Fanget Cécile, Chauleur Céline, Stadler Amandine, Presles Emilie, Varlet Marie-Noëlle, Gris Jean-Christophe, Raia-Barjat Tiphaine
Department of Gynecology and Obstetrics, University Hospital, Saint Etienne, France.
Research Unit EA3065, Saint Etienne University Jean Monnet F 42023, Saint Etienne, France.
PLoS One. 2016 Jun 13;11(6):e0156593. doi: 10.1371/journal.pone.0156593. eCollection 2016.
The aim of this study was to correlate placental volumes deduced from three-dimensional ultrasound and virtual organ computer-aided analysis (VOCAL) software with systemic concentrations of D-dimer and soluble endothelial protein C receptor (sEPCR).
This was a monocentric experimental prospective study conducted from October 2008 to July 2009. Forty consecutive patients at risk of placental vascular pathology (PVP) recurrence or occurrence were included. Placental volumes were systematically measured three times (11-14, 16-18 and 20-22 weeks of gestation (WG)) by two independent sonographers. D-dimers and sEPCR plasma concentrations were measured using ELISA kits (Enzyme Linked ImmunoSorbent Assay).
Eleven patients had a PVP. The plasma D-dimer level was positively correlated with placental volume (r = 0.45, p < 0.001). A smaller placental volume and placental quotient was evidenced in women who developed a PVP at the three gestational ages, and the difference was more pronounced during the third exam (20 WG). No obvious correlation could be demonstrated between the development of a PVP and the levels of D-dimer and sEPCR. There was no significant difference in the values of placental volumes measured by the two sonographers.
The placenta growth could be a major determinant of the elevation of D-dimer during pregnancy. Consideration of placental volume could allow for modulation of the D-dimer concentrations for restoring their clinical interest.
本研究旨在将通过三维超声和虚拟器官计算机辅助分析（VOCAL）软件得出的胎盘体积与D - 二聚体和可溶性内皮蛋白C受体（sEPCR）的全身浓度进行关联分析。
这是一项于2008年10月至2009年7月进行的单中心实验性前瞻性研究。纳入了40例有胎盘血管病变（PVP）复发或发生风险的连续患者。由两名独立的超声检查人员对胎盘体积进行三次系统测量（妊娠11 - 14周、16 - 18周和20 - 22周）。使用酶联免疫吸附测定（ELISA）试剂盒测量D - 二聚体和sEPCR血浆浓度。
11例患者发生了PVP。血浆D - 二聚体水平与胎盘体积呈正相关（r = 0.45，p < 0.001）。在三个孕周发生PVP的女性中，胎盘体积和胎盘商较小，且在第三次检查（20周妊娠）时差异更为明显。PVP的发生与D - 二聚体和sEPCR水平之间未显示出明显相关性。两名超声检查人员测量的胎盘体积值无显著差异。
胎盘生长可能是孕期D - 二聚体升高的主要决定因素。考虑胎盘体积可能有助于调节D - 二聚体浓度，以恢复其临床意义。
