scholarly journals PLACENTAL HEMODYNAMIC ASSESSMENT IN WOMEN WITH SEVERE PREECLAMPSIA IN SECOND- AND THIRD-TRIMESTER PREGNANCY BY 3D POWER QUANTITATIVE DOPPLER ULTRASOUND

2020 ◽  
Vol 20 (09) ◽  
pp. 2040001
Author(s):  
SUFEN ZHOU ◽  
PENG AN ◽  
KAI LIAN ◽  
LING GAN ◽  
WEI FENG ◽  
...  

Objective: The present study analyzed the fetal–placental hemodynamic parameters in women with severe preeclampsia in second- and third-trimester pregnancy with a view to developing effective predictive indicators for preeclampsia and providing support for the prenatal clinical treatment of preeclampsia. Materials and Methods: From January 2015 to January 2019, 160 pregnant women diagnosed with severe preeclampsia at Xiangyang First People’s Hospital were recruited as the study group. The diagnostic criteria for preeclampsia were in accordance with the guidelines of the International Society for the Study of Hypertension in Pregnancy (ISSHP). A sample of 160 healthy pregnant women with normal blood pressure were selected as the control group. The GE Voluson E8 and E10 four-dimensional (4D) ultrasonic diagnostic instruments and the three-dimensional (3D) power Doppler in angio-quantitative mode were used to measure the hemodynamic parameters of the placenta, left uterine artery (LUA), right uterine artery (RUA), middle cerebral artery (MCA), umbilical artery (UA), and ductus venosus (DV) in the two groups. The above parameters were analyzed statistically using SPSS 22.0. Results: The systolic/diastolic velocity ratio (S/D), pulsatility index (PI), and resistance index (RI) of the MCA in the study group were lower than those of normal subjects of the same gestational age (P < 0.05). These parameters in the UA were higher in the study group than those in normal subjects (P < 0.05). The ratios between the peak ventricular systolic velocity and the peak atrial systolic velocity (S/A), pulsatility index for the vein (PIV), pre-load index (PLI), and peak velocity index for the vein (PVIV) in the DV were significantly different between the study and normal groups (P < 0.05). The placental vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were lower in the study group than those in normal subjects of the same gestational age (P < 0.05). There were good correlations between VI, VFI and RUA, PI, with correlation coefficients of −0.697 and −0.702, respectively. FI was the indicator that had the highest diagnostic efficacy for severe preeclampsia. The predictive sensitivity of the FI with a cut-off value of 34.92 was 96.3%, and the corresponding specificity was 86.9%. Conclusions: Placental FI had the highest predictive efficacy for severe preeclampsia and provides a reliable quantitative indicator and data support for preeclampsia management. 3D power quantitative Doppler ultrasound provides a novel avenue for the study of severe preeclampsia.

2019 ◽  
Vol 33 (20) ◽  
pp. 3484-3489
Author(s):  
Sarah G. Običan ◽  
Linda Odibo ◽  
Methodius G. Tuuli ◽  
Alejandro Rodriguez ◽  
Anthony O. Odibo

2009 ◽  
Vol 29 (2) ◽  
pp. 135-147 ◽  
Author(s):  
Brena Carvalho Pinto de Melo ◽  
Melania Maria Ramos de Amorim ◽  
Leila Katz ◽  
Isabela Coutinho ◽  
Giselly Veríssimo

2013 ◽  
Vol 39 (1) ◽  
pp. 42-44 ◽  
Author(s):  
MA Ferdous ◽  
MM Sharif ◽  
AS Mohiuddin ◽  
F Shegufta

This cross sectional study was carried out on 60 pregnant Bangladeshi women in the department of Radiology and Imaging, BIRDEM for measurement of Pulsatility Index (PI) of umbilical artery of their fetuses by duplex colour Doppler sonography during 2nd and 3rd trimester of pregnancies. Considering total 2nd and 3rd trimesters the mean PI value of umbilical artery was 1.24 (SD±0.27). While considering the gestational in separate trimesters, study showed that the value of PI in 2nd trimester was 1.33 (SD±0.29) and in 3rd trimester PI was 1.18 (SD±0.25). Paired t test shows there was a highly significant (t=35.79, df=59, Level of significance=0.001) difference between mean values of PI in different gestational ages. It was observed that there was gradual decrease of PI value with increase of gestational age (r= -0.207) but this decrease of PI was not statistically significant (p=0.113). Regression analysis between dependent PI value and independent gestational age showed linear negative relationship but this was not statistically significant (p=0.11). This study revealed that the Pulsatility index of umbilical artery was decreased with increase of gestational age from 2nd to 3rd trimester. DOI: http://dx.doi.org/10.3329/bmrcb.v39i1.15809 Bangladesh Med Res Counc Bull 2013; 39: 42-44


Author(s):  
Sumesh Choudhary ◽  
Vineet Mishra ◽  
Rohina Aggarwal ◽  
Kavita Mistry

Background: In recent years there have been significant developments in the use of 3D Power Doppler (3DPD) imaging and quantitative 3DPD histogram analysis to estimate both placental volume and intraplacental vasculature. This study is to evaluate the distribution and variation of placental vascular indices according to gestational age and placental volume and position. Co relate the umbilical Doppler indices with placental vascular indices.Methods: From September 2016 to October 2017, three-dimensional (3D)-power Doppler ultrasound was performed in 200 singalton pregnancies from 20 to 40 weeks of gestation. Using the same pre-established settings for all patients, power Doppler was applied to the placenta and placental volume was obtained by the rotational technique (VOCAL). The 3D-power histogram was used to determine the placental vascular indices: vascularization index (VI), flow index (FI) and vascularization-flow index (VFI). Umbilical Doppler was measured on the free loop of umbilical cord. The placental vascular indices were then plotted against gestational age placental volume, position and umbilical Doppler SD ratio, PI and RI. These values were evaluated in IUGR fetus.Results: Analysis of the results showed that the placental vascular indices estimated by 3D-power Doppler ultrasonography presented constant distribution throughout gestation despite the significant increase in placental volume. Placental position at fundal region shows higher value of VI, FI, and VFI. Placental position with relation to VI, FI, and VFI shows statistically significant with p value <0.01. Placental vascular indices VI, FI and VFI when corelated with systolic/ diastolic ratio, pulsatility index and resistive resistance index of umbilical artery shows poor negative correlation, only VI and FI shows statistically significant with SD ratio as p value is <0.01and <0.04. VFI did not show statistically significant as p value is 0.10(NS). With pulsatility index p value is statistically significant is less than<0.01 with vascular indices. Resistive index p value is statistically significant is less than <0.01 for VI and VFI but not significant with FI as p value is 0.06.Conclusions: Doppler ultrasound assists in the evaluation of placental vascularization in normal and IUGR pregnancies, may play an important role in future research on fetoplacental insufficiency.


2018 ◽  
Vol 04 (01) ◽  
pp. 18-22
Author(s):  
Sanjib Kumar Das ◽  
Ipsita Acharya ◽  
Sasmita Pariida ◽  
Jayshree Mohanty ◽  
Mamata Singh ◽  
...  

Author(s):  
Shabd Singh Yadav ◽  
Aditi Singh ◽  
Kalpana Yadav

Background: Intrauterine growth restriction (IUGR) is a major and silent cause of perinatal morbidity and mortality. Rate of IUGR in developing countries is 6 times higher than that of developed countries. 14 to 20 million infants are affected with IUGR in developing countries annually. The highest incidence is found in south central Asia (33%) and India (21%). Aim of study was to evaluate the role of early 3rd trimester ultrasound in diagnosis and role of color Doppler in prediction of adverse perinatal outcome in IUGR.Methods: A prospective case-control study was conducted on 720 women admitted in GMH Rewa for one year. 360 antenatal cases diagnosed as IUGR on ultrasound were taken as study group, same number of non IUGR cases were taken as control. Study cases were followed with Doppler. The umbilical artery pulsatility index (UA PI), middle cerebral artery pulsatility index (MCA PI) and cerebro-placental ratio were calculated and the results were analysed.Results: Inferences drawn from the study were: rate of caesarean section was significantly higher (31%) in study group, perinatal outcome was poor in more number of cases (10.8%) in study group than the control group (3.4%), and the sensitivity and specificity of cerebroplacental ratio was more reliable indicator in comparison to that of UA PI and MCA PI in prediction of adverse perinatal outcome.Conclusions: Looking at the high burden of IUGR cases in our country and its adverse effects on perinatal outcome, if early third trimester ultrasound is made mandatory for all pregnant women, most of the IUGR cases can be detected and managed timely and perinatal outcome can be significantly improved.


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