Novel placental ultrasound assessment: Potential role in pre-gestational diabetic pregnancy

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Title: Novel placental ultrasound assessment: Potential role in pre-gestational diabetic pregnancy
Authors: Moran, Mary
Mulcahy, C.
Daly, Leslie E.
Zombori, Gergely
Downey, P.
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 diabetesNovel 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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