Hashish Nawara, Hassan Ayman, El-Semary Aly, Gohar Rovan, Youssef M A F M
Department of Obstetrics and Gynecology, Cairo University , Cairo , Egypt .
J Matern Fetal Neonatal Med. 2015 Jun;28(9):1094-8. doi: 10.3109/14767058.2014.943177. Epub 2014 Jul 28.
Preeclampsia (PE) is a known cause of maternal, fetal and neonatal morbidity and mortality. Thus, evaluation of the predicting value of combining the 3D assessment of placental volume with the assessment of placental perfusion indices through 3D power Doppler (3DPD) at 11-14 weeks in pregnant women at high risk to develop PE could be a suitable screening method.
3D assessment of placental volume and 3DPD assessment of placental vascularization indices at 11-13 weeks and uterine artery Doppler scan (RI and PI) at 21-22 weeks were conducted in this prospective case-control study. Their predictive ability for PE was assessed.
One-hundred pregnant women divided into two groups were enrolled in our study. High-risk group (n = 50) and control group (n = 50). Thirty-eight (76%) patients in the high-risk group and 6.0 (12%) patients in the control group developed PE, respectively. The mean values of placental volume (<0.001), vascularization index (<0.001), vascularization flow index (<0.002) were significantly lower in the high-risk group. Meanwhile, uterine artery RI (0.011) and PI (<0.001) was significantly higher in the study group. Uterine artery PI is negatively correlated with placental volume and vascularization indices (-0.36).
Our findings suggest that 3D placental volume measurement and 3DPD assessment of placental vascular indices in the first trimester has the potential to detect women at risk for subsequent development of PE.
子痫前期(PE)是孕产妇、胎儿及新生儿发病和死亡的已知原因。因此,评估在孕11 - 14周时,将胎盘体积的三维评估与通过三维能量多普勒(3DPD)对胎盘灌注指数的评估相结合,对发生PE高危孕妇的预测价值,可能是一种合适的筛查方法。
在这项前瞻性病例对照研究中,于孕11 - 13周进行胎盘体积的三维评估和胎盘血管化指数的3DPD评估,并于孕21 - 22周进行子宫动脉多普勒扫描(阻力指数和搏动指数)。评估它们对PE的预测能力。
我们的研究纳入了100名分为两组的孕妇。高危组(n = 50)和对照组(n = 50)。高危组分别有38例(76%)患者和对照组有6例(12%)患者发生PE。高危组的胎盘体积(<0.001)、血管化指数(<0.001)、血管化血流指数(<0.002)的平均值显著更低。同时,研究组的子宫动脉阻力指数(0.011)和搏动指数(<0.001)显著更高。子宫动脉搏动指数与胎盘体积和血管化指数呈负相关(-0.36)。
我们的研究结果表明,孕早期三维胎盘体积测量和3DPD评估胎盘血管指数有可能检测出随后发生PE风险的女性。