller placentas but with similar vascularity to normotensive AGA pregnancies

Summary

Objective

To undertake an observational study to see whether first trimester placental vascularity, measured with a standardized power Doppler index: 3D-FMBV, is different in pregnancies which either develop pre-eclampsia or lead to term, normotensive small for gestational age (SGA) babies. Data Availability Statement: All relevant data are within the paper and its Supporting Information files.

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