Evaluation of placental vascularization by three-dimensional ultrasound examination in second and third trimester of pregnancies complicated by chronic hypertension, gestational hypertension or pre-eclampsia

Andrea Surányi, Ábel Altorjay, László Kaiser, T. Nyári, Gábor Németh

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4 Citations (Scopus)

Abstract

Objectives The purpose of this study was to assess three-dimensional placental power Doppler indices in second and third trimester of pregnancies complicated by chronic-, gestational hypertension or pre-eclampsia. Methods We analyzed 226 pregnancies prospectively measuring three-dimensional placental power Doppler indices (vascularization index, flow index, vascularization flow index) in cases of normal blood pressure (N = 109), chronic hypertension (N = 43), gestational hypertension (N = 57) and pre-eclampsia (N = 17). We evaluated the correlation among vascularization indices, flow characteristics of uterine arteries and perinatal outcome. We assessed the influence of maternal factors (pregestational body mass index, previous pregnancies/deliveries, maternal age) on vascularization indices, and analyzed histological findings of placenta from pregnancy hypertension groups. Results Vascularization index was significantly higher (p = 0.010) in pregnancies with chronic- and lower (p = 0.152) in pregnancies with gestational hypertension and preeclampsia compared to the normal group. Flow index was significantly lower in all three pathological groups compared to normal group. Placental volume was significantly smaller (p < 0.001) in all three pathological groups than in normal pregnancies at the time of delivery, and there was no significant difference between the three affected groups. The rate of adverse pregnancy outcomes showed no significant difference between the normal and chronic hypertension groups. We observed significantly lower 1′, 5′ and 10′ APGAR scores (p < 0.,001), and birth weight in preeclampsia compared to chronic-, gestational hypertension, and normal groups. Maternal factors had no influence on the development of the power Doppler indices. Conclusion Vascularization indices seem good markers for the prediction of risks and adverse outcomes in case of pregnancy hypertension.

Original languageEnglish
Pages (from-to)51-59
Number of pages9
JournalPregnancy Hypertension
Volume8
DOIs
Publication statusPublished - Apr 1 2017

Fingerprint

Pregnancy Induced Hypertension
Third Pregnancy Trimester
Second Pregnancy Trimester
Pre-Eclampsia
Hypertension
Pregnancy
Mothers
Uterine Artery
Maternal Age
Pregnancy Outcome
Birth Weight
Placenta
Body Mass Index
Blood Pressure

Keywords

  • 3-Dimensional ultrasound
  • Chronic hypertension
  • Gestational hypertension
  • Placenta
  • Pre-eclampsia
  • Vascularization

ASJC Scopus subject areas

  • Internal Medicine
  • Obstetrics and Gynaecology

Cite this

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title = "Evaluation of placental vascularization by three-dimensional ultrasound examination in second and third trimester of pregnancies complicated by chronic hypertension, gestational hypertension or pre-eclampsia",
abstract = "Objectives The purpose of this study was to assess three-dimensional placental power Doppler indices in second and third trimester of pregnancies complicated by chronic-, gestational hypertension or pre-eclampsia. Methods We analyzed 226 pregnancies prospectively measuring three-dimensional placental power Doppler indices (vascularization index, flow index, vascularization flow index) in cases of normal blood pressure (N = 109), chronic hypertension (N = 43), gestational hypertension (N = 57) and pre-eclampsia (N = 17). We evaluated the correlation among vascularization indices, flow characteristics of uterine arteries and perinatal outcome. We assessed the influence of maternal factors (pregestational body mass index, previous pregnancies/deliveries, maternal age) on vascularization indices, and analyzed histological findings of placenta from pregnancy hypertension groups. Results Vascularization index was significantly higher (p = 0.010) in pregnancies with chronic- and lower (p = 0.152) in pregnancies with gestational hypertension and preeclampsia compared to the normal group. Flow index was significantly lower in all three pathological groups compared to normal group. Placental volume was significantly smaller (p < 0.001) in all three pathological groups than in normal pregnancies at the time of delivery, and there was no significant difference between the three affected groups. The rate of adverse pregnancy outcomes showed no significant difference between the normal and chronic hypertension groups. We observed significantly lower 1′, 5′ and 10′ APGAR scores (p < 0.,001), and birth weight in preeclampsia compared to chronic-, gestational hypertension, and normal groups. Maternal factors had no influence on the development of the power Doppler indices. Conclusion Vascularization indices seem good markers for the prediction of risks and adverse outcomes in case of pregnancy hypertension.",
keywords = "3-Dimensional ultrasound, Chronic hypertension, Gestational hypertension, Placenta, Pre-eclampsia, Vascularization",
author = "Andrea Sur{\'a}nyi and {\'A}bel Altorjay and L{\'a}szl{\'o} Kaiser and T. Ny{\'a}ri and G{\'a}bor N{\'e}meth",
year = "2017",
month = "4",
day = "1",
doi = "10.1016/j.preghy.2017.03.004",
language = "English",
volume = "8",
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journal = "Pregnancy Hypertension",
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TY - JOUR

T1 - Evaluation of placental vascularization by three-dimensional ultrasound examination in second and third trimester of pregnancies complicated by chronic hypertension, gestational hypertension or pre-eclampsia

AU - Surányi, Andrea

AU - Altorjay, Ábel

AU - Kaiser, László

AU - Nyári, T.

AU - Németh, Gábor

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Objectives The purpose of this study was to assess three-dimensional placental power Doppler indices in second and third trimester of pregnancies complicated by chronic-, gestational hypertension or pre-eclampsia. Methods We analyzed 226 pregnancies prospectively measuring three-dimensional placental power Doppler indices (vascularization index, flow index, vascularization flow index) in cases of normal blood pressure (N = 109), chronic hypertension (N = 43), gestational hypertension (N = 57) and pre-eclampsia (N = 17). We evaluated the correlation among vascularization indices, flow characteristics of uterine arteries and perinatal outcome. We assessed the influence of maternal factors (pregestational body mass index, previous pregnancies/deliveries, maternal age) on vascularization indices, and analyzed histological findings of placenta from pregnancy hypertension groups. Results Vascularization index was significantly higher (p = 0.010) in pregnancies with chronic- and lower (p = 0.152) in pregnancies with gestational hypertension and preeclampsia compared to the normal group. Flow index was significantly lower in all three pathological groups compared to normal group. Placental volume was significantly smaller (p < 0.001) in all three pathological groups than in normal pregnancies at the time of delivery, and there was no significant difference between the three affected groups. The rate of adverse pregnancy outcomes showed no significant difference between the normal and chronic hypertension groups. We observed significantly lower 1′, 5′ and 10′ APGAR scores (p < 0.,001), and birth weight in preeclampsia compared to chronic-, gestational hypertension, and normal groups. Maternal factors had no influence on the development of the power Doppler indices. Conclusion Vascularization indices seem good markers for the prediction of risks and adverse outcomes in case of pregnancy hypertension.

AB - Objectives The purpose of this study was to assess three-dimensional placental power Doppler indices in second and third trimester of pregnancies complicated by chronic-, gestational hypertension or pre-eclampsia. Methods We analyzed 226 pregnancies prospectively measuring three-dimensional placental power Doppler indices (vascularization index, flow index, vascularization flow index) in cases of normal blood pressure (N = 109), chronic hypertension (N = 43), gestational hypertension (N = 57) and pre-eclampsia (N = 17). We evaluated the correlation among vascularization indices, flow characteristics of uterine arteries and perinatal outcome. We assessed the influence of maternal factors (pregestational body mass index, previous pregnancies/deliveries, maternal age) on vascularization indices, and analyzed histological findings of placenta from pregnancy hypertension groups. Results Vascularization index was significantly higher (p = 0.010) in pregnancies with chronic- and lower (p = 0.152) in pregnancies with gestational hypertension and preeclampsia compared to the normal group. Flow index was significantly lower in all three pathological groups compared to normal group. Placental volume was significantly smaller (p < 0.001) in all three pathological groups than in normal pregnancies at the time of delivery, and there was no significant difference between the three affected groups. The rate of adverse pregnancy outcomes showed no significant difference between the normal and chronic hypertension groups. We observed significantly lower 1′, 5′ and 10′ APGAR scores (p < 0.,001), and birth weight in preeclampsia compared to chronic-, gestational hypertension, and normal groups. Maternal factors had no influence on the development of the power Doppler indices. Conclusion Vascularization indices seem good markers for the prediction of risks and adverse outcomes in case of pregnancy hypertension.

KW - 3-Dimensional ultrasound

KW - Chronic hypertension

KW - Gestational hypertension

KW - Placenta

KW - Pre-eclampsia

KW - Vascularization

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U2 - 10.1016/j.preghy.2017.03.004

DO - 10.1016/j.preghy.2017.03.004

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VL - 8

SP - 51

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JO - Pregnancy Hypertension

JF - Pregnancy Hypertension

SN - 2210-7789

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