Περίληψη:
Objective: The study aims to evaluate the predictive value of first trimester placental volume in pregnancies destined to develop fetal growth restriction (FGR) and preeclampsia (PE). Methods: Prospective observational study including placentas from 34 FGR, 12 PE, 15 GH (gestational hypertension) pregnancies, and 265 controls. Placental volume (PV) was obtained using VOCAL technique, and a z score was calculated (z-PV). The association of PV with other first trimester variables and maternal characteristics was assessed with Spearman's correlation. Results: PV increased exponentially with crown-rump length (CRL) and was unrelated to maternal factors (weight, age, parity, and smoking status) as well as first trimester uterine artery Doppler, free β-hCG, nuchal translucency, or fetal heart rate. However, PV was positively associated with maternal height, CRL, PAPP-A, and birth weight. z-PV was a strong predictor for FGR with abnormal fetal Dopplers (AUC = 0.9472, P < 0.001). z-PV provided moderate prediction of FGR with normal fetal Dopplers (AUC = 0.8396, P < 0.001), PE (AUC = 0.8312, P < 0.001), and GH (AUC = 0.7640, P < 0.001). The addition of maternal weight, PAPP-A, β-hCG, and uterine artery Doppler improved our models. Conclusion: At 11 to 14 weeks, PV is an independent predictor of pregnancy complications related to placental insufficiency, and the predictive ability is greater for FGR pregnancies with abnormal fetal Dopplers. © 2018 John Wiley & Sons, Ltd.
Συγγραφείς:
Papastefanou, I.
Chrelias, C.
Siristatidis, C.
Kappou, D.
Eleftheriades, M.
Kassanos, D.
Λέξεις-κλειδιά:
chorionic gonadotropin beta subunit; pregnancy associated plasma protein A, Article; birth weight; body weight; controlled study; crown rump length; female; fetus; fetus echography; fetus growth; first trimester pregnancy; gestational age; human; intrauterine growth retardation; major clinical study; maternal age; maternal hypertension; maternal smoking; nuchal translucency measurement; observational study; parity; placenta insufficiency; placenta weight; preeclampsia; pregnancy complication; premature labor; priority journal; prospective study; pulsatility index; uterine artery; adult; case control study; diagnostic imaging; intrauterine growth retardation; organ size; pathology; placenta; placenta disorder; predictive value; preeclampsia; pregnancy; register; three dimensional imaging, Adult; Case-Control Studies; Female; Fetal Growth Retardation; Humans; Imaging, Three-Dimensional; Organ Size; Placenta; Placenta Diseases; Placental Insufficiency; Pre-Eclampsia; Predictive Value of Tests; Pregnancy; Pregnancy Trimester, First; Prospective Studies; Registries; Ultrasonography, Prenatal; Uterine Artery
