Department of Obstetrics and Gynecology, Minia University, Minia, Egypt.
Department of Reproductive Health Research, National Research Centre, Cairo, Egypt.
Int J Gynaecol Obstet. 2021 Sep;154(3):466-473. doi: 10.1002/ijgo.13572. Epub 2021 Mar 13.
To assess the efficacy of first-trimester three-dimensional (3D) placental volume as well as 3D power Doppler of placental vascular indices for early prediction of pre-eclampsia.
The prospective cohort study included over 2019 women with a singleton pregnancy in their first trimester at 11-13+ weeks of pregnancy. All women were examined by 3D abdominal ultrasound, including Doppler techniques for the placental volume and placental vascular indices. Uterine artery Doppler indices were also assessed. All participants were cared for until delivery for assessment of pregnancy outcomes.
In all, 163 women developed pre-eclampsia while 1856 women remained normotensive. The women with pre-eclampsia had significantly lower placental volume (77.09 ml vs. 99.8 ml, p < 0.001), and placental vascular indices (vascularization index, flow index, and vascularization flow index were 7.41 vs. 9.89, 39.03 vs. 46.63, and 2.77 vs. 4.4, respectively, p < 0.001). In contrast, women with pre-eclampsia had significantly high mean uterine pulsatility index and resistance index (2.02 vs. 1.11, 0.83 vs. 0.64, respectively, p < 0.001) compared with the normotensive women. The placental vascular indices were highly sensitive, whereas the placental volume and the mean uterine pulsatility index and resistance index had higher specificity for the prediction of pre-eclampsia.
First-trimester assessment through 3D placental volume and power Doppler of placental vascular indices, especially in combination with uterine artery Doppler assessment, revealed an increase in the accuracy of early detection of women at risk for developing pre-eclampsia.
评估早孕期三维（3D）胎盘体积和胎盘血管指数的 3D 能量多普勒，以早期预测子痫前期。
这项前瞻性队列研究纳入了 2019 名在孕 11-13+ 周时行首次孕期腹部 3D 超声检查的单胎妊娠孕妇。所有孕妇均接受 3D 腹部超声检查，包括胎盘体积和胎盘血管指数的多普勒技术。还评估了子宫动脉多普勒指数。所有参与者均接受护理直至分娩，以评估妊娠结局。
共有 163 名孕妇发生子痫前期，1856 名孕妇血压正常。发生子痫前期的孕妇胎盘体积显著较小（77.09 ml 比 99.8 ml，p<0.001），胎盘血管指数也显著较低（血管化指数、血流指数和血流血管化指数分别为 7.41 比 9.89、39.03 比 46.63 和 2.77 比 4.4，p<0.001）。相比之下，发生子痫前期的孕妇平均子宫动脉搏动指数和阻力指数显著较高（2.02 比 1.11，0.83 比 0.64，p<0.001）。胎盘血管指数对预测子痫前期具有很高的敏感性，而胎盘体积和平均子宫动脉搏动指数和阻力指数对预测子痫前期具有更高的特异性。
早孕期通过 3D 胎盘体积和胎盘血管指数的 3D 能量多普勒评估，尤其是与子宫动脉多普勒评估相结合，提高了对有子痫前期风险的孕妇进行早期检测的准确性。
