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

Background. Serious perinatal, most of all, neurological consequences of placental insufficiency condition necessity further search it’s markers for optimal delivery time. Methods. At third term of pregnancy we examined 16 singleton physiological pregnant women (first group) and 27 placental insufficiency patients (second group). We standard obstetrical examined, ultrasound fetometry, basic arteries of functional system mother-placenta-fetus Doppler and three-dimensional power Doppler in central, two paracentral and two periphery placenta areas. We processing images by VOCAL and analyzed vascularisation (VI), flow (FI) and vascularisation-flow indexes (VFI). Results. In placentae correlated groups FI differ in size reliable in central (t=4,03; p<0,001 и U=240,00; p<0,001) and paracentral (t=2,61; p<0,05 и U=348,00; p<0,05) areas. Patients second group indexes were relative on 17% and 8% less than patients first group indexes. Patients second group VFI was on 35% less than patients first group VFI (t=2,08; p<0,05 и U=337,00; p<0,05). We described results of comparison three-dimensional power Doppler intraplacental blood flow indexes from patients second group with different degree hemodynamic disorder. Conclusion. In placental insufficiency presence reduction blood circulation, particular in central placenta area, conditioned by reduction blood flow in initial vessels number. Central placenta area FI may be regarded new additional criterion of placental insufficiency at third term of pregnancy.

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Role of diffusion MR imaging (DWI) and three-dimensional ultrasound (3DUS) in the assessment of placental insufficiency in the gestational hypertension

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0062-3 ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Sahar Mansour ◽

Soha Hamed ◽

Safia Sayed ◽

Shreen Hosny

Keyword(s):

High Risk ◽

Gestational Hypertension ◽

Power Doppler ◽

Three Dimensional ◽

Placental Insufficiency ◽

Adc Value ◽

Non Invasive ◽

Significant Difference ◽

The Right ◽

And Control

Abstract Background DWI is a non-invasive MR modality that is not contrast-based. In the current study, we aimed to evaluate DWI in correlation with 3DUS in the detection of placental insufficiency in high-risk pregnancies complicated with hypertension. This prospective analysis included 80 pregnancies; 40 hypertensive and 40 controls, gestational age ranged from 22 to 34 weeks. All cases had undergone 3DUS aided by power Doppler scanning and DWI. There is no given contrast. Data were correlated to histopathology. Results Doppler US showed a significant relation between RI of the right uterine artery of cases and control (P = 0.014). There was also a positive correlation between the presence of the diastolic notch and RI value. The mean ADC value in the controls was 1.87 ± 0.26 mm2/s, while in hypertensive was 1.36 ± 0.09 mm2/s. In DWI images, there was a significant difference between patients with normal and those with abnormal placental signals (P value = 0.047). Also, there was a significant difference between the measurement of placental volume by MRI and US among cases and controls (P values ≤0.001 and 0.017, respectively). Conclusion Diffusion-weighted imaging can detect early subtle findings and signs of placental dysfunction more than detected with 3DUS, so it can add to the diagnostic accuracy of US in imaging of pregnancies at high risk of placental insufficiency.

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