Could 3D placental volume and perfusion indices measured at 11-14 weeks predict occurrence of preeclampsia in high-risk pregnant women?

Objective: Preeclampsia (PE) is a known cause of maternal, fetal and neonatal morbidity and mortality. Thus, evaluation of the predicting value of combining the 3D assessment of placental volume with the assessment of placental perfusion indices through 3D power Doppler (3DPD) at 11-14 weeks in pregnant women at high risk to develop PE could be a suitable screening method.

Methods: 3D assessment of placental volume and 3DPD assessment of placental vascularization indices at 11-13 weeks and uterine artery Doppler scan (RI and PI) at 21-22 weeks were conducted in this prospective case-control study. Their predictive ability for PE was assessed.

Results: One-hundred pregnant women divided into two groups were enrolled in our study. High-risk group (n = 50) and control group (n = 50). Thirty-eight (76%) patients in the high-risk group and 6.0 (12%) patients in the control group developed PE, respectively. The mean values of placental volume (<0.001), vascularization index (<0.001), vascularization flow index (<0.002) were significantly lower in the high-risk group. Meanwhile, uterine artery RI (0.011) and PI (<0.001) was significantly higher in the study group. Uterine artery PI is negatively correlated with placental volume and vascularization indices (-0.36).

Conclusion: Our findings suggest that 3D placental volume measurement and 3DPD assessment of placental vascular indices in the first trimester has the potential to detect women at risk for subsequent development of PE.