Soongsatitanon Adjima, Phupong Vorapong
a Placental Related Diseases Research Unit and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine , Chulalongkorn University , Bangkok , Thailand.
J Obstet Gynaecol. 2019 May;39(4):474-479. doi: 10.1080/01443615.2018.1529152. Epub 2018 Dec 25.
The objective of the study was to determine the sensitivity of the placental volume for predicting preeclampsia and/or intrauterine growth restriction (IUGR) in the first trimester. A prospective observational study was conducted in pregnant women with a gestational age of 11 to 13 weeks. A 3 D transabdominal placental volume measurement was performed at the time of first-trimester aneuploidy screening. The predictive values of this test were calculated. The data from 360 pregnant women was analysed. Seventeen cases developed preeclampsia and/or IUGR. The 10 percentile of placental volume was used as the cut-off level. The sensitivity, specificity, positive predictive value and negative predictive value of placental volume less than the 10 percentile for prediction of preeclampsia and/or IUGR were 23.5%, 90.7%, 11.1% and 96%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value for prediction of early onset preeclampsia were 50%, 90.7%, 3.0% and 99.7%, respectively. This study demonstrated that the placental volume was lower in the cases with preeclampsia and/or IUGR. It was not an effective screening tool for preeclampsia and/or IUGR in the first trimester. IMPACT STATEMENT What is already known on this subject? Placental volume may reflect trophoblast invasion, but much earlier, in the first trimester. The estimation of a smaller early placental volume has been shown to be significantly associated with preeclampsia and IUGR. What do the results of this study add? The placental volume was lower in the cases with preeclampsia and/or IUGR. It was not an effective screening tool for preeclampsia and/or IUGR in the first trimester. But it might be used for predicting early onset preeclampsia. What are the implications of these findings for clinical practice and/or further research? Further research of placental volume in the first trimester for predicting an early onset preeclampsia should be conducted.
本研究的目的是确定孕早期胎盘体积对预测先兆子痫和/或胎儿宫内生长受限(IUGR)的敏感性。对孕周为11至13周的孕妇进行了一项前瞻性观察研究。在孕早期非整倍体筛查时进行经腹三维胎盘体积测量。计算该检测的预测值。分析了360名孕妇的数据。17例发生了先兆子痫和/或胎儿宫内生长受限。将胎盘体积的第10百分位数用作临界值。胎盘体积小于第10百分位数对先兆子痫和/或胎儿宫内生长受限预测的敏感性、特异性、阳性预测值和阴性预测值分别为23.5%、90.7%、11.1%和96%。对早发型先兆子痫预测的敏感性、特异性、阳性预测值和阴性预测值分别为50%、90.7%、3.0%和99.7%。本研究表明,先兆子痫和/或胎儿宫内生长受限病例的胎盘体积较低。它不是孕早期先兆子痫和/或胎儿宫内生长受限的有效筛查工具。影响声明关于该主题已知的情况是什么?胎盘体积可能反映滋养层细胞浸润,但在孕早期要早得多。已表明早期胎盘体积较小的估计值与先兆子痫和胎儿宫内生长受限显著相关。本研究的结果增加了什么?先兆子痫和/或胎儿宫内生长受限病例的胎盘体积较低。它不是孕早期先兆子痫和/或胎儿宫内生长受限的有效筛查工具。但它可能用于预测早发型先兆子痫。这些发现对临床实践和/或进一步研究有何意义?应进一步研究孕早期胎盘体积对预测早发型先兆子痫的作用。