Novel placental ultrasound assessment: Potential role in pre-gestational diabetic pregnancy
|Title:||Novel placental ultrasound assessment: Potential role in pre-gestational diabetic pregnancy||Authors:||Moran, Mary
Daly, Leslie E.
McAuliffe, Fionnuala M.
|Permanent link:||http://hdl.handle.net/10197/7662||Date:||Aug-2014||Abstract:||Objectives: Management of women with pre-gestational diabetes continues to be challenging for clinicians. This study aims to determine if 3D power Doppler (3DPD) analysis of placental volume and flow, and calculation of placental calcification using a novel software method, differ between pregnancies with type 1 or type 2 diabetes and normal controls, and if there is a relationship between these ultrasound placental parameters and clinical measures in diabetics. Methods: This was a prospective cohort study of 50 women with diabetes and 250 controls (12–40 weeks gestation). 3DPD ultrasound was used to evaluate placental volume, vascularisation index (VI), flow index (FI) and vascularisation-flow index (VFI). Placental calcification was calculated by computer analysis. Results in diabetics were compared with control values, and correlated with early pregnancy HbA1c, Doppler results and placental histology. Results: Placental calcification and volume increased with advancing gestation in pre-gestational diabetic placentae. Volume was also found to be significantly higher than in normal placentae. VI and VFI were significantly lower in diabetic pregnancies between 35 and 40 weeks gestation. A strong relationship was seen between a larger placental volume and both increasing umbilical artery pulsatility index and decreasing middle cerebral artery pulsatility index. FI was significantly lower in cases which had a booking HbA1c level ≥6.5%. Ultrasound assessed placental calcification was reduced with a histology finding of delayed villous maturation. No other correlation with placental histology was found. Conclusions: This study shows a potential role for 3D placental evaluation, and computer analysis of calcification, in monitoring pre-gestational diabetic pregnancies.||Type of material:||Journal Article||Publisher:||Elsevier||Copyright (published version):||2014 Elsevier||Keywords:||Pre-gestational diabetes; Novel ultrasound placental assessment||DOI:||10.1016/j.placenta.2014.03.007||Language:||en||Status of Item:||Peer reviewed|
|Appears in Collections:||Medicine Research Collection|
Public Health, Physiotherapy and Sports Science Research Collection
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