Department OB Gyn, Geburtshilfliche Abteilung Donauspital am SMZ-Ost, Langobardenstrasse 122, A-1220 Vienna, Austria.
Placenta. 2010 Sep;31(9):756-63. doi: 10.1016/j.placenta.2010.06.011. Epub 2010 Jul 14.
To evaluate whether 3D placental and myometrial power Doppler blood perfusion in the first trimester can be used to detect risk pregnancies.
3D power Doppler vascularization index (VI) and flow index (FI) of the entire placenta and the neighbouring myometrium were separately measured in the first trimester in all women with singleton pregnancies during a period of three months. In addition we measured placental volume, placental quotient, PAPP-A, as well as uterine artery at 12 and 22 weeks (mean PI and mean notch) and compared those data with the pregnancy outcome.
Data from 383 women could be evaluated. 10 developed pre-eclampsia (PE). Both flow and vascularization were markedly lower in the placentas compared to the adjoining decidua and myometria. There was some correlation between placental vascularization Index (PVI) as well as deciduo-myometrial vascularization index (MVI) and placental volume, PAPP-A and number of pregnancies and a marked correlation between PVI and especially MVI to mean notch at 12 weeks and 22 weeks (PVI: -0.215, -0.274 MVI: -0.316,-0.322). PVI and MVI were significantly reduced in women with pregnancy problems and showed the greatest reduction in PE-pregnancies (p: 0.0018, 0.0004). Of all measured parameters MVI showed the best sensitivity for the detection of PE.
The correlation between PVI and MVI in the first trimester and mean notch in the second shows that they provide valuable information at as early as 12 weeks which normally so far is only available at 22 weeks by uterine artery Doppler flow. As MVI measures the percentage of vessels in the deciduo-myometrial area it could also provide information on trophoblast invasion. This hypothesis is supported in particular by a marked decrease of the MVI in pregnancy problems especially in PE-pregnancies.
评估在早孕期，胎盘和子宫肌层的 3D 能量多普勒血流灌注是否可以用于检测高危妊娠。
在三个月内，对所有单胎妊娠的孕妇进行早孕期的 3D 能量多普勒血管化指数（VI）和血流指数（FI）的检测，分别测量胎盘和邻近子宫肌层的整体。此外，我们还测量了胎盘体积、胎盘指数、PAPP-A，以及 12 周和 22 周的子宫动脉（平均 PI 和平均切迹），并将这些数据与妊娠结局进行比较。
共 383 名妇女的数据可进行评估。10 例发生子痫前期（PE）。胎盘的血流和血管化均明显低于胎盘旁蜕膜和子宫肌层。胎盘血管化指数（PVI）和蜕膜-子宫肌层血管化指数（MVI）与胎盘体积、PAPP-A 和孕次有一定相关性，而 PVI 和 MVI 与 12 周和 22 周的平均切迹有显著相关性（PVI：-0.215，-0.274；MVI：-0.316，-0.322）。在有妊娠问题的妇女中，PVI 和 MVI 明显降低，在 PE 妊娠中降低最明显（p：0.0018，0.0004）。在所有测量的参数中，MVI 对 PE 的检测具有最佳的敏感性。
早孕期的 PVI 和 MVI 与中孕期的平均切迹之间存在相关性，表明它们在 12 周时就提供了有价值的信息，而这一信息在目前通常只能在 22 周时通过子宫动脉多普勒血流来获得。由于 MVI 测量了蜕膜-子宫肌层区域内血管的百分比，它还可以提供关于滋养细胞浸润的信息。这一假说尤其得到了 MVI 在妊娠问题中，尤其是在 PE 妊娠中明显降低的支持。
