Three-dimensional placental volume and mean grey value: Normal ranges in a Turkish population and correlation with maternal serum biochemistry and Doppler parameters

Ultrasonographic evaluation of feto-placental tissues at different intrauterine locations in rabbit

The main purpose of examining multiparous species with real-time ultrasonography is to determine the gestational age and make various fetal measurements for early diagnosis of growth anomalies and sibling mismatches. This study investigated changes in fetometric measurements, obstetric Doppler indices and placental image analysis results based on gestational age and fetal location in fetuses located cranially and caudally between 16 and 24 days gestation in 22 healthy pregnant New Zealand rabbits. The first study group consisted of fetuses positioned at the cranial end (n = 22) while the second group consisted of fetuses positioned at the caudal end (n = 22) in each pregnancy. Fetal biparietal head diameter (BPD) and trunk diameter (TD) were measured, and mean grayness values (MGV) were determined from placental image analysis of each fetus. Using Doppler USG, the pulsatile (PI) and resistance (RI) indices of the uterine artery (UtA) and umbilical artery (UmA) were recorded. By the end of the study, BPD and TD values for cranial and caudal fetuses had significantly increased with gestational age (P < 0.001). The MGV values of caudal fetuses were significantly higher (except for the 16th day) (P < 0.05). The UtA PI value of the caudal fetuses was significantly higher (except for the 18th day) (P < 0.01). The UtA RI values of caudal fetuses were significantly higher than cranial ones on the 16 and 24th days (P < 0.05). The PI of the UmA increased until the 20th day before decreasing significantly in both study groups (P < 0.001). The UmA RI value decreased according to the gestational age in both groups (P < 0.001). It was significantly higher in the caudal fetuses on the 20th day (P < 0.05). The somatic rate of all fetuses peaked at the end of the second trimester, although caudal fetuses had higher fetometric values, and this location difference also affected placental echotexture. In both vessels of caudal fetuses, pulsatility and resistance values were higher. The 20th day of pregnancy was a threshold for the Doppler exam results. In conclusion, growth and metabolic status of fetuses located in different uterine locations in healthy pregnant New Zealand rabbits vary. Based on the these growth curves and hemodynamic data, more comprehensive studies of intrauterine life may be possible.

Mode of conception does not appear to affect placental volume in the first trimester

OBJECTIVE

To study whether infertility treatments, including IVF and non-IVF fertility treatments, are associated with diseases of placental insufficiency in early gestation. First trimester placental volumes by ultrasound and chorionic villi weight during sampling (CVS) were performed to detect differences between pregnancies conceived spontaneously versus with fertility treatments.

DESIGN

Retrospective cohort.

SETTING

Academic tertiary center.

PATIENT(S)

Women with singleton pregnancies undergoing CVS and first trimester ultrasound from April 2007 to November 2015.

INTERVENTION(S)

Estimated placental volume (EPV) was calculated from ultrasound images using a validated computation and CVS estimated tissue weight was performed using a validated visual analogue scale.

MAIN OUTCOME MEASURE(S)

Adjusted linear regression was used to compare EPV and CVS weight based on mode of conception.

RESULT(S)

A total of 1,977 spontaneous and 334 conceived with fertility treatments (133 non-IVF and 201 IVF) pregnancies were included. Significant differences in maternal age, gravidity, hypertension, and smoking status were identified. EPV and CVS weight were correlated with maternal age, gestational age, and maternal hypertension. Adjusted linear regression showed no difference in EPV in pregnancies conceived with fertility treatments versus spontaneously. The CVS weight was significantly lower in the IVF conceptions in unadjusted univariate analyses. However, after adjusted regression, this was no longer significant.

CONCLUSION(S)

Mode of conception does not appear to affect first trimester placental size. As differences in maternal age, hypertension, and smoking status differ among the groups and are correlated to placental size, it may be the underlying patient population leading to abnormal placentation and insufficiency, not the fertility treatments used.

Three-dimensional ultrasonographic placental volume in gestational diabetes mellitus

OBJECTIVES

We aimed to evaluate the placental volume and placental mean gray value in gestational diabetes mellitus (GDM) and healthy placentas using three-dimensional (3D) ultrasound and Virtual Organ Computer-aided AnaLysis (VOCAL).

METHODS

This case-control prospective study consisted of 39 singleton pregnancies complicated by GDM and 42 healthy singleton pregnancies matched for gestational age, maternal age and parity. Placental volume and placental volumetric mean gray values were evaluated. The placental volume (cm(3)) was analyzed using the VOCAL imaging analysis program and 3D histogram was used to calculate the volumetric mean gray value (%).

RESULTS

Placental volume was significantly larger in GDM (411.59 ± 170.82 versus 343.86 ± 128.94 cm(3); p = 0.046). There was no significant difference in mean gray value between GDM and healthy placentas (36.65 ± 7.02 versus 38.71 ± 7.91, respectively; p = 0.277). Placental volume was significantly correlated with gestational week (r = 0.219, p = 0.035) and parity (r = 0.228, p = 0.048). There was negative significant relation between placental volume and umbilical artery systolic/diastolic ratio, pulsatility index and resistance index (r = -0.278, p = 0.007; r = -0.315, p = 0.002; r = -0.322, p = 0.001, respectively).

CONCLUSIONS

Placental volume increases significantly in GDM, whereas mean gray values do not alter significantly. These data may reflect the placental changes in GDM placentas that may help to understand the pathophysiology better.