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胎盘厚度在胎儿生物测量评估及子宫和脐动脉多普勒指标中的评估及预测价值

Evaluation and Predictive Value of Placental Thickness in Fetal Biometric Assessment and Doppler Indices of the Uterine and Umbilical Arteries.

作者信息

Azizinik Fahimeh, Katouli Fatemeh Shakki, Zeinalkhani Fahimeh, Fazelnia Faezeh, Tahamtan Mohammadreza

机构信息

Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran.

MD, Assistant Professor of Radiology, Department of Radiology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Clin Ultrasound. 2025 Jul 14. doi: 10.1002/jcu.70009.

Abstract

OBJECTIVE

The placenta plays a critical role in fetal development by facilitating the exchange of oxygen and nutrients from maternal blood while removing carbon dioxide and metabolic waste. It also acts as a protective barrier against infections and maintains pregnancy by producing key hormones. As the first organ to reflect pathological changes during pregnancy, placental evaluation can aid in the early detection of pregnancy complications. The primary objective of this study was to assess the correlation between placental thickness (PT) and fetal biometric parameters during the second-trimester anomaly screening, aiming to facilitate earlier detection of pregnancy outcomes.

MATERIALS AND METHODS

This cross-sectional study included 300 healthy pregnant women with gestational ages between 18 and 22 weeks, determined by last menstrual period or first-trimester ultrasound. Participants underwent routine biometric ultrasound assessments, including biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), estimated fetal weight (EFW), and Doppler evaluations of the umbilical and uterine arteries. PT was measured perpendicularly to the uterine wall at the site of cord insertion. Statistical analyses included descriptive statistics, Pearson correlation coefficients, and independent t-tests, with statistical significance set at p < 0.001.

RESULTS

The mean placental thickness (PT) was 23.45 ± 3.99 mm. Statistically significant (p < 0.001) but weak positive correlations were observed between PT and the following fetal growth parameters: estimated fetal weight (EFW) (r = 0.29), abdominal circumference (AC) (r = 0.33), head circumference (HC) (r = 0.21), biparietal diameter (BPD) (r = 0.27), and femur length (FL) (r = 0.29). Gestational age showed a weak positive correlation with PT (r = 0.32). Correlations between PT and Doppler indices, including the umbilical artery pulsatility index (PI) and uterine artery PI, were trivial (r = -0.16 and r = 0.06, respectively). No significant differences in PT were observed based on fetal gender.

CONCLUSION

PT demonstrates statistically significant correlations with fetal biometric parameters and gestational age, suggesting its potential utility as a marker for fetal growth and development. However, its association with Doppler indices is trivial, indicating limited utility in vascular assessments. These findings highlight the need for further investigation into PT as a noninvasive marker for prenatal assessment, particularly in larger cohorts and during the third trimester.

摘要

目的

胎盘在胎儿发育过程中起着关键作用,它促进母体血液中的氧气和营养物质交换,同时排出二氧化碳和代谢废物。它还作为抵御感染的保护屏障,并通过产生关键激素维持妊娠。作为妊娠期间第一个反映病理变化的器官,胎盘评估有助于早期发现妊娠并发症。本研究的主要目的是评估孕中期异常筛查期间胎盘厚度(PT)与胎儿生物测量参数之间的相关性,旨在促进对妊娠结局的更早检测。

材料与方法

这项横断面研究纳入了300名健康孕妇,其孕周通过末次月经或孕早期超声确定,介于18至22周之间。参与者接受了常规的生物测量超声评估,包括双顶径(BPD)、头围(HC)、腹围(AC)、股骨长度(FL)、估计胎儿体重(EFW),以及脐动脉和子宫动脉的多普勒评估。在脐带插入部位垂直于子宫壁测量PT。统计分析包括描述性统计、Pearson相关系数和独立t检验,统计学显著性设定为p < 0.001。

结果

平均胎盘厚度(PT)为23.45±3.99mm。观察到PT与以下胎儿生长参数之间存在统计学显著(p < 0.001)但较弱的正相关:估计胎儿体重(EFW)(r = 0.29)、腹围(AC)(r = 0.33)、头围(HC)(r = 0.21)、双顶径(BPD)(r = 0.27)和股骨长度(FL)(r = 0.29)。孕周与PT呈弱正相关(r = 0.32)。PT与多普勒指数之间的相关性很小,包括脐动脉搏动指数(PI)和子宫动脉PI(分别为r = -0.16和r = 0.06)。根据胎儿性别未观察到PT有显著差异。

结论

PT与胎儿生物测量参数和孕周存在统计学显著相关性,表明其作为胎儿生长发育标志物的潜在效用。然而,它与多普勒指数的关联很小,表明在血管评估中的效用有限。这些发现凸显了进一步研究PT作为产前评估的非侵入性标志物的必要性,特别是在更大的队列和孕晚期。

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