Factors Associated with Placental Vascularization Measured by 3D Power Doppler Ultrasonographic Sphere Biopsy between 11 and 14 Weeks of Gestation

2018 ◽  
Vol 35 (10) ◽  
pp. 964-971 ◽  
Author(s):  
Amelie Boutin ◽  
Regina Dembickaja ◽  
Mercedes Campanero ◽  
Kypros Nicolaides ◽  
Suzanne Demers
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Gestational Age ◽  
Maternal Age ◽  
Power Doppler ◽  
First Trimester ◽  
Flow Index ◽  
Crown Rump Length ◽  
Nulliparous Women ◽  
3D Power Doppler

Objective Preeclampsia is associated with placental vascularization disorders. Ultrasonographic sphere biopsy (USSB) of the placenta can estimate the vascularization of the placenta and potentially the risk of preeclampsia. We aimed to explore the factors related to placental vascularization measured with USSB in the first trimester. Study Design A prospective cohort was conducted in women recruited at 11 to 14 weeks. Three-dimensional acquisition of the placenta with power Doppler was undertaken along with crown-rump length (CRL). Using USSB of the full placental thickness at its center, vascularization index, flow index, and vascular flow index were measured. Pearson's correlation coefficients and multivariate linear regression were used to correlate the vascularization indices with CRL and maternal characteristics. Results A total of 5,612 women were recruited at a mean gestational age of 12.8 ± 0.6 weeks. We observed that vascularization indices increase with CRL. After adjustment, we observed that maternal age, ethnicity other than Caucasian, and body mass index were associated with lower vascularization indices, while diabetes, smoking, and assisted reproduction technology were not. We observed that parous women without history of preeclampsia had greater vascularization indices compared with nulliparous women. Conclusion Placental vascularization indices assessed by USSB fluctuate with gestational age, ethnicity, maternal age, body mass index, and previous pregnancy history.

scholarly journals Assessing the relationship between pregravid body mass index and risk of adverse maternal pregnancy and neonatal outcomes: prospective data in Southwest China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yue Chen ◽  
Ke Wan ◽  
Yunhui Gong ◽  
Xiao Zhang ◽  
Yi Liang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cesarean Delivery ◽  
Body Mass ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Southwest China ◽  
Adverse Pregnancy Outcomes ◽  
Relative Importance ◽  
Adverse Pregnancy

AbstractThe relevance of pregestational body mass index (BMI) on adverse pregnancy outcomes remained unclear in Southwest China. This study aimed to investigate the overall and age-category specific association between pre-gestational BMI and gestational diabetes mellitus (GDM), preeclampsia, cesarean delivery, preterm delivery, stillbirth, macrosomia, and small-for-gestational age (SGA) or large-for-gestational age (LGA) neonates in Southwest China. Furthermore, it explores the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. 51,125 Chinese singleton pregnant women were recruited as study subjects. Multiple logistic regression models were used to examine the influence of pre-pregnancy BMI on adverse pregnancy outcomes. Gradient boosting machine was used to evaluate the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. It is found that women who were overweight or obese before pregnancy are at higher risk of adverse pregnancy outcomes except for SGA neonates, while pre-pregnancy underweight is a protective factor for GDM, preeclampsia, cesarean delivery, macrosomia and LGA, but not SGA. Younger mothers are more susceptible to GDM and macrosomia neonates, while older mothers are more prone to preeclampsia. Pre-pregnancy BMI has more influence on various pregnancy outcomes than maternal age. To improve pregnancy outcomes, normal BMI weight as well as relatively young maternal ages are recommended for women in child-bearing age.

scholarly journals The possibility of modifications methods of determine volume of amniotic fluid

2016 ◽  
Vol 65 (3) ◽  
pp. 12-17
Author(s):  
Viktor A Mudrov
Keyword(s):  
Body Mass Index ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Body Mass ◽  
Gestational Age ◽  
First Trimester ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Pregnancy And Childbirth ◽  
Maternity Hospitals

Selection of the optimal tactics of pregnancy and childbirth significantly depends on the expected volume of amniotic fluid. The amount of amniotic fluid reflects a condition of a fetus and changes at pathological conditions of both a fetus, and an uteroplacental complex. The aim of the study was a modification of methods for determining the expected volume of amniotic fluid. On the basis of maternity hospitals Trans-Baikal Region in the years 2013-2015 was held retrospective and prospective analysis of 300 labor histories, which were divided into 3 equal groups: 1 group - pregnant women with a body mass index (BMI) for Quetelet less than 24, Group 2 - with a BMI from 24 to 30, group 3 - with a BMI more than 30. In order to determine the expected volume of amniotic fluid were used the subjective method, the Chamberlain’s and Phelan’s methods. The error in determining volume of amniotic fluid by the existing methods exceeds 10 %, that defined need of creation of a quantitative method. On the basis of mathematical and 3d-modeling of the volume of amniotic fluid and fetal weight determined pattern change, which is expressed by the formula: VAF = IAF × М × π / GA2, where IAF - index of amniotic fluid (mm), M - fetal weight (g), GA - gestational age (weeks). Through a comprehensive analysis of anthropometric research of the pregnant women defined formula’s volume of amniotic fluid: V = 0,017 × HUF × (AC - 25 × BMI / GA)2 - М, where GA - gestational age (weeks), AC - abdominal circumference of the pregnant women (cm), BMI - body mass index for Quetelet in the first trimester of pregnancy (kg/m2), HUF - height of an uterine fundus (cm), M - the estimated fetal weight (g). In calculating volume of amniotic fluid according to the proposed ultrasonic formula error does not exceed 5,3 %, anthropometric formula error does not exceed 10,2 %. Thus, the method has a smaller error compared to the standard, and can be used to reliably determine volume of amniotic fluid in II and III trimester of pregnancy.

scholarly journals First trimester screening for pre-eclampsia and intrauterine growth restriction using three-dimensional Doppler angiography (SPIRIT): protocol for a multicentre prospective study in nulliparous pregnant women

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037751
Author(s):  
Charline Bertholdt ◽  
Gabriela Hossu ◽  
Claire Banasiak ◽  
Marine Beaumont ◽  
Olivier Morel
Keyword(s):  
Pregnant Women ◽  
Intrauterine Growth Restriction ◽  
Power Doppler ◽  
First Trimester ◽  
Growth Restriction ◽  
Flow Index ◽  
Intrauterine Growth ◽  
Uncomplicated Pregnancy ◽  
Nulliparous Women ◽  
Biomarker Analysis

IntroductionPre-eclampsia (PE) and intrauterine growth restriction (IUGR) are two major pregnancy complications, related to chronic uteroplacental hypoperfusion. Nowadays, there is no screening or diagnostic test for uteroplacental vascularisation deficiency in pregnant women. Since 2004, 3 three-imensional power Doppler (3DPD) angiography has been used for the evaluation of uteroplacental vascularisation and three vascular indices are usually calculated: Vascularisation Index (VI), Flow Index (FI) and vascularisation-FI (VFI). A high intraobserver and interobserver reproducibility and a potential interest for placental function study were reported by our team and others.The main objective of our study is to determine differences in 3DPD indices at first trimester between pregnancies defined at their outcome as uncomplicated pregnancy, PE (mild and severe) and IUGR in nulliparous women.Methods and analysisThis is a national multicentre prospective cohort study conducted in four French maternity units. We expect to include 2200 women in a period of 36 months. The nulliparous pregnant women will be recruited during their first trimester consultation (11–13+6 gestation week (GW)).The 3DPD and uterine artery Doppler acquisition will be included in the current routine 11–13+6 GW ultrasound. Also, additional blood samples will be taken for biomarker analysis (PAPP-A and P1GF) and biological collection. Uteroplacental VIs (FI and VFI) will be measured. For each subgroup (uncomplicated pregnancy, PE and IUGR), mean values in 3DPD indices will be computed and compared using a pairwise t test with a Bonferroni correction p value adjustment.Ethics and disseminationThe study was approved by the French Ethics Committee, the Comité de Protection des Personnes SUD MEDITERRANEE IV on 13 February 2018 with reference number 17 12 03. The results of this study will be published in a peer-reviewed journal and will be presented at relevant conferences.Trial registration numberNCT03342014; Pre-results. PHRCN-16-0567.

scholarly journals P07.08: First trimester evaluation of the tricuspid flow: influence of body mass index and gestational age

2012 ◽  
Vol 40 (S1) ◽  
pp. 195-195
Author(s):  
G. R. Lobo ◽  
P. M. Nowak ◽  
A. P. Panigassi ◽  
A. F. Lima ◽  
L. Nardozza ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Gestational Age ◽  
First Trimester

scholarly journals Fetal heart assessment in the first trimester of pregnancy: influence of crown-rump length and maternal body mass index

2013 ◽  
Vol 28 (4) ◽  
Author(s):  
David Baptista Silva Pares ◽  
Angélia Iara Felipe Lima ◽  
Edward Araújo Júnior ◽  
Luciano Marcondes Machado Nardozza ◽  
Wellinton P. Martins ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Fetal Heart ◽  
First Trimester ◽  
Maternal Body Mass Index ◽  
Maternal Body ◽  
Crown Rump Length ◽  
First Trimester Of Pregnancy

scholarly journals Evaluation and correlation of placental vasculature by three-dimensional power Doppler ultrasonography with umbilical Doppler in normal and IUGR pregnancies

2018 ◽  
Vol 7 (9) ◽  
pp. 3818
Author(s):  
Sumesh Choudhary ◽  
Vineet Mishra ◽  
Rohina Aggarwal ◽  
Kavita Mistry
Keyword(s):  
Gestational Age ◽  
Pulsatility Index ◽  
Doppler Ultrasonography ◽  
Power Doppler ◽  
Three Dimensional ◽  
Flow Index ◽  
P Value ◽  
Power Doppler Ultrasonography ◽  
3D Power Doppler ◽  
Placental Volume

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.

scholarly journals OP23.04: First trimester evaluation of the ductus venosus: influence of body mass index and gestational age

2012 ◽  
Vol 40 (S1) ◽  
pp. 123-124
Author(s):  
P. M. Nowak ◽  
G. R. Lobo ◽  
A. P. Panigassi ◽  
A. F. Lima ◽  
L. Nardozza ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Gestational Age ◽  
First Trimester ◽  
Ductus Venosus

Second-Trimester Placental Volume and Vascular Indices in the Prediction of Small-for-Gestational-Age Neonates

2014 ◽  
Vol 37 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Shih-Wen Fang ◽  
Chia-Yu Ou ◽  
Ching-Chang Tsai ◽  
Hung-Chun Fu ◽  
Hsin-Hsin Cheng ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Power Doppler ◽  
Body Height ◽  
3D Ultrasound ◽  
Flow Index ◽  
Second Trimester ◽  
3D Power Doppler ◽  
Placental Volume

Objective: To evaluate the ability of second-trimester placental volume and vascular indices to predict small-for-gestational-age (SGA) birth weight pregnancies. Material and Methods: Women with singleton pregnancies were prospectively evaluated at 17-20 weeks of gestation. Second-trimester placental volume and vascular indices were obtained and calculated using volume organ computer-aided analysis and three-dimensional (3D) power Doppler ultrasound. Participants were followed until delivery and their medical records were reviewed, including maternal age, parity and pregestational body weight and body height, as well as the gestational age, birth weight and gender of the fetus. Results: Of the 163 women with complete follow-up, 20 gave birth to SGA and 143 to appropriate-for-gestational-age (AGA) neonates. The mean second-trimester placental volume was significantly lower in the SGA than in the AGA group (170.6 ± 49.8 vs. 213.5 ± 75.8 cm3, p = 0.015). None of the vascular indices, including the vascularization index, flow index and vascularization flow index, differed significantly between the two groups. We also found that the optimum cutoff for placental volume at a gestational age of 17-18 weeks was 189.7 cm3. Discussion: Second-trimester placental volume was positively correlated with neonatal birth weight. Second-trimester placental volume measured on 3D ultrasound may be predictive of SGA neonates.

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