Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  18 (2024)
Volume  17 (2023)
Volume  16 (2022)
Volume  15 (2021)
Volume  14 (2020)
Volume  13 (2019)
Volume  12 (2018)
Volume  11 (2017)
Volume  10 (2016)
Volume  9 (2015)
Volume  8 (2014)
Volume  7 (2013)
Volume  6 (2012)
Volume  5 (2011)
Volume  4 (2010)
Volume  3 (2009)
Volume  2 (2008)
Volume  1 (2007)
Related articles

VOLUME 17 , ISSUE 2 ( April-June, 2023 ) > List of Articles

Original Article

Decreased Placental Perfusion Assessed by Three-dimensional Power Doppler Ultrasound in Pregnancies with Gestational Diabetes Mellitus

Toshiyuki Hata, Aya Koyanagi, Takahito Miyake, Mohamed AM AboEllail

Keywords : Gestational diabetes mellitus, Normal pregnancy, Placental perfusion, Placental vascular sonobiopsy, Three-dimensional power Doppler ultrasound

Citation Information : Hata T, Koyanagi A, Miyake T, AboEllail MA. Decreased Placental Perfusion Assessed by Three-dimensional Power Doppler Ultrasound in Pregnancies with Gestational Diabetes Mellitus. Donald School J Ultrasound Obstet Gynecol 2023; 17 (2):112-116.

DOI: 10.5005/jp-journals-10009-1977

License: CC BY-NC 4.0

Published Online: 05-07-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Objective: To assess placental perfusion in pregnancies with gestational diabetes mellitus (GDM) using placental vascular sonobiopsy (PVS). Methods: Three-dimensional power Doppler ultrasound (3D PD US) assessment of placental perfusion with virtual organ computer-aided analysis (VOCAL) histogram analysis was performed in 49 normal pregnancies (control) at 18–21 + 6 and 28–31 + 6 weeks of gestation, and 10 diet-controlled GDM pregnancies at 28–31 + 6 weeks gestation. 3D PD indices such as the vascularization index (VI), flow index (FI), and vascularization FI (VFI) were generated for each placenta. Results: Flow index (FI) values [35.5 (mean) ± 3.5 standard deviations (SD)] at 28–31 + 6 weeks gestation were significantly higher than those [32.3 (mean) ± 4.1 (SD)] at 18–21 + 6 weeks (p < 0.0001), whereas there were no significant differences in VI or VFI values between 18–21 + 6 and 28–31 + 6 weeks of gestation in the control group. FI values [31.9 (mean) ± 3.9 (SD)] in the GDM group were significantly lower than those [35.5 (mean) ± 3.5 (SD)] in the control group at 28–31 + 6 weeks gestation (p = 0.0056), whereas between control and GDM groups no significant differences were found in VI and VFI values. Discussion: Our findings suggest that placental perfusion is reduced in diet-controlled GDM pregnancies. The lower FI in GDM pregnancies may be interpreted as placental vascular vasoconstriction, indicating placental hypoperfusion.

HTML PDF Share
  1. Rodrigues S, Robinson EJ, Ghezzo H, et al. Interaction of body weight and ethnicity on risk of gestational diabetes. Am J Clin Nutr 1999;70:1083–1089. DOI: 10.1093/ajcn/70.6.1083
  2. Mrizak I, Arfa A, Fekih M, et al. Inflammation and impaired endothelium- dependant vasodilatation in non obese women with gestational diabetes mellitus: preliminary results. Lipids Health Dis 2013;12:93. DOI: 10.1186/1476-511X-12-93
  3. Meng Q, Shao L, Luo X, et al. Expression of VEGF-A and VEGFR-2 in placentae from GDM pregnancies. Reprod Biol Endocrinol 2016;14(1):61. DOI: 10.1186/s12958-016-0191-8
  4. Aldahmash WM, Alwasel SH, Aljerian K. Gestational diabetes mellitus induces placental vasculopathies. Environ Sci Pollut Res Int 2022;29(13):19860–19868. DOI: 10.1007/s11356-021-17267-y
  5. Yu CH, Chang CH, Ko HC, et al. Assessment of placental fractional moving blood volume using quantitative three-dimensional power Doppler ultrasound. Ultrasound Med Biol 2003;29(1):19–23. DOI: 10.1016/s0301-5629(02)00695-6
  6. Merce LT, Barco MJ, Bau S. Reproducibility of the study of placental vascularization by three-dimensional power Doppler. J Perinat Med 2004;32(3):228–233. DOI: 10.1515/JPM.2004.043
  7. Merce LT, Barco MJ, Bau S, et al. Assessment of placental vascularization by three-dimensional power Doppler “vascular biopsy” in normal pregnancies. Croatia Med J 2005;46(5):765–771.
  8. 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
  9. Hata T, Tanaka H, Noguchi J, et al. Three-dimensional ultrasound evaluation of the placenta. Placenta 2011;32(2):105–115. DOI: 10.1016/j.placenta.2010.11.001
  10. Noguchi J, Tanaka H, Koyanagi A, et al. Three-dimensional power Doppler indices at 18-22 weeks’ gestation for prediction of fetal growth restriction or pregnancy-induced hypertension. Arch Gynecol Obstet 2015;292(1):75–79. DOI: 10.1007/s00404-014-3603-z
  11. Sato M, Noguchi J, Mashima M, et al. 3D power Doppler ultrasound assessment of placental perfusion during uterine contraction in labor. Placenta 2016;45:32–36. DOI: 10.1016/j.placenta.2016.06.018
  12. International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, et al. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010;33(3):676–682. DOI: 10.2337/dc09-1848
  13. Okai T. Standard values of ultrasonic measurements in Japanese fetuses. J Med Ultrason 2003;30:J415–J440.
  14. de Paula CFS, Ruano R, Campos JA, et al. Quantitative analysis of placental vasculature by three-dimensional power Doppler ultrasonography in normal pregnancies from 12 to 40 weeks of gestation. Placenta 2009;30(2):142–148. DOI: 10.1016/j.placenta.2008.11.010
  15. Guimarães Filho HA, Araujo Júnior E, Matter R, et al. Placental blood flow measured by three-dimensional power Doppler ultrasound at 26 to 35 weeks gestation in normal pregnancies. J Matern Fetal Neonatal Med 2010;23(1):69–73. DOI: 10.3109/14767050903121431
  16. Mihu CM, Mihu D, Drugan T, et al. Study of intraplacental vascularization 3D power Doppler ultrasound in pregnancies with normal evolution. Gineco 2010;6:210–216.
  17. Morel O, Grangé G, Fresson J, et al. Vascularization of the placenta and the sub-placental myometrium: feasibility and reproducibility of a three-dimensional power Doppler ultrasound quantification technique. A pilot study. J Matern Fetal Neonatal Med 2011;24(2):284–290. DOI: 10.3109/14767058.2010.486845
  18. Stanley JL, Cheung CC, Rueda-Clausen CF, et al. Effect of gestational diabetes on maternal artery function. Reprod Sci 2011;18(4):342–352. DOI: 10.1177/1933719110393029
  19. Suranyi A, Kozinszky Z, Molnar A, et al. Placental three-dimensional power Doppler indices in mid-pregnancy and late pregnancy complicated by gestational diabetes mellitus. Prenat Diagn 2013;33(10):952–958. DOI: 10.1002/pd.4172
  20. Reiter A, Hajduk B, Geka F, et al. Doppler studies of gestational diabetes in the third trimester. Ultraschall Med 2011;32(Suppl 2):E162–E168. DOI: 10.1055/s-0031-1273415
  21. Pairleitner H, Steiner H, Hasenoehrl G, et al. Three dimensional power Doppler sonography: imaging and quantifying blood flow and vascularization. Ultrasound Obstet Gynecol 1999;14(2):139–143. DOI: 10.1046/j.1469-0705.1999.14020139.x
  22. Raine-Fenning NJ, Nordin NM, Ramnarine KV, et al. Determining the relationship between three-dimensional power Doppler data and true blood flow characteristics: an in-vitro flow phantom experiment. Ultrasound Obstet Gynecol 2008;32(4):540–550. DOI: 10.1002/uog.6110
  23. Zalud I, Shaha S. Three-dimensional sonography of the placental and uterine spiral vasculature: influence of maternal age and parity. J Clin Ultrasound 2008;36(7):391–396. DOI: 10.1002/jcu.20485
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.