Abstract
ObjectiveTo explore the correlation between in vivo placental volumetric parameters in the first trimester of pregnancy and ex vivo parameters of fetoplacental vascular function after delivery.MethodsIn ten singleton physiological pregnancies, placental volume (PV) and uteroplacental vascular volume (uPVV) were measured offline in three-dimensional ultrasound volumes at 7, 9, and 11 weeks gestational age (GA) using Virtual Organ Analysis and Virtual Reality. Directly postpartum, term placentas were ex vivo dually perfused and pressure in the fetoplacental vasculature was measured to calculate baseline pressure (pressure after a washout period), pressure increase (pressure after a stepwise fetal flow rate increase of 1 mL/min up to 6 mL/min) and flow-mediated vasodilation (FMVD; reduction in inflow hydrostatic pressure on the fetal side at 6 mL/min flow rate). Correlations between in vivo and ex vivo parameters were assessed by Spearman’s correlation coefficients (R).ResultsThroughout the first trimester, PV was negatively correlated with pressure increase (Rgrowth = −0.84) and, at 11 weeks GA, also positively correlated with FMVD (R = 0.89). At 7 weeks GA, uPVV and uPVV/PV ratio were negatively correlated with pressure increase (R = −0.58 and R = −0.81, respectively) and positively correlated with FMVD (R = 0.62 and R = 0.90, respectively).DiscussionMainly in the early first trimester, larger placental volumetric parameters are associated with lower pressure and more FMVD in the fetoplacental vasculature after delivery. This may suggest that larger and/or more vascularized placentas in early pregnancy have better adaptive mechanisms and possibly lead to better pregnancy outcomes.
Highlights
Placenta-related pregnancy complications, such as preeclampsia (PE) and fetal growth restriction (FGR), are highly prevalent and affect fetal development and pregnancy outcome, and future maternal and offspring health (Barker et al, 2007; Bellamy et al, 2007; Steegers et al, 2010)
The results of this study suggest that, mainly in the early first trimester, larger placental volumetric parameters, measured by 3D ultrasound and Virtual Reality (VR) technique, are associated with lower pressure and more flow-mediated vasodilation (FMVD) in the fetoplacental vasculature after delivery
Correlations between in vivo placental growth throughout the first trimester and ex vivo placental parameters were negative for the growth of placental volume (PV) and pressure increase (R = −0.84), but positive for FMVD (R = 0.50) not statistically significant
Summary
Placenta-related pregnancy complications, such as preeclampsia (PE) and fetal growth restriction (FGR), are highly prevalent and affect fetal development and pregnancy outcome, and future maternal and offspring health (Barker et al, 2007; Bellamy et al, 2007; Steegers et al, 2010). Most of these pregnancy complications originate already in the first trimester of pregnancy (Steegers-Theunissen et al, 2013). From mid-gestation onward, there is an exponential growth in vascular volume of fetoplacental vessels to accommodate the needs of the growing fetus (Gude et al, 2004)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
