Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, United Kingdom.
Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada.
Am J Perinatol. 2018 Aug;35(10):964-971. doi: 10.1055/s-0038-1632369. Epub 2018 Feb 19.
Preeclampsia is associated with placental vascularization disorders. Ultrasonographic sphere biopsy (USSB) of the placenta can estimate the vascularization of the placenta and potentially the risk of preeclampsia. We aimed to explore the factors related to placental vascularization measured with USSB in the first trimester.
A prospective cohort was conducted in women recruited at 11 to 14 weeks. Three-dimensional acquisition of the placenta with power Doppler was undertaken along with crown-rump length (CRL). Using USSB of the full placental thickness at its center, vascularization index, flow index, and vascular flow index were measured. Pearson's correlation coefficients and multivariate linear regression were used to correlate the vascularization indices with CRL and maternal characteristics.
A total of 5,612 women were recruited at a mean gestational age of 12.8 ± 0.6 weeks. We observed that vascularization indices increase with CRL. After adjustment, we observed that maternal age, ethnicity other than Caucasian, and body mass index were associated with lower vascularization indices, while diabetes, smoking, and assisted reproduction technology were not. We observed that parous women without history of preeclampsia had greater vascularization indices compared with nulliparous women.
Placental vascularization indices assessed by USSB fluctuate with gestational age, ethnicity, maternal age, body mass index, and previous pregnancy history.
子痫前期与胎盘血管化障碍有关。胎盘超声球活检(USSB)可评估胎盘的血管化程度,并可能预测子痫前期的风险。我们旨在探讨在妊娠早期用 USSB 测量的胎盘血管化与哪些因素有关。
这是一项在 11 至 14 周招募的女性中进行的前瞻性队列研究。对胎盘进行三维能量多普勒采集,并测量冠臀长(CRL)。在胎盘中心的全胎盘厚度处进行 USSB,测量血管化指数、血流指数和血管血流指数。采用 Pearson 相关系数和多元线性回归分析血管化指数与 CRL 和产妇特征的相关性。
共招募了 5612 名平均妊娠年龄为 12.8±0.6 周的女性。我们观察到血管化指数随 CRL 增加而增加。调整后,我们观察到母亲年龄、非白种人种族和体重指数与较低的血管化指数相关,而糖尿病、吸烟和辅助生殖技术则不相关。我们观察到没有子痫前期病史的经产妇的血管化指数大于初产妇。
USSB 评估的胎盘血管化指数随胎龄、种族、母亲年龄、体重指数和既往妊娠史而波动。