Hitzerd Emilie, Reijnders Igna F, Mulders Annemarie G M G J, Koning Anton H J, Reiss Irwin K M, Danser A H Jan, Steegers-Theunissen Régine P M, Simons Sinno H P, Koster Maria P H
Department of Pediatrics, Division of Neonatology, Erasmus MC University Medical Center, Rotterdam, Netherlands.
Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands.
Front Physiol. 2020 Jan 24;11:6. doi: 10.3389/fphys.2020.00006. eCollection 2020.
To explore the correlation between placental volumetric parameters in the first trimester of pregnancy and parameters of fetoplacental vascular function after delivery.
In ten singleton physiological pregnancies, placental volume (PV) and uteroplacental vascular volume (uPVV) were measured offline in three-dimensional ultrasound volumes at 7, 9, and 11 weeks gestational age (GA) using Virtual Organ Analysis and Virtual Reality. Directly postpartum, term placentas were dually perfused and pressure in the fetoplacental vasculature was measured to calculate baseline pressure (pressure after a washout period), pressure increase (pressure after a stepwise fetal flow rate increase of 1 mL/min up to 6 mL/min) and flow-mediated vasodilation (FMVD; reduction in inflow hydrostatic pressure on the fetal side at 6 mL/min flow rate). Correlations between and parameters were assessed by Spearman's correlation coefficients (R).
Throughout the first trimester, PV was negatively correlated with pressure increase ( = -0.84) and, at 11 weeks GA, also positively correlated with FMVD ( = 0.89). At 7 weeks GA, uPVV and uPVV/PV ratio were negatively correlated with pressure increase ( = -0.58 and = -0.81, respectively) and positively correlated with FMVD ( = 0.62 and = 0.90, respectively).
Mainly in the early first trimester, larger placental volumetric parameters are associated with lower pressure and more FMVD in the fetoplacental vasculature after delivery. This may suggest that larger and/or more vascularized placentas in early pregnancy have better adaptive mechanisms and possibly lead to better pregnancy outcomes.
探讨妊娠早期胎盘容积参数与产后胎儿 - 胎盘血管功能参数之间的相关性。
在10例单胎生理妊娠中，于孕7周、9周和11周时，使用虚拟器官分析和虚拟现实技术对三维超声容积数据进行离线测量，获取胎盘体积（PV）和子宫 - 胎盘血管容积（uPVV）。产后直接对足月胎盘进行双重灌注，并测量胎儿 - 胎盘血管系统中的压力，以计算基线压力（冲洗期后的压力）、压力增加量（胎儿流速逐步从1 mL/min增加至6 mL/min后的压力）和血流介导的血管舒张（FMVD；流速为6 mL/min时胎儿侧流入静水压的降低）。通过Spearman相关系数（R）评估各参数之间的相关性。
在整个孕早期，PV与压力增加量呈负相关（R = -0.84），且在孕11周时，PV与FMVD也呈正相关（R = 0.89）。在孕7周时，uPVV和uPVV/PV比值与压力增加量呈负相关（分别为R = -0.58和R = -0.81），与FMVD呈正相关（分别为R = 0.62和R = 0.90）。
主要在孕早期，较大的胎盘容积参数与产后胎儿 - 胎盘血管系统中较低的压力和更多的FMVD相关。这可能表明妊娠早期较大和/或血管化程度更高的胎盘具有更好的适应机制，并且可能导致更好的妊娠结局。
