Sono-elastographic evaluation of Placenta and Its Correlation with Placental Thickness and Uterine Artery Doppler Parameters
Introduction: Placenta is the supplier of nutrients to the developing fetus. Placental health is directly related to the fetal health. The placental thickness and elasticity have direct impact on the fetal birth weight and wellbeing. There are not many studies in India, correlating the placental...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2019-04-01
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| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | http://www.ijars.net/articles/PDF/2467/40179_CE[Ra1]_F(SHU)_PF1(AJ_AC)_PFA(AJ_SHU)_PN(SHU).pdf |
| Summary: | Introduction: Placenta is the supplier of nutrients to the
developing fetus. Placental health is directly related to the
fetal health. The placental thickness and elasticity have direct
impact on the fetal birth weight and wellbeing. There are not
many studies in India, correlating the placental elasticity with
fetal birth weight and wellbeing.
Aim: To correlate the placental thickness, mean uterine artery
Pulsatility Index (PI), placental stiffness, gestational weight and
birth weight in controls, gestational diabetes and pregnancyinduced hypertensive patients.
Materials and Methods: This exploratory correlative study
was performed on 222 pregnant women in the third trimester
of pregnancy. The patients in the third trimester, referred to
obstetric ultrasonography from January 2017 to June 2018
were included in the study. The thickness of the placenta was
measured at the umbilical cord insertion site. Sono-elastography
was performed at the centre, superior and inferior ends of the
placenta and the average stiffness was recorded. The average
gestational age was estimated using standard sonographic
techniques. The average gestational age, placental thickness,
stiffness on sono-elastography, mean uterine artery pulsatility
index and association with gestational diabetes/pregnancyinduced hypertension were correlated and analysed.
Results: The placental thickness ranged between 27-34 mm in
the pregnancy-induced hypertension group with mean of 30.36
mm and standard deviation of 1.868. The thickness ranged
between 33-51 mm with a mean of 40.75 mm and standard
deviation of 4.181 in patients with gestational diabetes. The
Pulsatility Index of the uterine arteries ranged between 1.6-
2.2 in pregnancy-induced hypertensive patients with a mean
of 1.824. In gestational diabetes patients, the uterine artery
Pulsatility Index ranged between 0.6-1.1 with a mean of 0.866.
The placental stiffness was significantly higher in pregnancyinduced hypertension group with the mean stiffness being
7.233 and standard deviation of 0.7025 as against the stiffness
of 2.906 kpa with standard deviation of 0.2923 in controls
and 2.838 with standard deviation of 0.3424 in gestational
diabetes patients. All the babies with maternal pregnancyinduced hypertension had low birth weight than the controls
and the babies of gestational diabetes patients had higher
birth weight.
Conclusion: The placentae in patients with gestational diabetes
are larger with larger foetuses. The stiffness of the placenta is
not affected by gestational diabetes. The placenta and fetus are
smaller in pregnancy-induced hypertensive patients. Stiffness
of the placenta is increased in pregnancy-induced hypertension.
The placental stiffness can be used as an additional prognostic
parameter in the outcome of pregnancy-induced hypertension.
The higher the stiffness, more are the chances of intrauterine
growth restriction and small fetus. |
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| ISSN: | 2277-8543 2455-6874 |