Model application to quantitatively evaluate placental features from ultrasound images with gestational diabetes
Abstract
PURPOSE: The goal of this study was to introduce PFCnet (placental features classification network), an multimodel model for evaluating and classifying placental features in gestational diabetes mellitus (GDM) and normal late pregnancy. Deep learning algorithms could be utilized to fully automate the examination of alterations in the placenta caused by hyperglycemia. METHODS: A total of 718 placental ultrasound images, including 139 cases of GDM, were collected, including gray-scale images (GSIs) and microflow images (MFIs). Ultrasonic assessment parameters and perinatal features were recorded. We divided gestational age into two categories for analysis (37 weeks and 37 weeks) based on the cut-off value level of placental maturity. The PFCnet model was introduced for identifying placental characteristics from normal and GDM pregnancies after extensive training and optimization. The model was scored using metrics such as sensitivity, specificity, accuracy, and the area under the curve (AUC). RESULTS: In view of multimodal fusion (GSIs and MFIs) and deep network optimization training, the overall diagnostic performance of the PFCnet model depending on the region of interest (ROI) was excellent (AUC: 93%), with a sensitivity of 89%, a specificity of 92%, and an accuracy of 92% in the independent test set. The fusion features of GSIs and MFIs in the placenta showed a higher discriminative power than single-mode features (accuracy: Fusion 92% vs. GSIs 84% vs. MFIs 82%). The independent test set at 37 weeks exhibited a better specificity (75% vs. 69%) but a lower sensitivity(95% vs. 100%). CONCLUSIONS: With its dual channel identification of placental parenchymal and vascular lesions in obstetric complications, the PFCnet classification model has the potential to be a useful tool for detecting placental tissue abnormalities caused by hyperglycemia.
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Gupta et al. and Sun et al. detected early and small changes in placental tissue texture using AI-assisted US and microvascular Doppler imaging in women with hypertensive disorders of pregnancy and gestational diabetes.
“Early and small changes in placental tissue texture were detected by Gupta et al. and Sun et al. through using AI-assisted US and microvascular Doppler imaging in women with hypertensive disorders of pregnancy [118,119] and gestational diabetes [120].”
Cites
Hyperglycemia and adverse pregnancy outcomes
(2008) · New England Journal of Medicine · doi:10.1056/nejmoa0707943 · Cited by 5,563 · see citing works
2. Classification and Diagnosis of Diabetes: <i>Standards of Medical Care in Diabetes—2021</i>
American Diabetes Association (2021) · Diabetes Care · doi:10.2337/dc21-s002 · Cited by 3,116 · see citing works
Gestational Diabetes and the Incidence of Type 2 Diabetes
Kim, C., Newton, K. M., & Knopp, R. H. (2002) · Diabetes Care · doi:10.2337/diacare.25.10.1862 · Cited by 2,276 · see citing works
The Pathophysiology of Gestational Diabetes Mellitus
Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19113342 · Cited by 1,874 · cited 1× · see citing works
“Despite the fact that many research have looked into the placental pathology of gestational diabetes mellitus (GDM), 7,15 the pathophysiology is still unknown, limiting the development of effective and promising treat-ment targets.”
BackgroundThe “Great Obstetrical Syndromes” are associated with disorders of deep placentation
Brosens, I., Pijnenborg, R., Vercruysse, L., & Romero, R. (2011) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.08.009 · Cited by 1,568 · see citing works
Medical image analysis using convolutional neural networks: a review
Anwar, S. M., Majid, M., Qayyum, A., Awais, M., Alnowami, M., & Khan, M. K. (2018) · Journal of Medical Systems · doi:10.1007/s10916-018-1088-1 · Cited by 1,431 · see citing works
Kramer, C. K., Campbell, S., & Retnakaran, R. (2019) · Diabetologia · doi:10.1007/s00125-019-4840-2 · Cited by 965 · see citing works
(2014) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2013.10.012 · Cited by 914 · see citing works
Lowe, W. L., Scholtens, D. M., Lowe, L. P., Kuang, A., Nodzenski, M., Talbot, O., Catalano, P. M., Linder, B., Brickman, W. J., Clayton, P., et al. (2018) · JAMA · doi:10.1001/jama.2018.11628 · Cited by 591 · see citing works
Inflammation in maternal obesity and gestational diabetes mellitus
Pantham, P., Aye, I. L. M. H., & Powell, T. L. (2015) · Placenta · doi:10.1016/j.placenta.2015.04.006 · Cited by 582 · see citing works
Hyperglycemia and Adverse Pregnancy Outcomes
Metzger, B. E., Lowe, L. P., Dyer, A. R., Trimble, E. R., Chaovarindr, U., Coustan, D. R., Hadden, D. R., McCance, D. R., Hod, M., McIntyre, H. D., et al. (2009) · Obstetric Anesthesia Digest · doi:10.1097/01.aoa.0000344706.95925.dc · Cited by 479 · see citing works
Daly, B., Toulis, K. A., Thomas, N., Gokhale, K., Martin, J., Webber, J., Keerthy, D., Jolly, K., Saravanan, P., & Nirantharakumar, K. (2018) · PLOS Medicine · doi:10.1371/journal.pmed.1002488 · Cited by 328 · see citing works
Placental pathology in women with gestational diabetes
DASKALAKIS, G., Marinopoulos, S. S., KRIELESI, V., Papapanagiotou, A., Papantoniou, N. E., Mesogitis, S. A., & Antsaklis, A. J. (2008) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/00016340801908783 · Cited by 219 · see citing works
Evers, I. M., Nikkels, P. G. J., Sikkema, J. M., & Visser, G. H. A. (2003) · Placenta · doi:10.1016/s0143-4004(03)00128-0 · Cited by 146 · see citing works
Placental structure in gestational diabetes mellitus
Carrasco‐Wong, I., Moller, A., Giachini, F. R. C., Lima, V. V., Toledo, F., Stojanova, J., Sobrevía, L., & Martín, S. S. (2019) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2019.165535 · Cited by 143 · see citing works
Automated thyroid nodule detection from ultrasound imaging using deep convolutional neural networks
Abdolali, F., Kapur, J., Jaremko, J. L., Noga, M., Hareendranathan, A. R., & Punithakumar, K. (2020) · Computers in Biology and Medicine · doi:10.1016/j.compbiomed.2020.103871 · Cited by 122 · see citing works
Stereology of the placenta in type 1 and type 2 diabetes
Higgins, M., Felle, P., Mooney, E. E., Bannigan, J., & McAuliffe, F. M. (2011) · Placenta · doi:10.1016/j.placenta.2011.04.015 · Cited by 89 · see citing works
Placental Vascular Dysfunction in Diabetic Pregnancies: Intimations of Fetal Cardiovascular Disease?
Leach, L. (2011) · Microcirculation · doi:10.1111/j.1549-8719.2011.00091.x · Cited by 81 · see citing works
Correlation of placental pathology with prenatal ultrasound findings
Sebire, N. J., & Sepúlveda, W. (2008) · Journal of Clinical Pathology · doi:10.1136/jcp.2008.055251 · Cited by 72 · see citing works
Jirkovská, M., Kučera, T., Kalab, J., Jadrníček, M., Niedobová, V., Janáček, J., Kubínová, L., Moravcová, M., Žižka, Z., & Krejčí, V. (2012) · Placenta · doi:10.1016/j.placenta.2012.01.014 · Cited by 69 · see citing works
Alokail, M., & Al-Attas, O. S. (1994) · Endocrine Journal · doi:10.1507/endocrj.41.355 · Cited by 60 · see citing works
Placenta changes in pregnancy with gestational diabetes.
Edu, A., Teodorescu, C. O. D., Dobjanschi, C. G., Socol, Z. Z., Teodorescu, V., Matei, A., Albu, D.-F., & Radulian, G. (2016) · PubMed · Cited by 54 · see citing works
Burgos-Artizzu, X. P., Perez-Moreno, Á., Coronado-Gutiérrez, D., Gratacós, E., & Palacio, M. (2019) · Scientific Reports · doi:10.1038/s41598-019-38576-w · Cited by 51 · see citing works
Benefits and Pitfalls of Ultrasound in Obstetrics and Gynecology
Abinader, R., & Warsof, S. L. (2019) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2019.01.011 · Cited by 36 · see citing works
Adibi, J. J., Burton, G. J., Clifton, V. L., Collins, S., Frias, A. E., Gierman, L. M., Grigsby, P. L., Jones, H. N., Lee, C. Q. E., Maloyan, A., et al. (2017) · Placenta · doi:10.1016/j.placenta.2017.02.021 · Cited by 18 · see citing works
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Jost, E., Kosian, P., Jimenez Cruz, J., Albarqouni, S., Gembruch, U., Strizek, B., & Recker, F. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12216833 · Cited by 44 · see citing works
“Early and small changes in placental tissue texture were detected by Gupta et al. and Sun et al. through using AI-assisted US and microvascular Doppler imaging in women with hypertensive disorders of pregnancy [118,119] and gestational diabetes [120].”
MethodArtificial Intelligence in Gestational Diabetes Care: A Systematic Review
AlSaad, R., Elhenidy, A. M., Tabassum, A., Odeh, N. B., AboArqoub, E., Odeh, A. E., AlTamimi, M., Abd-Alrazaq, A. A., Thomas, R. M., Bashir, M., et al. (2025) · Journal of Diabetes Science and Technology · doi:10.1177/19322968251355967 · Cited by 29 · see citing works
Zhou, H., Chen, W., Chen, C., Zeng, Y., Chen, J., Lin, J., He, K., & Guo, X. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1344666 · Cited by 19 · see citing works
The Association of Placental Grading with Perinatal Outcomes: A Systematic Review and Meta-Analysis
Siargkas, A., Pachi, C., Nigdelis, M. P., Stavros, S., Domali, E., Mamopoulos, A. M., Tsakiridis, I. G., & Dagklis, T. (2025) · Diagnostics · doi:10.3390/diagnostics15101264 · Cited by 4 · see citing works
张, 妍. (2024) · Advances in Clinical Medicine · doi:10.12677/acm.2024.14102760
Emerging applications of artificial intelligence for obstetric ultrasound: A scoping review
Gupta, V., Santos, N., Ripa, S. D., & Walker, D. A. (2026) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.70789 · Cited by 2 · see citing works
Barada, S., & Selvanambi, R. (2026) · Frontiers in Artificial Intelligence · doi:10.3389/frai.2026.1890320
- Authors
- Sun, H., Jiao, J., Ren, Y., Guo, Y., & Wang, Y.
- Affiliations
- Obstetrics and Gynecology Hospital of Fudan University (CN)
- Fudan University (CN)
- Corresponding author
- Ren, Yunyun
- Guo, Yi
- Wang, Yuanyuan
- Venue
- Journal of Clinical Ultrasound
- Publisher
- Wiley
- Published
- 2022-07-10
- Volume
- 50
- Issue
- 7
- Pages
- 976-983
- ISSN
- 0091-2751 (ISSN-L)
- 1097-0096
- OpenAlex
- W4285007515
- Cited by
- 7
- References
- 26
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 1
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Ultrasound (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Keywords
- gestational diabetes mellitus, placental ultrasound, deep learning classification, multimodal image fusion, placental vascular lesions, placental maturity, late pregnancy
- MeSH terms
- Female, Gestational Age, Humans, Hyperglycemia, Infant, Newborn, Placenta, Pregnancy, Ultrasonography, Diabetes, Gestational
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