Citation Information :
Sweed MS, El-Bishry GA, Abou-Gamrah AE, AbdEl-Hamid MM, NasrEl-Din EA, El-Hawwary GE. First-trimester 3D Power Doppler of Uteroplacental Circulation and Placental Volume for the Prediction of Preeclampsia: A Prospective Cohort Study. Donald School J Ultrasound Obstet Gynecol 2021; 15 (1):109-113.
Aim and objective: To evaluate the role of first-trimester 3D power Doppler of placental circulation and placental volume in the prediction of poor pregnancy outcomes. Materials and methods: This prospective cohort study included 375 pregnant women. 3D scans for the determination of placental volume and vascularization indices were performed. The primary outcome was the occurrence of preeclampsia (PE). Results: Placental 3D power Doppler indices were significantly lower in women who developed PE [vascularization index (VI) = 3.13 ± 2.1, flow index (FI) = 14.9 ± 9.3, vascularization flow index (VFI) = 0.1 ± 0.9] and fetal growth restriction (FGR) (VI = 4.5 ± 2.4, FI = 15.3 ± 7.9, VFI = 0.3 ± 0.6) compared with those who did not (VI = 9.7 ± 1.9, FI = 28.9 ± 4.6, VFI = 1.8 ± 1.4) (VI = 10.9 ± 1.6, FI = 30.9 ± 7.6, VFI = 1.9 ± 0.9), respectively (p < 0.001). The cutoff values for the prediction of PE were VI ≤ 3.22, FI ≤ 17.73, and VFI ≤ 0.5, while those for the prediction of intrauterine FGR were VI ≤ 4.12, FI ≤ 15.93, and VFI ≤ 0.3. Conclusion: First-trimester evaluation of placental bed vasculature with 3D power Doppler can be used as a good predictor of PE. Clinical significance: First-trimester 3D power Doppler of placental bed vasculature can help early prediction of PE and FGR allowing early intervention giving opportunity for better pregnancy outcomes.
Cnossen JS, Vollebregt KC, Vrieze N, et al. Accuracy of mean arterial pressure and blood pressure measurements in predicting pre-eclampsia: systematic review and meta-analysis. BMJ 2008;336(7653):1117–1120. DOI: 10.1136/bmj.39540.522049.BE.
Cnossen JS, Morris RK, ter Riet G, et al. Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ 2008;178(6):701–711. DOI: 10.1503/cmaj.070430.
Odibo AO, Goetzinger KR, Huster KM, et al. Placental volume and vascular flow assessed by 3D power Doppler and adverse pregnancy outcomes. Placenta 2011;32(3):230–234. DOI: 10.1016/j.placenta.2011.01.010.
Merce LT, Barco MJ, Bau S, et al. Assessment of placental vascularization by three-dimensional power Doppler” vascular biopsy” in normal pregnancies. Croat Med J 2005;46(5):765–771.
Hafner E, Schuchter K, van Leeuwen M, et al. Three-dimensional sonographic volumetry of the placenta and the fetus between weeks 15 and 17 of gestation. Ultrasound Obstet Gynecol 2001;18(2):116–120. DOI: 10.1046/j.1469-0705.2001.00489.x.
Noguchi J, Hata K, Tanaka H, et al. Placental vascular sonobiopsy using three-dimensional power Doppler ultrasound in normal and growth restricted fetuses. Placenta 2009;30(5):391–397. DOI: 10.1016/j.placenta.2009.02.010.
Hafner E, Metzenbauer M, Stümpflen I, et al. First trimester placental and myometrial blood perfusion measured by 3D power Doppler in normal and unfavourable outcome pregnancies. Placenta 2010;31(9):756–763. DOI: 10.1016/j.placenta.2010.06.011.
Odeh M, Ophir E, Maximovsky O, et al. Placental volume and three-dimensional power Doppler analysis in prediction of pre-eclampsia and small for gestational age between week 11 and 13 weeks and 6 days of gestation. Prenat Diagn 2011;31(4):367–371. DOI: 10.1002/pd.2697.
Dar P, Gebb J, Reimers L, et al. First-trimester 3-dimensional power Doppler of the uteroplacental circulation space: a potential screening method for preeclampsia. Am J Obstet Gynecol 2010;203(3):238.e1–238.e7. DOI: 10.1016/j.ajog.2010.06.006.
Rizzo G, Capponi A, Pietrolucci ME, et al. First-trimester placental volume and vascularization measured by 3-dimensional power Doppler sonography in pregnancies with low serum pregnancy-associated plasma protein a levels. J Ultrasound Med 2009;28(12):1615–1622. DOI: 10.7863/jum.2009.28.12.1615.
Adil Ali S, Gamal el-Din mansour M, Farouk O, et al. Efficiency of placental three dimentional power Doppler ultrasonography for predicting preeclampsia in early pregnancy. Egypt J Rad Nucl Med 2018;49(3):892–898. DOI: 10.1016/j.ejrnm.2017.11.006.
Raine-Fenning NJ, Nordin NM, Ramnarine KV, et al. Evaluation of the effect of machine settings on quantitative three-dimensional power Doppler angiography: an in-vitro flow phantom experiment. Ultrasound Obstet Gynecol 2008;32(4):551–559. DOI: 10.1002/uog.6138.
Jones NW, Hutchinson ES, Brownbill P, et al. In vitro dual perfusion of human placental lobules as a flow phantom to investigate the relationship between fetoplacental flow and quantitative 3D power Doppler angiography. Placenta 2009;30(2):130–135. DOI: 10.1016/j.placenta.2008.11.002.