Histomorphometric characteristics of first trimester chorionic villi in pregnancies with low serum pregnancy-associated plasma protein-A levels: relationship with placental three-dimensional power doppler ultrasonographic vascularization.
OBJECTIVE
To evaluate histomorphometric vascular characteristics from samples obtained by chorionic villus sampling (CVS) in pregnancies with low serum pregnancy-associated plasma protein-A (PAPP-A) levels and to relate these findings to three-dimensional (3D) placental volume and power Doppler vascularization.


METHODS
Immediately before CVS, placental 3D-power Doppler ultrasonography was performed at 11 + 0 to 13 + 6 weeks in 12 pregnancies with PAPP-A concentrations <0.3 multiples of median (MoM) as well as in 11 control women. Using a standardized setting placental volume, vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were measured. Histomorphometric parameters of villi were blindly evaluated with a video-computerized-image-analysis system.


RESULTS
Pregnancies with low PAPP-A showed a significantly reduced number of capillary vessels per villus cross-section (p = 0.005) and a smaller capillary diameter (p = 0.041). Placental vascular indices were significantly related to the number of fetal capillary vessels per villus (VI: r = 0.51, p = 0.03; FI: r = 0.48, p = 0.04; VFI: r = 0.56, p = 0.01).


CONCLUSIONS
Differences in placental vascularization are present in first trimester in pregnancies with low PAPP-A and they are associated to altered 3D placental Doppler indices.
Rizzo
Giuseppe
G
Fetal Medicine Center, Genoma, Rome, Italy.
Silvestri
Evelina
E
Capponi
Alessandra
A
Servadei
Francesca
F
Pietrolucci
Maria Elena
ME
Capece
Antonio
A
Pisa
Roberto
R
Arduini
Domenico
D
D002824:Chorionic Villi / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000648:ultrastructure; D015193:Chorionic Villi Sampling; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D010920:Placenta / Q000098:blood supply* / Q000000981:diagnostic imaging*; D021041:Placental Circulation / Q000502:physiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood* / Q000378:metabolism; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis / Q000378:metabolism*; D018608:Ultrasonography, Doppler / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods*
D011266:Pregnancy-Associated Plasma Protein-A