3D power doppler placental bed vascularization in the first trimester prediction of preeclampsia
Objective. To assess the performance of first trimester preeclampsia (PE) prediction by 3D power Doppler (3DPD) vascular indices (VI, vascularization index; FI, flow index; VFI, vascularization-flow index) of the placental bed.Kholin A.M., Khodzaeva Z.S., Gus A.I.
Subject and methods: It was case-control study including 736 singleton pregnancies taken part in the first trimester prenatal screening program. Maternal factors, mean arterial blood pressure, maternal serum biomarkers (PlGF, PAPP-A, hCGβ), uterine artery pulsatility index (UtAPI) was carried out together with 3DPD angiography to assess the placental bed vascularization and to calculate 3DPD placental bed vascular indices.
Results. PE group included 102 cases, which consist 29 early PE cases, and 73 late PE cases; 570 cases was unaffected group. The placental bed indices of vascularization at first trimester are decreased in patients who later develop PE compared to unaffected pregnancies, the vascularization index (VI) was most significant marker, which had a detection rate of 48.2% for early PE and 41.2% for all PE (at false positive rate of 10%). Such predictive marker as UtAPI at a first trimester had a detection rate of 37.9% for early PE and 25,5% for all PE at false positive rate of 10%.
Conclusions. Assessment of vascularization of the placental bed in the first trimester by 3D power Doppler (VI) has a good potential for PE prediction in combined models. The vascularization index of the placental bed was superior to the uterine artery pulsatility index in PE prediction, mainly the early onset forms of PE. Further researches are needed to clarify the role of first trimester placental bed 3DPD angiography in clinical practice, and it combining with other non-ultrasound markers.
Keywords
preeclampsia
first trimester screening
prediction
three-dimensional power Doppler
uterine artery Doppler
placental bed
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Received 08.09.2017
Accepted 22.09.2017
About the Authors
Alexey Kholin, M.D., Research Associate, Department of Maternal Fetal Medicine, National Medical Research Center of Obstetrics, Gynecology and Perinatology namedafter V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: a_kholin@oparina4.ru
Zulfiya Khodzhaeva, M.D., Ph.D., Professor, Principal Investigator, Department of Maternal-Fetal Medicine, National Medical Research Center of Obstetrics,
Gynecology and Perinatology named after V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: z_khodzhaeva@oparina4.ru
Alexander Gus, M.D., Ph.D., Head of Ultrasound Department, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: a_gus@oparina4.ru
For citations: Kholin A.M., Khodzaeva Z.S., Gus A.I. 3D power doppler placental bed vascularization in the first trimester prediction of preeclampsia. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (2): 36-43. (in Russian)
https://dx.doi.org/10.18565/aig.2018.2.36-43
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