Placental volume and vascular flow assessed by 3D power Doppler and adverse pregnancy outcomes

• Published in: Placenta (Eastbourne) Vol. 32; no. 3; pp. 230 - 234
• Main Authors: Odibo, A.O, Goetzinger, K.R, Huster, K.M, Christiansen, J.K, Odibo, L, Tuuli, M.G
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.03.2011; Elsevier
• Subjects: 3D power Doppler; Adult; Area Under Curve; Biological and medical sciences; Cohort Studies; Diabetes, Gestational - diagnostic imaging; Diabetes, Gestational - etiology; Embryology: invertebrates and vertebrates. Teratology; Female; Fundamental and applied biological sciences. Psychology; Humans; Internal Medicine; Logistic Models; Obstetrics and Gynecology; Placenta - blood supply; Placenta - diagnostic imaging; Placental volume; Pre-Eclampsia - diagnostic imaging; Pre-Eclampsia - etiology; Predictive Value of Tests; Preeclampsia; Pregnancy; Pregnancy Trimester, First; Prospective Studies; ROC Curve; Small for gestational age; Ultrasonography, Doppler - methods; Ultrasonography, Prenatal - methods; Vascular flow indices; Vascular flow indices; Small for gestational age; 3D power Doppler; Preeclampsia; Placental volume; Sonography; Doppler ultrasound study; Pregnancy; Vertebrata; Mammalia; Placenta; Prognosis; Fetal membrane; Power flow; Volume
• ISSN: 0143-4004; 1532-3102
• DOI: 10.1016/j.placenta.2011.01.010

Abstract Objective To estimate the utility of first-trimester 3D-placental volume and vascular flow indices in the prediction of adverse pregnancy outcomes. Methods A prospective cohort study including women with singleton pregnancies seen between 11 and 14 weeks as part of a screening program for aneuploidy. Placental volume and vascularization indices were obtained using 3D power Doppler imaging and the VOCAL technique. Placental volume (PV), Vascularization Index (VI), Flow Index (FI) and Vascularization Flow Index (VFI) were calculated. The adverse pregnancy outcomes investigated include preeclampsia (PE), gestational hypertension (GH) and small for gestational age (SGA). The predictive ability of each variable was evaluated using receiver-operating characteristic (ROC) curves. Results Of 388 women included, PE was seen in 30 (7.7%), GH in 37 (9.0%) and SGA in 31 (8.0%). Placental volume was not significantly different between the pregnancies with adverse outcomes and those without. The mean values of the VI and VFI were significantly lower in the pregnancies that developed PE but not in GH or SGA. The area under the ROC curve for the prediction of PE was 0.71, 0.69 and 0.70 for VI, FI and VFI, respectively. Conclusion The study confirms lower 3D power Doppler vascular flow indices in pregnancies that develop PE. The discriminatory ability of using these indices alone for predicting PE appears modest.