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
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.
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.
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