Value of 3D Ultrasonographic Assessment of Placental Volume and Perfusion Indices in The First Trimester as a Predictor to the Occurrence of Preeclampsia

Background: Preeclampsia (PE) is one of the hypertension illnesses associated with pregnancy, affecting 3-5% of pregnant women, and is a significant cause of maternal morbidity and perinatal mortality. Detection of placenta changes in the first trimester by three-dimensional power-Doppler ultrasound can be used to detect preeclampsia early.
Objective: The aim of the current work was to demonstrate if 3D- Indicators of placental volume and vascular flow in the first trimester might predict preeclampsia.
Patients and methods: This prospective cohort study included 324 pregnant women with singleton pregnancies, attending at Prenatal Care Outpatient Clinic, Zagazig University Hospitals for regular antenatal care between weeks 11 + 0 and 13 + 6 of pregnancy. Transabdominal the 3D power Doppler ("placental biopsy") was used to assess placental vascularization. Making use of the Virtual Organ Computer-aided Analysis (VOCALTM) imaging tool, the obtained spherical volume was analyzed. three vascular indices, were calculated: Index of vascularization (VI), vascularization- flow index, as well as flow index (VFI).
Results: A comparison of placental volume of healthy pregnancy group and preeclamptic pregnancies in the current study showed a statistically significant considerable distinction (P value 0.001). The mean volume in the two groups was 84.9±22.3 and 45.6±11.4 cm³, respectively. The volume of the placenta was higher in the healthy pregnancy group compared to preeclamptic pregnancy group. In addition, a comparison between normal pregnancy and pregnancies with PE, in terms of FI, VI, and VFI, indicated a difference that is statistically significant (P value 0.001). The averages of FI, VI, and VFI in the two groups were (95.4±9.1, 24.7±8.1, 13.1±3. 7) and (16.2±5.8, 54.6±10.9, 8.1±2.1) respectively. These findings clearly reveal that placentas from preeclampsia complicated pregnancies have lesser blood vessels (reduced VI) and lower blood flow (reduced FI). According to our findings, this ultrasonographic technology can forecast the development of PE.
Conclusions: It could be concluded that the quantitative measurement of placental vasculature and volume using noninvasive 3D Power Doppler and the VOCAL™ technique during the first trimester may be utilized to predict preeclampsia. Patients who later develop preeclampsia tend to have decreased placental volume and poorer 3DPD indices in this critical area during the first trimester.