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

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.

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

2014 ◽  
Vol 8 (4) ◽  
pp. 329-335 ◽  
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.

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

2009 ◽  
Vol 29 (9) ◽  
pp. 1609-1618 ◽  
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.

Ultrasonographic Evaluation of Glycemic Control Effect on Placental Vascularization in Pregnancy with Type 1 Diabetes Mellitus

2019 ◽  
Vol 128 (12) ◽  
pp. 788-795
Author(s):  
Zoltan Kozinszky ◽  
AbelT. Altorjay ◽  
Andras Molnar ◽  
Tibor Nyári ◽  
Sandor G. Vari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Type 1 Diabetes Mellitus ◽  
Pregnant Women ◽  
Power Doppler ◽  
Flow Index ◽  
Ultrasound Technique ◽  
Placental Perfusion

Abstract Aims The aim of our study was to assess the effect of glycemic control on placental vascularization in pregnancies complicated by type 1 diabetes mellitus (T1DM) and to compare dataset of optimal/suboptimal glycemic control to normal placental 3-dimensional power Doppler (3-DPD) indices in 2nd and 3rd trimester. Methods Placental vascularization of pregnant women was prospectively evaluated by 3-DPD ((vascularization-index (VI); flow-index (FI); vascularization-flow-index (VFI)) ultrasound technique. The normal pregnancies (n=214) were compared to those complicated by T1DM (n=53) with optimal (HbA1C≤6%;≤ 42 mmol/mol) and suboptimal (HbA1C>6%;>42 mmol/mol) glycemic control. Results Pregnancies complicated by T1DM expressed lower placental vascularization indices as compared with normal pregnancies (adjusted odds ratio (AOR) for VI:0.86; FI:0.94; VFI:0.76). Placental 3-DPD indices have a significant correlation with HbA1C and optimal glycemic control is associated with lower placental perfusion (AOR for VI:1.64; FI:1.13; VFI:2.34). Short-term adverse neonatal outcome was predicted by lower 3-DPD indices (AORVI:0.83, AORFI:0.93, AORVFI:0.66, p<0.05 for each index). Besides the glycemic control, the pregestational body mass index (BMI), had significant influences on placental perfusion. Conclusions VI displayed the best screening ability for suboptimal glycemic control with a sensitivity of 90.9%. The suboptimal glycemic control has a direct deteriorating effect on placental vasculature. Therefore the ultrasound examination could be an adjunct diagnostic modality for pregnant women with T1DM.

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.

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.

scholarly journals Lifestyle intervention to prevent gestational diabetes mellitus and adverse maternal outcomes among pregnant women at high risk for gestational diabetes mellitus

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097913
Author(s):  
Xueyan Lin ◽  
Ting Yang ◽  
Xueqin Zhang ◽  
Wei Wei
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Lifestyle Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Maternal Outcomes ◽  
Multivariate Logistic Regression

Objective We assessed the effects of a lifestyle intervention on gestational diabetes mellitus (GDM) incidence and risk of adverse maternal outcomes among pregnant women at high risk for GDM. Methods From July to December 2018, we enrolled 1822 eligible pregnant women; of these, 304 had at least one risk factor for GDM. Participants were randomly allocated to the intervention or control group. Usual prenatal care was offered to both groups; the intervention group also received individually modified education on diet, physical activity, and weight control. The GDM diagnosis was based on an oral glucose tolerance test at 24–28 gestational weeks. Multivariate logistic regression was used to evaluate the effects of the lifestyle intervention on risk of GDM and adverse maternal outcomes. Results A total of 281 women (139 in the intervention group and 142 controls) were included. Incidences of GDM and adverse maternal outcomes were all significantly lower in the intervention than in the control group. Multivariate logistic regression indicated that women in the intervention group had a lower risk of GDM and adverse maternal outcomes, after adjusting potential confounding factors. Conclusion The present lifestyle intervention was associated with lower risks of GDM and adverse maternal outcomes.

scholarly journals Role of Three Dimensional Doppler Ultrasonography And Leukemia Inhibitory Factor From Endometrial Secretion In Predicting Clinical Pregnancy In IVF Treatment

2021 ◽  
Author(s):  
Ivan Sini ◽  
Nining Handayani ◽  
Ph.D Hara Alida MD ◽  
Arief Boediono ◽  
Budi Wiweko ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Leukemia Inhibitory Factor ◽  
Protein Concentration ◽  
Power Doppler ◽  
Three Dimensional ◽  
Endometrial Receptivity ◽  
Clinical Pregnancy ◽  
Inhibitory Factor ◽  
Flow Index

Abstract PurposeThis study aimed to evaluate the potential synergistic role of three-dimensional power Doppler angiography ultrasound and the expression of Leukemia Inhibitory factor (LIF) protein in predicting the endometrial receptivity of fresh In Vitro Fertilization (IVF) cycles. Materials and methods This prospective study involved 29 good prognosis women who underwent fresh IVF cycles with fresh blastocysts transfer. Serial measurements of sub-endometrial parameters via power Doppler angiography including vascularity index (VI), flow index (FI), and vascularization flow index (VFI) were conducted consecutively on the day of oocyte maturation trigger, ovum pick-up, and blastocyst transfer. Aspiration of endometrial secretion was performed on the day of embryo transfer. ResultsAfter performing multiple logistic regression analyses, the mean index of VI on the trigger day and LIF protein concentration at the window of implantation was significantly higher in clinically pregnant women than that of the non-pregnant women (p <0.05). The area under the curve (AUC) of LIF concentration was shown to have a powerful predictive value to forecast clinical pregnancy (0.884, p <0.05), with a cut-off value of 713 pg/mL. Likewise, VI index on the trigger day was adequate to become a predictor for the pregnancy event (AUC 0.803, the cut-off value >5.381, p<0.05). A combination of both variables utilizing the cut-off value was adequate for the differentiation of pregnant and non-pregnant cases (p <0.05). ConclusionVI index assessed on trigger day and the expression of LIF protein concentration at the window of implantation provided sufficient information to predict endometrial receptivity.

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