Placental virtual biopsy: 3D-US hemodynamics of normal pregnancy versus gestational diabetes

Objectives: We used three-dimensional ultrasound with trans-abdominal Power-Doppler (3D-US PD) to determine placental vascular evolution in normal pregnancies (NP) and in insulin-dependent Gestational Diabetes Pregnancies (GDP). Study design: We obtained 473 measurements from 43 NP at 20 weeks-40 we...

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Bibliographic Details
Published in:Journal of biomedical graphics and computing 2014-02, Vol.4 (1), p.10-10
Main Authors: Troyano-Luque, Juan, Ferrer-Roca, Olga, Barco-Marcellan, Maria-Jesus, Martinez Wallin, Ingrid, Perez-Medina, Tirso, Padilla-Perez, Ana, De La Rosa, Margarita Alvarez
Format: Article
Language:English
Subjects:
Blood flow
Blood vessels
Circulation
Correlation
Diabetes
Diagnostic systems
Gestation
Pregnancy
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Summary:Objectives: We used three-dimensional ultrasound with trans-abdominal Power-Doppler (3D-US PD) to determine placental vascular evolution in normal pregnancies (NP) and in insulin-dependent Gestational Diabetes Pregnancies (GDP). Study design: We obtained 473 measurements from 43 NP at 20 weeks-40 weeks gestation and 122 measurements from 70 insulin-dependent GDP at 22 weeks-40 weeks. Standardization was achieved recording three successive placental vascular tree volumes, measuring the spherical volume between the chorionic and basal plates always under or near funicular insertion. Parameters analysed were: mean intensity of blood flow (Flow Index, FI); percentage of volume occupied by vessels (Vascularisation Index, VI); and intensity of blood flow in the volume occupied by vessels (Vascularisation-flow index, VFI). Results: In NP, FI increased throughout early pregnancy and decreased before delivery and correlated with fetal parameters. In contrast, in GDP, FI was high from the onset, better correlated with placental parameters, and had a diagnostic cutoff value of 45, which was only found in 7% of NP at the end of the pregnancy. VI was variable and had a low diagnostic value, being related to placental parameters; VI values were significantly lower in NP (17.4 plus or minus 7.4%) than in GDP (21 plus or minus 12%) with a diagnostic cutoff point at 31%. In NP, FI-peak was at 32 weeks, two weeks after the VI-peak, while VFI showed no significant differences. Conclusions: The results showed that placental blood flow (FI) was related to fetal circulation, while the percentage of vessels per volume (VI) was related to maternal circulation. 3D-US PD indicated a diagnosis of GDP for FI > 45 and VI > 30%. We also discuss the values of change in VI that predict changes in fetal FI.
ISSN:1925-4008
1925-4016
DOI:10.5430/jbgc.v4n1p10