Pala H G, Artunc Ulkumen B, Uyar Y, Koyuncu F M, Bulbul Baytur Y
Division of Perinatology, Department of Obstetrics and Gynecology, Celal Bayar University School of Medicine , Manisa , Turkey.
J Obstet Gynaecol. 2015 Apr;35(3):259-62. doi: 10.3109/01443615.2014.958146. Epub 2014 Sep 25.
The aim of this study is to evaluate the relationship between three-dimensional (3D) ultrasound measurements of placenta at 11-13(6) weeks' gestation and maternal serum levels of pregnancy associated plasma protein-A (PAPP-A), free beta human chorionic gonadotrophin (fβhCG), Doppler parameters in early pregnancy. This prospective study consisted of 334 singleton pregnancies at 11-13(6) weeks' gestation. Placental volume and placental volumetric mean grey values were evaluated. The placental volume (cm(3)) was analysed using the Virtual Organ Computer-aided AnaLysis (VOCAL) imaging program and 3D histogram was used to calculate the volumetric mean grey value (%). Mean maternal age was 28.35 ± 7.55. Mean gestational age was 12.29 ± 0.68 weeks. Placental volume was 77.04 ± 35.74 cm(3). Mean grey value of the placenta was 34.38 ± 8.02%. Correlation analysis revealed that placental volume was significantly correlated with the crown-rump length (r = 0.173, p = 0.002), gestational week (r = 0.116, p = 0.036), ductus venosus pulsatility index (r = -0.101, p = 0.04) and maternal weight (r = 0.099, p = 0.037). There was a significant relation between the mean grey value of the placenta and maternal age (r = 0.131, p = 0.02), nuchal translucency (r = -0.109, p = 0.048), PAPP-A (r = 0.108, p = 0.04) and fβhCG (r = 0.104, p = 0.042). Volumetry of the placenta can be carried out with a high percentage of 1st trimester pregnancies. Volumetry during the 1st trimester could be helpful because of the less advanced state of placentation. This examination is easy to perform and the measurements can be acquired correctly and quickly.
本研究旨在评估孕11 - 13⁺⁶周时胎盘的三维(3D)超声测量值与孕妇血清妊娠相关血浆蛋白-A(PAPP-A)、游离β人绒毛膜促性腺激素(fβhCG)水平以及孕早期多普勒参数之间的关系。这项前瞻性研究纳入了334例孕11 - 13⁺⁶周的单胎妊娠。评估了胎盘体积和胎盘体积平均灰度值。使用虚拟器官计算机辅助分析(VOCAL)成像程序分析胎盘体积(cm³),并使用3D直方图计算体积平均灰度值(%)。孕妇平均年龄为28.35±7.55岁。平均孕周为12.29±0.68周。胎盘体积为77.04±35.74 cm³。胎盘平均灰度值为34.38±8.02%。相关性分析显示,胎盘体积与头臀长(r = 0.173,p = 0.002)、孕周(r = 0.116,p = 0.036)、静脉导管搏动指数(r = -0.101,p = 0.04)和孕妇体重(r = 0.099,p = 0.037)显著相关。胎盘平均灰度值与孕妇年龄(r = 0.131,p = 0.02)、颈项透明层厚度(r = -0.109,p = 0.048)、PAPP-A(r = 0.108,p = 0.04)和fβhCG(r = 0.104,p = 0.042)之间存在显著关系。孕早期大部分妊娠都可以进行胎盘容积测量。孕早期进行容积测量可能会有帮助,因为胎盘形成状态尚不完善。这项检查易于实施,测量结果能够正确且快速地获取。