Abstract
pregnancy outcomes. The current sensitivity and positive predictive value of this association has, however, not yet justified initiation of increased antenatal surveillance in these patients. This study was carried out to identify if 3D placental evaluation enhances the performance of this serum marker as a predictor of adverse pregnancy outcomes. Methods: 62 patients with PAPP-A levels lower than 0.4 multiples of median (MoM) were evaluated between 11 weeks to 13 weeks 6 days of gestation with 3D power Doppler studies in this prospective study. Placental volume, Vascularisation Index (VI), Flow Index and Vascularisation Flow Index (VFI) were computed with standardised equipment settings and correlated with pregnancy outcomes. Results: 38 patients had an uneventful pregnancy outcome. 29 of these had normal 3D placental parameters. Of the 24 patients with adverse outcomes 19 had a small volume placenta, impaired 3D placental vascularisation indices or both. Conclusions: 3D and 3D power Doppler evaluation of the placenta in the late first trimester improves the prediction of adverse outcomes in patients with low PAPP-A levels.
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