Reduced placental volume and flow in severe growth restricted fetuses

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Citações na Scopus
4
Tipo de produção
article
Data de publicação
2016
Título da Revista
ISSN da Revista
Título do Volume
Editora
HOSPITAL CLINICAS, UNIV SAO PAULO
Citação
CLINICS, v.71, n.6, p.332-337, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
OBJECTIVES: To evaluate placental volume and vascular indices in pregnancies with severe fetal growth restriction and determine their correlations to normal reference ranges and Doppler velocimetry results of uterine and umbilical arteries. METHODS: Twenty-seven fetuses with estimated weights below the 3rd percentile for gestational age were evaluated. Placental volume and vascular indices, including vascularization, flow, and vascularization flow indices, were measured by three-dimensional ultrasound using a rotational technique and compared to a previously described nomogram. The observed-to-expected placental volume ratio for gestational age and observed-to-expected placental volume ratio for fetal weight were calculated. Placental parameters correlated with the Doppler velocimetry results of uterine and umbilical arteries. RESULTS: The mean uterine artery pulsatility index was negatively correlated with the observed-to-expected placental volume ratio for gestational age, vascularization index and vascularization flow index. The observed-to-expected placental volume ratio for gestational age and observed-to-expected placental volume ratio for fetal weight and vascularization index were significantly lower in the group with a bilateral protodiastolic notch. No placental parameter correlated with the umbilical artery pulsatility index. CONCLUSIONS: Pregnancies complicated by severe fetal growth restriction are associated with reduced placental volume and vascularization. These findings are related to changes in uterine artery Doppler velocimetry. Future studies on managing severe fetal growth restriction should focus on combined results of placental three-dimensional ultrasound and Doppler studies of uterine arteries.
Palavras-chave
Placenta, Ultrasonography Doppler, Imaging Three-Dimensional, Placenta Circulation, Fetal Growth Retardation
Referências
  1. ABRAMOWICZ JS, 1989, J ULTRAS MED, V8, P219
  2. Arakaki T, 2015, ULTRASOUND OBST GYN, V45, P539, DOI 10.1002/uog.14633
  3. ARDUINI D, 1990, J PERINAT MED, V18, P165, DOI 10.1515/jpme.1990.18.3.165
  4. Chen CP, 2002, AM J OBSTET GYNECOL, V187, P764, DOI 10.1067/mob.2002.125243
  5. Cox P, 2009, BEST PRACT RES CL OB, V23, P751, DOI 10.1016/j.bpobgyn.2009.06.006
  6. de Paula CFS, 2009, PLACENTA, V30, P142, DOI 10.1016/j.placenta.2008.11.010
  7. Garite TJ, 2004, AM J OBSTET GYNECOL, V191, P481, DOI 10.1016/j.ajog.2004.01.036
  8. Guiot C, 2008, ULTRASOUND OBST GYN, V31, P171, DOI 10.1002/uog.5212
  9. HADLOCK FP, 1985, AM J OBSTET GYNECOL, V151, P333
  10. Hadlock FP, 1990, FETAL ULTRASOUND, V28, P39
  11. Hafner E, 2013, PLACENTA, V34, P892, DOI 10.1016/j.placenta.2013.06.303
  12. Hafner E, 2010, PLACENTA, V31, P756, DOI 10.1016/j.placenta.2010.06.011
  13. Hata T, 2011, PLACENTA, V32, P105, DOI 10.1016/j.placenta.2010.11.001
  14. Junaid TO, 2014, PLACENTA, V35, P808, DOI 10.1016/j.placenta.2014.07.013
  15. Kingdom J, 2000, EUR J OBSTET GYN R B, V92, P35, DOI 10.1016/S0301-2115(00)00423-1
  16. Lai PK, 2010, ULTRASOUND OBST GYN, V36, P202, DOI 10.1002/uog.7608
  17. Lecarpentier E, 2012, PLACENTA, V33, P769, DOI 10.1016/j.placenta.2012.06.013
  18. Luria O, 2012, PRENATAL DIAG, V32, P1174, DOI 10.1002/pd.3980
  19. Martins WP, 2010, ULTRASOUND OBST GYN, V35, P361, DOI 10.1002/uog.7562
  20. Martins WP, 2012, ULTRASOUND OBST GYN, V40, P200, DOI 10.1002/uog.11076
  21. Mayhew TM, 2007, PLACENTA, V28, P233, DOI 10.1016/placenta.2006.02.011
  22. McIntire DD, 1999, NEW ENGL J MED, V340, P1234, DOI 10.1056/NEJM199904223401603
  23. Merce LT, 2005, CROAT MED J, V46, P765
  24. Merce LT, 2004, J PERINAT MED, V32, P228, DOI 10.1515/JPM.2004.043
  25. Mitra S C, 2000, J Matern Fetal Med, V9, P282
  26. Morel O, 2010, ULTRASOUND OBST GYN, V36, P635, DOI 10.1002/uog.7741
  27. Negrini R, 2011, ARCH GYNECOL OBSTET, V284, P53, DOI 10.1007/s00404-010-1595-x
  28. Noguchi J, 2009, PLACENTA, V30, P391, DOI 10.1016/j.placenta.2009.02.010
  29. Pairleitner H, 1999, ULTRASOUND OBST GYN, V14, P139, DOI 10.1046/j.1469-0705.1999.14020139.x
  30. Papageorghiou AT, 2004, BEST PRACT RES CL OB, V18, P383, DOI 10.1016/j.bpobgyn.2004.02.003
  31. Parra-Saavedra M, 2014, ULTRASOUND OBST GYN, V44, P330, DOI 10.1002/uog.13358
  32. Pomorski M, 2014, ADV MED SCI-POLAND, V59, P23, DOI 10.1016/j.advms.2013.06.002
  33. Pomorski M, 2012, ARCH GYNECOL OBSTET, V285, P331, DOI 10.1007/s00404-011-1968-9
  34. Raine-Fenning NJ, 2008, ULTRASOUND OBST GYN, V32, P115, DOI 10.1002/uog.5394
  35. Rizzo G, 2009, J ULTRAS MED, V28, P1615
  36. Savchev S, 2012, ULTRASOUND OBST GYN, V39, P299, DOI 10.1002/uog.10150
  37. Schulten-Wijman MJNC, 2008, ULTRASOUND OBST GYN, V32, P560, DOI 10.1002/uog.6112
  38. de Paula CFS, 2008, J ULTRAS MED, V27, P1583
  39. Artunc Ulkumen B, 2014, J MATERN-FETAL NEO M, P1