Placental volume and vascularization flow indices by 3D power Doppler US using VOCAL technique and correlation with IGF-1, free beta-hCG, PAPP-A, and uterine artery Doppler at 11-14 weeks of pregnancy

J Perinat Med. 2011 Mar;39(2):137-41. doi: 10.1515/jpm.2010.136. Epub 2011 Jan 18.

Abstract

Aims: The purpose of this study was to investigate correlations between first trimester placental volume (PV) and blood flow indexes (FIs), bilateral uterine artery pulsatility indexes, notching, and biochemical parameters: pregnancy-associated plasma protein-A (PAPP-A), free beta-human chorionic gonadotropin (f-β-hCG), and insulin-like growth factor-1 (IGF-1) to predict the high-risk pregnancies in the first trimester.

Methods: We prospectively examined 310 patients at 11-14 weeks of pregnancy using transabdominal 3D gray scale and power Doppler ultrasound for assessing PV, vascularization index, FI, and vascularization FI (VFI). The acquired volumes were analyzed using VOCAL™ imaging software. The results were correlated with biochemical parameters.

Results: We found significant correlations between PV and biochemical parameters, and between placental blood flow studies and other parameters. Finally, PV/crown-rump length so called the placental quotient is also related to both PAPP-A and VFI.

Conclusions: Placental volumetry, uterine artery Doppler studies, blood flow calculations and biochemical parameters, such as f-β-hCG, PAPP-A, and IGF-1 could be important in the early and rapid diagnosis of high-risk pregnancies. Thus, they may be useful in first trimester prediction of fetal growth restriction presenting with alterations in PV and vascularity.

MeSH terms

  • Adult
  • Blood Flow Velocity
  • Chorionic Gonadotropin, beta Subunit, Human / blood*
  • Crown-Rump Length
  • Female
  • Fetal Growth Retardation / diagnosis
  • Humans
  • Imaging, Three-Dimensional
  • Insulin-Like Growth Factor I / metabolism*
  • Placenta / blood supply*
  • Placenta / diagnostic imaging*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Trimester, First
  • Pregnancy, High-Risk
  • Pregnancy-Associated Plasma Protein-A / metabolism*
  • Prospective Studies
  • Risk Factors
  • Ultrasonography, Doppler
  • Ultrasonography, Prenatal
  • Uterine Artery / diagnostic imaging
  • Young Adult

Substances

  • Chorionic Gonadotropin, beta Subunit, Human
  • Insulin-Like Growth Factor I
  • Pregnancy-Associated Plasma Protein-A