First trimester placental and myometrial blood perfusion measured by 3D power Doppler in normal and unfavourable outcome pregnancies
First trimester placental and myometrial blood perfusion measured by 3D power Doppler in normal and unfavourable outcome pregnancies
复制标题
DOI：
10.1016/j.placenta.2010.06.011
复制
发表时间：
2010-09-01
期刊：
影响因子：
3.8
通讯作者：
Philipp, K.
中科院分区：
文献类型：
--
作者：
Hafner, E.;Metzenbauer, M.;Philipp, K.
简介：旨在评估孕早期3D胎盘和子宫肌层能量多普勒血流灌注是否可用于检测危险妊娠。方法：对所有三个月内单胎妊娠的妇女在孕早期分别测量整个胎盘和邻近子宫肌层的3D能量多普勒血管化指数（VI）和血流指数（FI）。此外，我们还测量了第 12 周和第 22 周时的胎盘体积、胎盘商、PAPP-A 以及子宫动脉（平均 PI 和平均切迹），并将这些数据与妊娠结局进行比较。 结果：可以评估 383 名女性的数据。 10 发展为先兆子痫（PE）。与邻近的蜕膜和子宫肌层相比，胎盘中的血流和血管形成均明显较低。胎盘血管化指数（PVI）以及蜕膜肌层血管化指数（MVI）与胎盘体积、PAPP-A和妊娠次数之间存在一定的相关性，并且PVI，尤其是MVI与12周和22周时的平均切迹之间存在显着相关性（PVI：-0.215，-0.274 MVI：-0.316，-0.322）。有妊娠问题的女性的 PVI 和 MVI 显着降低，PE 妊娠的降低幅度最大 (p: 0.0018, 0.0004)。在所有测量参数中，MVI 显示出检测 PE 的最佳灵敏度。结论：妊娠早期 PVI 和 MVI 与妊娠第二个月平均切迹之间的相关性表明，它们早在 12 周就提供了有价值的信息，而迄今为止通常只能在 22 周时通过子宫动脉多普勒血流获得。由于 MVI 测量蜕膜肌层区域的血管百分比，它还可以提供有关滋养层侵袭的信息。这一假设得到了妊娠问题尤其是早泄妊娠中 MVI 显着下降的支持。 (C) 2010 Elsevier Ltd. 保留所有权利。
Introduction: To evaluate whether 3D placental and myometrial power Doppler blood perfusion in the first trimester can be used to detect risk pregnancies.Methods: 3D power Doppler vascularization index (VI) and flow index (FI) of the entire placenta and the neighbouring myometrium were separately measured in the first trimester in all women with singleton pregnancies during a period of three months. In addition we measured placental volume, placental quotient, PAPP-A, as well as uterine artery at 12 and 22 weeks (mean PI and mean notch) and compared those data with the pregnancy outcome.Results: Data from 383 women could be evaluated. 10 developed pre-eclampsia (PE). Both flow and vascularization were markedly lower in the placentas compared to the adjoining decidua and myometria. There was some correlation between placental vascularization Index (PVI) as well as deciduo-myometrial vascularization index (MVI) and placental volume, PAPP-A and number of pregnancies and a marked correlation between PVI and especially MVI to mean notch at 12 weeks and 22 weeks (PVI: -0.215, -0.274 MVI: -0.316,-0.322). PVI and MVI were significantly reduced in women with pregnancy problems and showed the greatest reduction in PE-pregnancies (p: 0.0018, 0.0004). Of all measured parameters MVI showed the best sensitivity for the detection of PE.Conclusion: The correlation between PVI and MVI in the first trimester and mean notch in the second shows that they provide valuable information at as early as 12 weeks which normally so far is only available at 22 weeks by uterine artery Doppler flow. As MVI measures the percentage of vessels in the deciduo-myometrial area it could also provide information on trophoblast invasion. This hypothesis is supported in particular by a marked decrease of the MVI in pregnancy problems especially in PE-pregnancies. (C) 2010 Elsevier Ltd. All rights reserved.