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Hernandez-Andrade E, Huntley ES, Bartal MF, Soto-Torres EE, Tirosh D, Jaiman S, Johnson A. Doppler evaluation of normal and abnormal placenta. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 60:28-41. [PMID: 34806234 DOI: 10.1002/uog.24816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
Doppler techniques are needed for the evaluation of the intraplacental circulation and can be of great value in the diagnosis of placental anomalies. Highly sensitive Doppler techniques can differentiate between the maternal (spiral arteries) and fetal (intraplacental branches of the umbilical artery) components of the placental circulation and assist in the evaluation of the placental functional units. A reduced number of placental functional units can be associated with obstetric complications, such as fetal growth restriction. Doppler techniques can also provide information on decidual vessels and blood movement. Abnormal decidual circulation increases the risk of placenta accreta. Doppler evaluation of the placenta greatly contributes to the diagnosis and clinical management of placenta accreta, vasa previa, placental infarcts, placental infarction hematoma, maternal floor infarction, massive perivillous fibrin deposition and placental tumors. However, it has a limited role in the diagnosis and clinical management of placental abruption, placental hematomas, placental mesenchymal dysplasia and mapping of placental anastomoses in monochorionic twin pregnancies. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- E Hernandez-Andrade
- Department of Obstetrics and Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas, Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - E S Huntley
- Department of Obstetrics and Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas, Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - M F Bartal
- Department of Obstetrics and Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas, Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - E E Soto-Torres
- Department of Obstetrics and Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas, Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - D Tirosh
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - S Jaiman
- Department of Obstetrics and Gynecology Wayne State University, Detroit, MI, USA
| | - A Johnson
- Department of Obstetrics and Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas, Health Science Center at Houston (UTHealth), Houston, TX, USA
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Yin G, Chen M, Li J, Zhao X, Yang S, Li X, Yuan Z, Wu A. Vascular corrosion casting of normal and pre-eclamptic placentas. Exp Ther Med 2017; 14:5535-5539. [PMID: 29285088 DOI: 10.3892/etm.2017.5207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/09/2016] [Indexed: 11/06/2022] Open
Abstract
Pre-eclampsia is an important cause of maternal and fetal morbidity and mortality that is associated with decreased placental perfusion. In the present study, vascular corrosion casting was used to investigate the differences in structural changes of the fetoplacental vasculature between normal and pre-eclamptic placentas. An improved epoxy resin vascular casting technique was used in the present study. Casting media were infused into 40 normal and 40 pre-eclamptic placentas through umbilical arteries and veins in order to construct three dimensional fetoplacental vasculatures. The number of branches, diameter, morphology and peripheral artery-to-vein ratio were measured for each specimen. The results indicated that the venous system of normal placentas was divided into 5-7 grades of branches and the volume of the vascular bed was 155.5±45.3 ml. In severe pre-eclamptic placentas, the volume was 106.4±36.1 ml, which was significantly lower compared with normal placentas (P<0.01). The venous system of pre-eclamptic placentas was divided into 4-5 grades of branches, which was much more sparse compared with normal placentas. In additions, the diameters of grade 1-3 veins and grade 2-3 arteries were significantly smaller in severe pre-eclampsia (P<0.05). In conclusion, pre-eclamptic placentas displayed a decreased volume of vascular bed, smaller diameters of grade 1-3 veins and grade 2-3 arteries, and an increased peripheral artery-to-vein ratio, which may be a cause of the placental dysfunction during severe pre-eclampsia.
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Affiliation(s)
- Geping Yin
- Department of Obstetrics and Gynecology, Jinan Military General Hospital, Jinan, Shandong 250031, P.R. China
| | - Ming Chen
- Department of Obstetrics and Gynecology, Jinan Military General Hospital, Jinan, Shandong 250031, P.R. China
| | - Juan Li
- Department of Obstetrics and Gynecology, Jinan Military General Hospital, Jinan, Shandong 250031, P.R. China
| | - Xiaoli Zhao
- Department of Obstetrics and Gynecology, Jinan Military General Hospital, Jinan, Shandong 250031, P.R. China
| | - Shujun Yang
- Department of Obstetrics and Gynecology, Jinan Military General Hospital, Jinan, Shandong 250031, P.R. China
| | - Xiuyun Li
- Department of Obstetrics and Gynecology, Jinan Military General Hospital, Jinan, Shandong 250031, P.R. China
| | - Zheng Yuan
- Department of Obstetrics and Gynecology, Jinan Military General Hospital, Jinan, Shandong 250031, P.R. China
| | - Aifang Wu
- Department of Obstetrics and Gynecology, Jinan Military General Hospital, Jinan, Shandong 250031, P.R. China
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Wang ZJ, Zhu XW, Huang QT, Yun ZQ, Cao YW, Chen YY, Zhong M. Three-dimensional reconstruction of human placental vascular network using in-vitro MRI data. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2016; 47:790-792. [PMID: 26564277 DOI: 10.1002/uog.15809] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 11/06/2015] [Accepted: 11/09/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Z J Wang
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - X W Zhu
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Q T Huang
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Z Q Yun
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Y W Cao
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Y Y Chen
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - M Zhong
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, Guangzhou, China
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Escudero C, Celis C, Saez T, San Martin S, Valenzuela F, Aguayo C, Bertoglia P, Roberts J, Acurio J. Increased placental angiogenesis in late and early onset pre-eclampsia is associated with differential activation of vascular endothelial growth factor receptor 2. Placenta 2014; 35:207-15. [DOI: 10.1016/j.placenta.2014.01.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 01/09/2014] [Accepted: 01/14/2014] [Indexed: 01/08/2023]
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