Dap M, Chen B, Banasiak C, Hossu G, Morel O, Beaumont M, Bertholdt C. MRI Angiography of normal and pathological pregnancy PLacentas Ex vivo (MAPLE): protocol for a prospective pilot study. (Preprint).
JMIR Res Protoc 2021;
11:e35051. [PMID:
35947435 PMCID:
PMC9403824 DOI:
10.2196/35051]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/09/2022] [Accepted: 04/27/2022] [Indexed: 11/23/2022] Open
Abstract
Background
Preeclampsia (PE) and intrauterine growth restriction (IUGR) are 2 major pregnancy complications due to abnormal placental vasculogenesis. Data on whole fetoplacental vasculature are still missing; hence, these pathologies are not well understood. Ex vivo magnetic resonance imaging (MRI) angiography has been developed to characterize the human placental vasculature by injecting a contrast agent within the umbilical cord.
Objective
The primary objective of this study is to compare the placental vascular architecture between normal and pathological pregnancies. This study’s secondary objectives are to (1) compare texture features on MRI between groups (normal and pathological), (2) quantitatively compare the vascular architecture between both pathological groups (pathological IUGR, and pathological PE), (3) evaluate the quality of the histological examination in injected placentas, and (4) compare vascularization indices to histological characteristics.
Methods
This is a prospective controlled study. We expect to include 100 placentas: 40 from normal pregnancies and 60 from pathological pregnancies (30 for IUGR and 30 for PE). Ex vivo MR image acquisition will be performed shortly after delivery and with preparation by injection of a contrast agent in the umbilical cord. The vascular architecture will be quantitatively described by vascularization indices measured from ex vivo MRI angiography data. Comparisons of vascularization indices and texture features in accordance with the group and within comparable gestational age will be also performed. After MR image acquisition, placental histopathological analysis will be performed.
Results
The enrollment of women began in November 2019. In view of the recruitment capacity of our institution and the availability of the MRI, recruitment should be completed by March 2022. As of November 2021, we enrolled 70% of the intended study population.
Conclusions
This study protocol aims to provide information about the fetal side of placental vascular architecture in normal and pathological placenta through MRI.
Trial Registration
Clinicaltrials.gov NCT04389099; https://clinicaltrials.gov/ct2/show/NCT04389099
International Registered Report Identifier (IRRID)
DERR1-10.2196/35051
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