Three-Dimensional Sonographic Assessment of Placental Volume and Vascularization in Pregnancies Complicated by Hypertensive Disorders
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Data
2014-03-01
Autores
Almeida Pimenta, Eduardo Jorge de
Silva de Paula, Carla Fagundes
Duarte Bonini Campos, Juliana Alvares [UNESP]
Fox, Karin Anneliese
Francisco, Rossana
Ruano, Rodrigo
Zugaib, Marcelo
Título da Revista
ISSN da Revista
Título de Volume
Editor
Amer Inst Ultrasound Medicine
Resumo
Objectives-The purpose of this study was to evaluate the association between placental volumes, placental vascularity, and hypertensive disorders in pregnancy.Methods A prospective case-control study was conducted between April 2011 and July 2012. Placental volumes and vascularity were evaluated by 3-dimensional sonographic, 3-dimensional power Doppler histographic, and 2-dimensional color Doppler studies. Pregnant women were classified as normotensive or hypertensive and stratified by the nature of their hypertensive disorders. The following variables were evaluated: observed-to-expected placental volume ratio, placental volume-to-estimated fetal weight ratio, placental vascular indices, and pulsatility indices of the right and left uterine and umbilical arteries.Results Sixty-six healthy pregnant women and 62 pregnant women with hypertensive disorders were evaluated (matched by maternal age, gestational age at sonography, and parity). Placental volumes were not reduced in pregnancy in women with hypertensive disorders (P > .05). Conversely, reduced placental vascularization indices (vascularization index and vascularization-flow index) were observed in pregnancies complicated by hypertensive disorders (P < .01; P < .01), especially in patients with superimposed preeclampsia (P = .04; P = .02). A weak correlation was observed between placental volumes, placental vascular indices, and Doppler studies of the uterine and umbilical arteries.Conclusions Pregnancies complicated by hypertensive disorders are associated with reduced placental vascularity but not with reduced placental volumes. These findings are independent of changes in uterine artery Doppler studies. Future studies of the prediction of preeclampsia may focus on placental vascularity in combination with results of Doppler studies of the uterine arteries.
Descrição
Palavras-chave
arterial hypertension, Doppler study, obstetric ultrasound, placental volume, placental size, placental vascularity, preeclampsia, pregnancy, 3-dimensional power Doppler sonography, 3-dimensional sonography, umbilical arteries, uterine arteries
Como citar
Journal Of Ultrasound In Medicine. Laurel: Amer Inst Ultrasound Medicine, v. 33, n. 3, p. 483-491, 2014.