Value of shear-wave elastography and cerebral–placental–uterine ratio in women diagnosed with preeclampsia and fetal growth restriction in prediction of adverse perinatal outcomes

A. Anuk, A. Tanaçan, S. Erol, Mihriban Alkan, O. Altınboğa, Ş. Çelen, H. Keskin, D. Şahın
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引用次数: 3

Abstract

Abstract Purpose The aim of this study was to measure placental stiffness with shear-wave elastography technique and to evaluate the relationship with cerebral–placental–uterine ratio (CPUR) and adverse perinatal outcomes in patient groups diagnosed with preeclampsia (PE) and fetal growth restriction (FGR) in the second and third trimesters compared to the control group. Materials and methods This prospective cross-sectional study was conducted at our hospital between March 2019 and March 2020. The study groups were divided into three groups: PE, FGR, and low risk pregnancy (LRP) group. The study population had singleton pregnancies and the placental site was at the anterior wall. Both shear-wave elasticity (SWE) and shear-wave velocity (SWV) were measured in the placenta during pregnancy. CPUR was calculated for each group. Results A total of 147 patients were included in this study. The mean SWE (kilopascals) values in the PE group were significantly higher than in the FGR and controls (difference of means = 3.67, 9.45; 95% CI (1.23–6.1, 7–11.8); p < .05), respectively. The mean SWV values were significantly higher in PE and FGR groups than controls (p < .05). CPUR showed correlation with central maternal surface of placenta (p: .02, r: −0.184), central fetal surface of placenta (p < .001, r: −0.288), peripheral maternal surface of placenta (p: .002, r: −0.252), and peripheral fetal surface of placenta SWE values (p: .03, r: −0.181). NICU admission was correlated with central fetal surface of placenta SWE values (p: .002, r: 0.258). Conclusion In conclusion, we demonstrated increased placental stiffness in both the PE and the FGR group. Also, this difference was found to be more prominent in preeclampsia. This technique seems useful for assessment of placental function and may strengthen the utility of Doppler parameters for predicting adverse perinatal outcomes in high-risk pregnancies.
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剪切波弹性成像和脑-胎盘-子宫比在诊断为子痫前期和胎儿生长受限的妇女中预测不良围产期结局的价值
摘要目的采用剪切波弹性成像技术测量胎盘硬度,并评价中晚期诊断为先兆子痫(PE)和胎儿生长受限(FGR)的患者组与对照组相比,与脑-胎盘-子宫比(CPUR)和不良围产期结局的关系。材料与方法本前瞻性横断面研究于2019年3月至2020年3月在我院进行。研究组分为PE组、FGR组和低危妊娠组(LRP)。研究人群为单胎妊娠,胎盘位于前壁。测定妊娠期胎盘的剪切波弹性(SWE)和剪切波速度(SWV)。计算各组的cpu。结果本研究共纳入147例患者。PE组的平均SWE(千帕斯卡)值显著高于FGR组和对照组(均数差= 3.67,9.45;95% ci (1.23-6.1, 7-11.8);P < 0.05)。PE组和FGR组的平均SWV值显著高于对照组(p < 0.05)。CPUR与母体胎盘中心面(p: 0.02, r: - 0.184)、胎儿胎盘中心面(p < 0.05)相关。母体胎盘外周表面SWE值(p: 0.002, r:−0.252),胎儿胎盘外周表面SWE值(p: 0.03, r:−0.181)。新生儿重症监护病房入院与胎盘中心胎面SWE值相关(p: 0.002, r: 0.258)。结论PE组和FGR组胎盘硬度均有所增加。此外,这种差异在子痫前期更为突出。这项技术似乎有助于评估胎盘功能,并可能加强多普勒参数预测高危妊娠不良围产期结局的效用。
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