P05.07: Three‐dimensional power Doppler of uteroplacental vascularisation in third trimester: comparison between normal and placental insufficiency pregnancies (EVUPA study)

Abstract

Intrauterine growth restriction (IUGR) and pre-eclampsia (PE) are two major pathologies related to placental vascular insufficiency. Uteroplacental vascularisation was quantified with 3D power Doppler (3DPD) in the third trimester in two populations: normal and impaired pregnancies (PE and/or IUGR). 84 women with normal pregnancy and 28 women with PE and/or IUGR pregnancies were prospectively included in this study. Utero-placental 3DPD acquisitions were performed within 72 hours before delivery using standardised machine settings. Placenta and beneath myometrium volumes were manually traced separately with the VOCAL imaging analysis software. 3DPD indices - vascularisation index (VI), flow index (FI) and vascularisation-flow index (VFI) - were calculated in each volume and compared between the 2 groups. The impact of placental position and body mass index (BMI) on 3DPD indices was also evaluated. The placental and myometrial volumes were not significantly different between normal and pathological pregnancies. The traced placental volumes were significantly reduced in case of posterior placenta (n=63) (p<0.001). Placental VI, FI and VFI were significantly reduced in PE and/or IUGR pregnancies (n= 28) compared with normal pregnancies (n= 84) ((p<0.01), for myometrium, only FI was significantly reduced in PE and/or IUGR pregnancies (p=0.02). Placental 3DPD indices (VI, FI and VFI) were significantly reduced in posterior placental cases or in the patients with BMI>25 Kg/m2 (n=48) (p<0.001). There was no impact of placental position or BMI on myometrial volume. Only myometrial FI was significantly reduced in posterior placental cases (p<0.05). 3DPD assessment of placental vascular indices has the potential for PE and or IUGR pregnancy diagnosis in the third trimester, the myometrial FI might be an interesting index for PE and or IUGR identification that isn't influenced by patient's BMI.