Division of Maternal-Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA.
Placenta. 2011 Mar;32(3):230-4. doi: 10.1016/j.placenta.2011.01.010. Epub 2011 Feb 4.
To estimate the utility of first-trimester 3D-placental volume and vascular flow indices in the prediction of adverse pregnancy outcomes.
A prospective cohort study including women with singleton pregnancies seen between 11 and 14 weeks as part of a screening program for aneuploidy. Placental volume and vascularization indices were obtained using 3D power Doppler imaging and the VOCAL technique. Placental volume (PV), Vascularization Index (VI), Flow Index (FI) and Vascularization Flow Index (VFI) were calculated. The adverse pregnancy outcomes investigated include preeclampsia (PE), gestational hypertension (GH) and small for gestational age (SGA). The predictive ability of each variable was evaluated using receiver-operating characteristic (ROC) curves.
Of 388 women included, PE was seen in 30 (7.7%), GH in 37 (9.0%) and SGA in 31 (8.0%). Placental volume was not significantly different between the pregnancies with adverse outcomes and those without. The mean values of the VI and VFI were significantly lower in the pregnancies that developed PE but not in GH or SGA. The area under the ROC curve for the prediction of PE was 0.71, 0.69 and 0.70 for VI, FI and VFI, respectively.
The study confirms lower 3D power Doppler vascular flow indices in pregnancies that develop PE. The discriminatory ability of using these indices alone for predicting PE appears modest.
评估早孕期三维胎盘体积和血管血流指数在预测不良妊娠结局中的作用。
这是一项前瞻性队列研究，纳入了在 11 至 14 周进行唐氏综合征筛查的单胎妊娠女性。使用三维能量多普勒成像和 VOCAL 技术获取胎盘体积和血管化指数。计算胎盘体积（PV）、血管化指数（VI）、血流指数（FI）和血管化血流指数（VFI）。研究的不良妊娠结局包括子痫前期（PE）、妊娠期高血压（GH）和胎儿生长受限（SGA）。使用受试者工作特征（ROC）曲线评估每个变量的预测能力。
388 例女性中，30 例（7.7%）发生 PE，37 例（9.0%）发生 GH，31 例（8.0%）发生 SGA。不良妊娠结局组与无不良妊娠结局组之间胎盘体积无显著差异。发生 PE 的妊娠中 VI 和 VFI 的平均值显著降低，但 GH 或 SGA 中无此差异。预测 PE 的 ROC 曲线下面积分别为 0.71、0.69 和 0.70，对应 VI、FI 和 VFI。
本研究证实了发生 PE 的妊娠中三维能量多普勒血管血流指数较低。单独使用这些指数预测 PE 的判别能力似乎有限。
