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

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.

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Three-Dimensional Power Doppler Analysis of Cerebral Circulation in Normal and Growth-Restricted Fetuses

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.2009.70 ◽

2009 ◽

Vol 29 (9) ◽

pp. 1609-1618 ◽

Cited By ~ 17

Author(s):

Jose L Bartha ◽

Eva M Moya ◽

Blas Hervías-Vivancos

Keyword(s):

Doppler Ultrasound ◽

Cerebral Circulation ◽

Pulsatility Index ◽

Power Doppler ◽

Three Dimensional ◽

Flow Index ◽

Power Doppler Ultrasound ◽

3D Power Doppler ◽

Doppler Indices ◽

Vascularization Index

The objective of the present study was to evaluate fetal cerebral circulation by using three-dimensional (3D) power Doppler ultrasound in normal and growth-restricted fetuses. A total of 100 normal grown fetuses were compared with other 25 with growth restriction (FGR). Three-dimensional power Doppler ultrasound was used to assess fetal cerebral 3D vascular indices: vascularization index, flow index (FI), and vascularization flow index (VFI). Both FI and VFI correlated positively with gestational age. On average, all the 3D vascular indices were increased in fetuses with FGR. The proportion of fetuses detected as having hemodynamic redistribution was higher when using 3D power Doppler indices than by means of the middle cerebral artery pulsatility index (52% versus 20%, P = 0.002). In conclusion, two of the three indices increased during gestation. All the fetal cerebral 3D vascular indices are increased in fetuses with FGR. In these fetuses, there were more cases suggesting hemodynamic redistribution than expected by conventional Doppler studies.

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First trimester placental volume and three dimensional power doppler ultrasonography in type I diabetic pregnancies

Prenatal Diagnosis ◽

10.1002/pd.3848 ◽

2012 ◽

Vol 32 (5) ◽

pp. 480-484 ◽

Cited By ~ 21

Author(s):

Giuseppe Rizzo ◽

Alessandra Capponi ◽

Maria Elena Pietrolucci ◽

Eloisa Aiello ◽

Domenico Arduini

Keyword(s):

Doppler Ultrasonography ◽

Power Doppler ◽

Three Dimensional ◽

First Trimester ◽

Power Doppler Ultrasonography ◽

Type I ◽

Placental Volume

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

Fetal Diagnosis and Therapy ◽

10.1159/000365148 ◽

2014 ◽

Vol 37 (2) ◽

pp. 123-128 ◽

Cited By ~ 2

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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OP29.06: Pulsatility index evaluated by STIC three-dimensional power Doppler ultrasonography: description of the technique and evaluation of reproducibility

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.9531 ◽

2011 ◽

Vol 38 (S1) ◽

pp. 141-141

Author(s):

W. P. Martins ◽

N. Raine-Fenning ◽

J. C. Lima ◽

C. O. Nastri

Keyword(s):

Pulsatility Index ◽

Doppler Ultrasonography ◽

Power Doppler ◽

Three Dimensional ◽

Power Doppler Ultrasonography

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Difference between Vascularization Indexes of the Placenta in Severe Pre-eclampsia and Normal Pregnancy by Three-dimensional Power Doppler Ultrasound

Donald School Journal of Ultrasound in Obstetrics & Gynecology ◽

10.5005/jp-journals-10009-1372 ◽

2014 ◽

Vol 8 (4) ◽

pp. 329-335 ◽

Cited By ~ 1

Author(s):

Wiku Andonotopo ◽

Herman Kristanto ◽

Julian Dewantiningrum ◽

Besari Adi Pramono

Keyword(s):

Pregnant Women ◽

Doppler Ultrasound ◽

Gestational Age ◽

Power Doppler ◽

Three Dimensional ◽

Normal Pregnancy ◽

Flow Index ◽

Control Group ◽

Power Doppler Ultrasound ◽

3D Power Doppler

ABSTRACT Aim The object of this study was to analyze the vascularization index of three-dimensional (3D) power Doppler ultrasound (PDUS) of the placenta in severe pre-eclampsia compared with normal pregnancy conditions by vascular biopsy sampling sphere. Subjects and methods This study is a prospective longitudinal observational study on 80 pregnant women which divided into 2 groups: Group I (study group) were 40 pregnant women with severe pre-eclampsia, group II (control group) were 40 pregnant women without disorder. Variables examined in this study were vascular index (VI), flow index (FI) and vascular flow index (VFI) of the 3D-PD placental perfusion. Its correlation to gestational age in normal pregnancy compared with the condition of preeclampsia were obtained by taking multiple biopsy sampling vascular sphere. All pregnant women underwent 3D PD-US examination (single examination only), data volume recorded of the placenta allows for off-line analysis without the presence of the patient, thus allowing the data analysis done anywhere and anytime by observers for the comparative analysis of interobserver reliability. Results The placenta can be visualized perfectly in both of the study group and also the control group. Average Kappa value for the acquisition of placental vascularization index measurements with 3D PD-US was 0.72 (0.61-0.82), 0.73 (0.65-0.82) and 0.71 (0.61-0.81) for VI, FI and VFI in the range of 20 to 38 weeks showed good interobserver reliability. All 3D power Doppler indices had a significant association with gestational age, with VI showed a less significant relationship (r = 0.207, p = 0.0139) and FI has the most significant relationship (r = 0.582, p < 0.001). FI index increased progressively with gestational age, while the VI index values indicate dispersion pattern and reached a plateau from week 30 onwards. Entering week 37th, there was a decrease in the value of the index VI until the end of pregnancy. Meanwhile, VFI index appears to resemble the pattern of a combination of both VI and FI index (r = 0.692, p <0.001). Conclusion All parameters of 3D power Doppler index was lower in the severe pre-eclampsia compared with normal pregnancy. 3D PD-US can be used to assess the vascularization of the placenta and the intensity of intra-placental blood flow. Placental vascular biopsy method is fairly efficient way to perform routine evaluations evolution of placental vascular branch during pregnancy. How to cite this article Andonotopo W, Kristanto H, Dewantiningrum J, Pramono BA. Difference between Vascularization Indexes of the Placenta in Severe Pre-eclampsia and Normal Pregnancy by Three-dimensional Power Doppler Ultrasound. Donald School J Ultrasound Obstet Gynecol 2014;8(4):329-335.

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Investigation Into the Predictive Potential of Three-Dimensional Ultrasonographic Placental Volume and Vascular Indices in Gestational Diabetes Mellitus

Frontiers in Endocrinology ◽

10.3389/fendo.2021.689888 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zhenyan Han ◽

Yuan Zhang ◽

Xuelan Li ◽

Wei-Hsiu Chiu ◽

Yuzhu Yin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Logistic Regression ◽

Pregnant Women ◽

Maternal Age ◽

Power Doppler ◽

Three Dimensional ◽

Flow Index ◽

Multivariate Logistic Regression ◽

3D Power Doppler ◽

Placental Volume

BackgroundThe use of ultrasonography in pregnancies complicated with gestational diabetes mellitus (GDM) can vary according to clinical practice. This study aims to compare the changes of placental volume (PV) and vascular indices measured by three-dimensional (3D) Power Doppler between pregnant women with and without GDM.Materials and MethodsThis was a prospective study of singleton pregnancies who took the early nuchal translucency examination from January 2018 to September 2019. Data on PV and vascular indices including vascularization index (VI), flow index (FI), and vascularization flow index (VFI) between pregnant women with and without GDM were measured by 3D Power Doppler ultrasound machine. Univariate and multivariate logistic regression determined the association between risk factors and GDM. Receiver operating characteristic (ROC) and area under the ROC curve (AUC) were applied to evaluate the diagnostic value of different parameters for GDM.ResultsOf the 141 pregnant women enrolled, 35 developed GDM and 106 did not. The maternal age and gravida in the GDM group were significantly higher than that in the non-GDM group. The PV, VI, FI, and VFI in the GDM group were significantly lower than that in the non-GDM group. There were no significant differences in other clinical parameters between the two groups. After adjustments in multivariate logistic regression analysis, significant differences were observed in VI [odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.951–1.002], FI (OR = 0.93, 955 CI: 0.86–1.00), and VFI (OR = 0.67, 95% CI = 0.52–0.87). ROC analysis indicated that the combination of maternal age, gravida, PV, and VFI was more accurate as a marker for detecting GDM than the PV, VI, FI, or VFI alone.ConclusionsThe 3D ultrasonography results suggest that PV and vascular indices (VI, FI, and VFI) during the first trimester may serve as potential markers for GDM diagnosis. The combination of maternal age, gravida, and sonographic markers may have good diagnostic values for GDM, which should be confirmed by further investigations.

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Comparison of Placental Three-Dimensional Power Doppler Vascular Indices and Placental Volume in Pregnancies with Small for Gestational Age Neonates

Journal of Clinical Medicine ◽

10.3390/jcm8101651 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1651 ◽

Cited By ~ 1

Author(s):

Sue-Jar Chen ◽

Chie-Pein Chen ◽

Fang-Ju Sun ◽

Chen-Yu Chen

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Power Doppler ◽

Three Dimensional ◽

First Trimester ◽

Flow Index ◽

Second Trimester ◽

Significant Difference ◽

Placental Volume ◽

Singleton Pregnancies

This prospective observational study aimed to compare the changes in placental vascular indices and placental volume using three-dimensional power Doppler (3DPD) ultrasound in pregnancies with small for gestational age (SGA) neonates. We enrolled 396 women with singleton pregnancies from September 2013 to June 2016. Placental vascular indices, including the vascularization index (VI), flow index (FI), and vascularization flow index (VFI), and placental volume were obtained using 3DPD ultrasound in the first and second trimesters. Of the enrolled women, 21 delivered SGA neonates and 375 did not. In the first trimester, the SGA group had a significantly lower mean FI (25.10 ± 7.51 versus 33.10 ± 10.97, p < 0.001) and VFI (4.59 ± 1.95 versus 6.28 ± 2.35, p = 0.001) than the non-SGA group. However, there was no significant difference in the placental volume between the two groups during the first trimester. In the second trimester, the SGA group also had a significantly lower mean FI (27.08 ± 7.97 versus 31.54 ± 11.01, p = 0.022) and VFI (6.68 ± 1.71 versus 8.68 ± 3.09, p < 0.001) than the non-SGA group. In addition, a significantly smaller placental volume was noted in the SGA group (104.80 ± 24.23 cm3 versus 122.67 ± 26.35 cm3, p = 0.003) than in the non-SGA group during the second trimester. The results showed that a decreased placental VFI occurred earlier than a decreased placental volume in SGA pregnancies.

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