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The relationship between human placental morphometry and ultrasonic measurements of utero-placental blood flow and fetal growth.

Accepted version
Peer-reviewed

Repository DOI


Type

Article

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Authors

Salavati, N 
Mayo, R Plitman 
Charnock-Jones, DS 
Smith, GCS 

Abstract

INTRODUCTION: Ultrasonic fetal biometry and arterial Doppler flow velocimetry are widely used to assess the risk of pregnancy complications. There is an extensive literature on the relationship between pregnancy outcomes and the size and shape of the placenta. However, ultrasonic fetal biometry and arterial Doppler flow velocimetry have not previously been studied in relation to postnatal placental morphometry in detail. METHODS: We conducted a prospective cohort study of nulliparous women in The Rosie Hospital, Cambridge (UK). We studied a group of 2120 women who had complete data on uterine and umbilical Doppler velocimetry and fetal biometry at 20, 28 and 36 weeks' gestational age, digital images of the placenta available, and delivered a liveborn infant at term. Associations were expressed as the difference in the standard deviation (SD) score of the gestational age adjusted ultrasound measurement (z-score) comparing the lowest and highest decile of the given placental morphometric measurement. RESULTS: The lowest decile of placental surface area was associated with 0.87 SD higher uterine artery Doppler mean pulsatility index (PI) at 20 weeks (95% CI: 0.68 to 1.07, P < 0.001). The lowest decile of placental weight was associated with 0.73 SD higher umbilical artery Doppler PI at 36 weeks (95% CI: 0.54 to 0.93, P < 0.001). The lowest decile of both placental weight and placental area were associated with reduced growth velocity of the fetal abdominal circumference between 20 and 36 weeks (both P < 0.001). CONCLUSION: Placental area and weight are associated with uterine and umbilical blood flow, respectively, and both are associated with fetal growth rate.

Description

Keywords

Doppler flow velocimetry, Fetal growth, Human, Morphometry, Placenta, Blood Flow Velocity, Cohort Studies, Female, Fetal Development, Gestational Age, Humans, Infant, Newborn, Maternal-Fetal Exchange, Organ Size, Placenta, Pregnancy, Ultrasonography, Prenatal, Umbilical Arteries, Uterine Artery

Journal Title

Placenta

Conference Name

Journal ISSN

0143-4004
1532-3102

Volume Title

38

Publisher

Elsevier BV
Sponsorship
Stillbirth and Neonatal Death Society (SANDS) (JE/DICT4/97771/14)
Cambridge University Hospitals NHS Foundation Trust (CUH) (unknown)
This study was funded by the NIHR Cambridge Comprehensive Biomedical Research Centre (grant number A019057) and Stillbirth and Neonatal Death Society (SANDS). GE donated two ultrasound machines for use in the project.