3-D volumetric MRI evaluation of the placenta in fetuses with complex congenital heart disease
Open accessAbstract
Introduction Placental insufficiency remains a common cause of perinatal mortality and neurodevelopmental morbidity. Congenital heart disease (CHD) in the fetus and its relationship to placental function is unknown. This study explores placental health and its relationship to neonatal outcomes by comparing placental volumes in healthy pregnancies and pregnancies complicated by CHD using in vivo three-dimensional MRI studies.Methods In a prospective observational study, pregnant women greater than 18 weeks gestation with normal pregnancies or pregnancies complicated by CHD were recruited and underwent fetal MR imaging. The placenta was manually outlined and the volume was calculated in cm(3). Brain volume was also calculated and clinical data were also collected. Relationships, including interactive effects, between placental and fetal growth, including brain growth, were evaluated using longitudinal multiple linear regression analysis.Results 135 women underwent fetal MRI between 18 and 39 weeks gestation (mean 31.6 ± 4.4). Placental volume increased exponentially with gestational age (p = 0.041). Placental volume was positively associated with birth weight (p < 0.001) and increased more steeply with birth weight in CHD-affected fetuses (p = 0.046). Total brain and cerebral volumes were smaller in the CHD group (p < 0.001), but brainstem volume (p < 0.001) was larger. Placental volumes were not associated with brain volumes.Discussion Impaired placental growth in CHD is associated with gestational age and birth weight at delivery. Abnormalities in placental development may contribute to the significant morbidity in this high-risk population. Assessment of placental volume by MRI allows for in vivo assessments of placental development.
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With increasing gestational age, total brain volume in congenital heart disease deviates more from normal during the antenatal period.
“With increasing gestational age, greater deviation of total brain volume in CHD is seen during the antenatal period.[35][36][37]”
From Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease (2017) · cites this paper as [36]
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- Authors
- Andescavage, N., Yarish, A., Donofrio, M., Bulas, D., Evangelou, I., Vezina, G., McCarter, R., duPlessis, A., & Limperopoulos, C.
- Affiliations
- Children's National (US)
- Corresponding author
- Limperopoulos, Catherine
- ORCID
- Venue
- Placenta
- Publisher
- Elsevier BV
- Published
- 2015-09
- Volume
- 36
- Issue
- 9
- Pages
- 1024-1030
- ISSN
- 0143-4004 (ISSN-L)
- PMC
- PMC4554892
- OpenAlex
- W2106916284
- Cited by
- 89
- References
- 39
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 6 · 2023: 3 · 2022: 12 · 2021: 14 · 2020: 11 · 2019: 6 · 2018: 8 · 2017: 4 · 2016: 10
- FWCI
- 5.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Placenta (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD040677)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- placental volume, congenital heart disease, fetal MRI, placental insufficiency, fetal growth, brain volume, birth weight, gestational age, brainstem volume, perinatal outcomes, placental development
- MeSH terms
- Adult, Brain, Female, Heart Defects, Congenital, Humans, Magnetic Resonance Imaging, Male, Organ Size, Placenta, Pregnancy, Cohort Studies, Case-Control Studies, Imaging, Three-Dimensional, Fetal Development, Young Adult
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