First trimester placental volume and vascular indices in pregnancies complicated by preeclampsia

• Published in: Prenatal diagnosis 2015-12, Vol.35 (12), p.1247-1254
• Main Authors: Plasencia, Walter, González-Dávila, Enrique, González Lorenzo, Alejandra, Armas-González, Marina, Padrón, Erika, González-González, Nieves L.
• Format: Article
• Language: English
• Subjects: Adult; Case-Control Studies; Female; Humans; Imaging, Three-Dimensional; Organ Size; Placenta - blood supply; Placenta - pathology; Pre-Eclampsia - pathology; Pregnancy; Pregnancy Trimester, First; Prospective Studies; Ultrasonography, Prenatal; Young Adult
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.4692

Objective To analyze placental volume and vascularization at first trimester in women with pre‐eclampsia, and secondarily, the effect of maternal characteristics on placental development and perinatal outcomes. Methods This was a prospective cohort study including women seen between 11 and 14 weeks of pregnancy. Biophysical and biochemical markers included in the screening program for aneuploidy were recorded. Placental volume and vascularization indices were obtained using three‐dimensional power‐Doppler imaging and Virtual Organ Computer‐aided Analysis (VOCAL) techniques. Results We compared 84 women with pre‐eclampsia versus 904 non‐affected. Placental volume and all vascular indices were lower in those with pre‐eclampsia. Multivariate analysis showed that parity and maternal weight had a significant effect on placental volume and vascularization indices (p = 0.004 and p = 0.011). In women with pre‐eclampsia, multiparity showed a negative effect on placental volume, gestational age, birth weight and Apgar test score. By contrast, in the non‐affected group, multiparity had a protective effect. Low maternal weight had a significantly worse effect on placental vascularization and perinatal outcomes in women with pre‐eclampsia. Conclusions Women with pre‐eclampsia showed significantly lower placental volume and vascularization indices at first trimester. Multiparity and low maternal weight independently exacerbated the negative effects of pre‐eclampsia on placental characteristics and perinatal outcomes. © 2015 John Wiley & Sons, Ltd. What's already known about this topic? The pathogenesis of pre‐eclampsia begins at the time of trophoblast invasion. Three‐dimensional ultrasound with power Doppler facilitates assessment of placental volume and entire placental circulation. The effect of pre‐eclampsia on placental volume remains unclear. What does this study add? Women with pre‐eclampsia showed significantly lower placental volume and vascularization indices at first trimester. Multiparity and low maternal weight independently exacerbated the negative effects of pre‐eclampsia on placental characteristics and perinatal outcomes.