title: Prediction of early- and late-onset pregnancy-induced hypertension using placental volume on three-dimensional ultrasound and uterine artery Doppler.
abstract: OBJECTIVE
  To determine whether uterine artery (UtA) Doppler findings and three-dimensional (3D) ultrasound measurement of placental volume during the first trimester allowed prediction of early- and late-onset pregnancy-induced hypertension (early PIH and late PIH).
  
  
  METHODS
  Subjects with singleton pregnancy who underwent an ultrasound scan at 11-13 weeks' gestation and delivered between 2011 and 2013 were enrolled prospectively into the study. The UtA Doppler indices and placental volume on 3D ultrasound at 11-13 weeks' gestation in cases that developed early PIH (< 34 weeks) or PIH later in pregnancy (≥ 34 weeks) were compared with values in unaffected pregnancies.
  
  
  RESULTS
  Ten cases of early PIH, 67 cases of late PIH and 1285 unaffected pregnancies were analyzed. The UtA pulsatility index (PI) was higher in cases of early PIH than that in unaffected pregnancies (median, 2.35 vs. 1.79; P = 0.043) but did not differ between cases of late PIH and unaffected pregnancies. Placental volume was smaller in cases of early PIH than that in unaffected pregnancies (median, 43 cm3 vs. 62 cm(3) ; P = 0.003) but did not differ between cases of late PIH and unaffected pregnancies. The area under the receiver-operating characteristics curve for the prediction of early PIH, by combining UtA-PI and placental volume, was 0.832 (95% CI, 0.742-0.921), with this combination providing a detection rate for early PIH of 67.5% for a 5% false-positive rate.
  
  
  CONCLUSIONS
  High UtA-PI and small placental volume were observed more often in cases of early PIH compared with unaffected pregnancies, but not in cases of late PIH. These results may indicate that there are differences in pathophysiology between early PIH and late PIH.
authors.affiliation: Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Arakaki
authors.forename: J
authors.initials: J
authors.lastname: Hasegawa
authors.forename: M
authors.initials: M
authors.lastname: Nakamura
authors.forename: S
authors.initials: S
authors.lastname: Hamada
authors.forename: M
authors.initials: M
authors.lastname: Muramoto
authors.forename: H
authors.initials: H
authors.lastname: Takita
authors.forename: K
authors.initials: K
authors.lastname: Ichizuka
authors.forename: A
authors.initials: A
authors.lastname: Sekizawa
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000000981:diagnostic imaging* / Q000473:pathology; D007231:Infant, Newborn; D010920:Placenta / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D012372:ROC Curve; D018617:Ultrasonography, Doppler, Pulsed; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000000981:diagnostic imaging*
keywords: first-trimester screening; placental volume; pre-eclampsia; pregnancy-induced hypertension; uterine artery