Comparison between three‐dimensional placental volume at 12 weeks and uterine artery impedance/notching at 22 weeks in screening for pregnancy‐induced hypertension, pre‐eclampsia and fetal growth restriction in a low‐risk population
Open accessAbstract
Objectives: To compare the value of three‐dimensional placental volume at 12 weeks and uterine artery Doppler at 22 weeks for predicting pregnancy‐induced hypertension (PIH), pre‐eclampsia and fetal growth restriction in a low‐risk population. Methods: Over a 20‐month period we calculated the placental quotient (PQ = placental volume/crown–rump length) at 11–13 weeks' gestation in all women with singleton pregnancies who booked for delivery in our hospital. At 22 weeks, in the same population, we calculated the mean pulsatility index (PI) of both uterine arteries and the presence of an early diastolic notch was noted. Logistic regression models, the PQ and Doppler parameters were used to compare the two screening methods for subgroups of pregnancy outcome. Results: Complete outcome data were obtained in 2489 consecutive singleton pregnancies. Logistic regression models for the detection of pre‐eclampsia had a sensitivity of 38.5% (PQ) vs. 44.8% (Doppler); for the detection of small‐for‐gestational age (SGA) the sensitivity was 27.1% (PQ) vs. 28.1% (Doppler) at a specificity of 90%. Taking a PQ of ≤ 10th centile, a mean uterine PI of ≥ 90th centile and a bilateral notch, the sensitivity for detection of SGA was 25.0%, 20.2% and 22.0%, respectively; for PIH it was 9.5%, 4.8% and 4.8%; for pre‐eclampsia without SGA it was 20.0%, 28%, 12%; for PIH/pre‐eclampsia with SGA it was 30.8%, 46.1% and 69.2%. In the group with the most severe complications, in which delivery took place before 34 weeks, the sensitivity was 50.0%, 50.0% and 38.9%, respectively. Conclusions: PQ at 12 weeks and uterine artery Doppler at 22 weeks have similar sensitivities for predicting pre‐eclampsia and fetal growth restriction, although uterine artery Doppler is marginally more sensitive for the prediction of pre‐eclampsia. While both methods are insufficient for screening in a low‐risk population, the PQ method has the potential advantage of being performed in the first trimester. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.
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A small placenta at the first-trimester scan is associated with an increased risk of impaired fetal growth and preeclampsia.
“A small placenta at the first-trimester scan is associated with an increased risk of impaired fetal growth and preeclampsia6,7.”
From Multi-centre deep learning for placenta segmentation in obstetric ultrasound with multi-observer and cross-country generalization (2023) · cites this paper as [6]
First trimester placental volume has long been known to correlate with birth weight at term.
“First trimester placental volume (PlVol) has long been known to correlate with birth weight at term (7-9), and it was suggested as early as 1981 that PlVol measured with B-mode ultrasound could be used to screen for growth restriction (10).”
From Fully automated, real-time 3D ultrasound segmentation to estimate first trimester placental volume using deep learning (2018) · cites this paper as [7]
Many studies have demonstrated that a low PlVol between 11 and 13 weeks of gestation can predict adverse pregnancy outcomes, including small for gestational age and preeclampsia.
“Since then many studies have demonstrated that a low PlVol between 11 and 13 weeks of gestation can predict adverse pregnancy outcomes, including small for gestational age (SGA) (11) and preeclampsia (7).”
From Fully automated, real-time 3D ultrasound segmentation to estimate first trimester placental volume using deep learning (2018) · cites this paper as [7]
First trimester placental volume and vascularity are linked to adverse pregnancy outcomes including FGR and pre-eclampsia.
“Both the volume and vascularity of the first trimester placenta has been demonstrated to be linked to adverse pregnancy outcomes including FGR and pre-eclampsia.”
From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [28]
Low placental volume (PlaV) at 11-13 weeks is associated with SGA/FGR and pre-eclampsia, independent of PAPP-A and nuchal translucency measurements.
“It has now been shown that low placental volume (PlaV) at 11–13 weeks is associated with SGA/FGR [23, 26–28] and pre-eclampsia [28, 29], and that this is independent of PAPP-A and nuchal translucency (NT) measurements [27].”
From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [28]
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The placenta in fetal growth restriction: What is going wrong?
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“Since then many studies have demonstrated that a low PlVol between 11 and 13 weeks of gestation can predict adverse pregnancy outcomes, including small for gestational age (SGA) (11) and preeclampsia (7).”
BackgroundUse of artificial intelligence and deep learning in fetal ultrasound imaging
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RetractedComparison of 2-D and 3-D estimates of placental volume in early pregnancy
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- Authors
- Hafner, E., Metzenbauer, M., Höfinger, D., Stonek, F., Schuchter, K., Waldhör, T., & Philipp, K.
- Affiliations
- Donauspital (AT)
- University of Vienna (AT)
- Corresponding author
- Hafner, E.
- ORCID
- Metzenbauer, M.
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2006-03-02
- Volume
- 27
- Issue
- 6
- Pages
- 652-657
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W2067587636
- Cited by
- 137
- References
- 19
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2023: 6 · 2022: 5 · 2021: 5 · 2020: 4 · 2019: 2 · 2018: 7 · 2017: 6 · 2016: 12 · 2015: 10 · 2014: 10 · 2013: 8 · 2012: 10
- FWCI
- 9.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Austrian Science Fund (P 13847)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Keywords
- placental volume, uterine artery Doppler, pulsatility index, uterine artery notch, preeclampsia, gestational hypertension, fetal growth restriction, small for gestational age, prenatal screening, low-risk pregnancy, third trimester ultrasound, sensitivity and specificity, singleton pregnancy, preterm birth
- MeSH terms
- Adolescent, Adult, Arteries, Female, Fetal Growth Retardation, Gestational Age, Humans, Infant, Newborn, Infant, Small for Gestational Age, Mass Screening, Middle Aged, Placenta, Pre-Eclampsia, Pregnancy, Pregnancy Outcome, Pulsatile Flow, Sensitivity and Specificity, Uterus, Ultrasonography, Prenatal, Crown-Rump Length, Ultrasonography, Doppler, Color, Hypertension, Pregnancy-Induced
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