Prediction of early‐ and late‐onset pregnancy‐induced hypertension using placental volume on three‐dimensional ultrasound and uterine artery Doppler

• Published in: Ultrasound in obstetrics & gynecology Vol. 45; no. 5; pp. 539 - 543
• Main Authors: Arakaki, T., Hasegawa, J., Nakamura, M., Hamada, S., Muramoto, M., Takita, H., Ichizuka, K., Sekizawa, A.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.05.2015; Wiley Subscription Services, Inc
• Subjects: Adult; Female; first‐trimester screening; Gestational Age; Humans; Hypertension; Hypertension, Pregnancy-Induced - diagnostic imaging; Hypertension, Pregnancy-Induced - pathology; Infant, Newborn; Placenta - diagnostic imaging; placental volume; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; pregnancy‐induced hypertension; pre‐eclampsia; ROC Curve; Ultrasonic imaging; Ultrasonography, Doppler, Pulsed; Ultrasonography, Prenatal; uterine artery; Uterine Artery - diagnostic imaging; first-trimester screening; pregnancy-induced hypertension; placental volume; pre-eclampsia; uterine artery
• ISSN: 0960-7692; 1469-0705; 1469-0705
• DOI: 10.1002/uog.14633

ABSTRACT Objectives To determine whether uterine artery (UtA) Doppler findings and three‐dimensional (3D) ultrasound measurement of placental volume during the first trimester allowed prediction of early‐ and late‐onset pregnancy‐induced hypertension (early PIH and late PIH). Methods Subjects with singleton pregnancy who underwent an ultrasound scan at 11–13 weeks' gestation and delivered between 2011 and 2013 were enrolled prospectively into the study. The UtA Doppler indices and placental volume on 3D ultrasound at 11–13 weeks' gestation in cases that developed early PIH (< 34 weeks) or PIH later in pregnancy (≥ 34 weeks) were compared with values in unaffected pregnancies. Results Ten cases of early PIH, 67 cases of late PIH and 1285 unaffected pregnancies were analyzed. The UtA pulsatility index (PI) was higher in cases of early PIH than that in unaffected pregnancies (median, 2.35 vs 1.79; P = 0.043) but did not differ between cases of late PIH and unaffected pregnancies. Placental volume was smaller in cases of early PIH than that in unaffected pregnancies (median, 43 cm3 vs 62 cm3; P = 0.003) but did not differ between cases of late PIH and unaffected pregnancies. The area under the receiver–operating characteristics curve for the prediction of early PIH, by combining UtA‐PI and placental volume, was 0.832 (95% CI, 0.742–0.921), with this combination providing a detection rate for early PIH of 67.5% for a 5% false‐positive rate. Conclusions High UtA‐PI and small placental volume were observed more often in cases of early PIH compared with unaffected pregnancies, but not in cases of late PIH. These results may indicate that there are differences in pathophysiology between early PIH and late PIH. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd. Linked Comment: Ultrasound Obstet Gynecol 2015; 45: 513–513