title: Three-dimensional sonographic assessment of placental volume and vascularization in pregnancies complicated by hypertensive disorders.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the association between placental volumes, placental vascularity, and hypertensive disorders in pregnancy.
  
  
  METHODS
  A prospective case-control study was conducted between April 2011 and July 2012. Placental volumes and vascularity were evaluated by 3-dimensional sonographic, 3-dimensional power Doppler histographic, and 2-dimensional color Doppler studies. Pregnant women were classified as normotensive or hypertensive and stratified by the nature of their hypertensive disorders. The following variables were evaluated: observed-to-expected placental volume ratio, placental volume-to-estimated fetal weight ratio, placental vascular indices, and pulsatility indices of the right and left uterine and umbilical arteries.
  
  
  RESULTS
  Sixty-six healthy pregnant women and 62 pregnant women with hypertensive disorders were evaluated (matched by maternal age, gestational age at sonography, and parity). Placental volumes were not reduced in pregnancy in women with hypertensive disorders (P > .05). Conversely, reduced placental vascularization indices (vascularization index and vascularization-flow index) were observed in pregnancies complicated by hypertensive disorders (P < .01; P < .01), especially in patients with superimposed preeclampsia (P = .04; P = .02). A weak correlation was observed between placental volumes, placental vascular indices, and Doppler studies of the uterine and umbilical arteries.
  
  
  CONCLUSIONS
  Pregnancies complicated by hypertensive disorders are associated with reduced placental vascularity but not with reduced placental volumes. These findings are independent of changes in uterine artery Doppler studies. Future studies of the prediction of preeclampsia may focus on placental vascularity in combination with results of Doppler studies of the uterine arteries.
authors.affiliation: Pavilion for Women, Texas Children's Hospital, 6651 Main St, Suite F1020, Houston, TX 77030 USA. rodrigoruano@hotmail.com.
authors.forename: Eduardo Jorge
authors.initials: EJ
authors.lastname: de Almeida Pimenta
authors.forename: Carla Fagundes
authors.initials: CF
authors.lastname: Silva de Paula
authors.forename: Juliana Alvares
authors.initials: JA
authors.lastname: Duarte Bonini Campos
authors.forename: Karin Anneliese
authors.initials: KA
authors.lastname: Fox
authors.forename: Rossana
authors.initials: R
authors.lastname: Francisco
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ruano
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D009929:Organ Size; D010920:Placenta / Q000098:blood supply* / Q000000981:diagnostic imaging*; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging*; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*
keywords: 3-dimensional power Doppler sonography; 3-dimensional sonography; Doppler study; arterial hypertension; obstetric ultrasound; placental size; placental vascularity; placental volume; preeclampsia; pregnancy; umbilical arteries; uterine arteries