Value of 3D Ultrasonographic Assessment of Placental Volume and Perfusion Indices in The First Trimester As Predictors to The Occurrence of Preeclampsia

Aim: The purpose of this study is to determine placental volume and vascular flow indices during the first trimester and their values as predictors of developing preeclampsia. Materials and Methods: A prospective analysis for standard antenatal follow up at 11 to 13 weeks of gestation was performed on 177 singleton pregnant women visiting the antenatal care outpatient clinic at Al-Sahel Teaching Hospital between June 2018 and June 2019. Transabdominal 3D ultrasonography ('placental biopsy') to determine placental volume and power Doppler assessment of placental vascularization were done for all cases. Results: Comparative analysis of placental volumes between the normal pregnancy and preeclamptic pregnancies groups revealed a statistically high significant difference ( P value < 0.001 ). The mean volume in the two groups was 84.9 ± 22 and 45.6 ± 11.4 cm3, respectively. In the normal pregnancy group, the volume of placenta was larger than preeclamptic pregnancies group. Also, comparative analysis of placental vascularization index (VI), flow index (FI), and vascularization flow index (VFI) between the normal pregnancy group and pregnancies group that developed preeclampsia revealed a statistically high significant difference ( P value <0.001 ). The mean values of (VI), (FI), and (VFI) in the two groups were (24.7±8.1, 95.4±9.1, 13.1±3. 7) and (16.2±5.8, 54.6±10.9, 8.1±2.1) respectively. Conclusion: Quantitative assessment of placental volume and vasculature using 3D power doppler VOCAL TM techniques can be used in the 1st trimester to predict preeclampsia. Placentas of pregnancy complicated with preeclampsia have smaller volume, fewer blood vessels (reduced VI) and decreased blood flow (reduced FI).