Abstract
BackgroundTraditionally, the placental functional integrity is suggested by indirect ultrasound measurements like fetal growth, amniotic fluid index, and uterine and umbilical artery Doppler indices. Only recently the elasticity of the placenta is studied as a measure of placental consistency and biomechanical prosperities and may reflect the placental function. Shear wave velocity is the quantitative parameter of the shear wave elastography. A high-risk pregnancy is a situation which puts the mother, the fetus, or both at greater risk than a normal pregnancy.ResultsThe shear wave velocity (SWV) showed no significant difference between the placenta of normal pregnancies in the second and third trimesters (0.85 ± 0.43 m/s and 0.89 ± 0.57 m/s, respectively). The placenta of patients with preeclampsia/eclampsia had high SWV in the second and third trimesters (2.13 ± 1.48 m/s and 2.23 ± 1.48 m/s) with a highly significant difference from the normal placenta (P < 0.001). The placentas with abnormal location (placenta previa) and penetration (placenta accreta) had higher SWV than the placenta of normal pregnancies. The mean SWV for placenta previa was 1.1 ± 0.74 m/s and 1.3 ± 0.81 m/s in the second and third trimesters, respectively, with a mildly significant difference with the normal placenta. The placenta accreta shows high mean SWV in the second and third trimesters (1.6 ± 0.65 m/s and 1.961.6 ± 0.65, respectively) which differed significantly (P < 0.001) from SWV in the normal placenta in the second and third trimesters.ConclusionShear wave velocity measurement as the quantitative parameter of acoustic radiation force impulse (ARFI) elastography reflects the placental elasticity in normal and high-risk pregnancies. The SWV increases in conditions like hypertension, preeclampsia, maternal renal disease, and diabetes and reflects the structural and biomechanical abnormalities in such diseases. High shear wave velocity correlates with the incidence of growth restriction and abnormal Doppler parameters especially in the hypertensive disease. The virtual touch quantification (VTQ) can be used as a complementary diagnostic and prognostic tool in high-risk pregnancy.
Highlights
The placental functional integrity is suggested by indirect ultrasound measurements like fetal growth, amniotic fluid index, and uterine and umbilical artery Doppler indices
The aim of the current study was to investigate the elasticity of the placenta in normal and high-risk pregnancy using quantitative shear wave elastography and measurement of shear wave velocity (SWV)
The females with essential hypertension and preeclampsia were the largest group in the high-risk group including 82 patients in the third trimester (26.4% of patients in the third trimester) and 20 patients in the second trimester (12.5% of patients in the second trimester)
Summary
The placental functional integrity is suggested by indirect ultrasound measurements like fetal growth, amniotic fluid index, and uterine and umbilical artery Doppler indices. Recently the elasticity of the placenta is studied as a measure of placental consistency and biomechanical prosperities and may reflect the placental function. The human placenta is the intermediate organ between the mother and fetus characterized by rapid growth and development, and it plays a pivotal role in the fetal oxygenation and nutrition [1]. The placental functional integrity is suggested by indirect ultrasound biomechanical prospect like other tissues. Recent studies suggested that the consistency and biomechanical properties of the placenta in cases with placental insufficiency differ from those of the normal placenta and normal pregnancy [5, 6]. Elastography is the relevant tool in studying the elasticity and biomechanical properties of tissues. Elastography has been used in differentiation between benign and malignant tissues in the breast [8, 9], thyroid [10, 11], and prostate [12], as well as evaluation of liver fibrosis [13,14,15]
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