title: Comparison of 2-D and 3-D estimates of placental volume in early pregnancy.
abstract: Ultrasound estimation of placental volume (PlaV) between 11 and 13 wk has been proposed as part of a screening test for small-for-gestational-age babies. A semi-automated 3-D technique, validated against the gold standard of manual delineation, has been found at this stage of gestation to predict small-for-gestational-age at term. Recently, when used in the third trimester, an estimate obtained using a 2-D technique was found to correlate with placental weight at delivery. Given its greater simplicity, the 2-D technique might be more useful as part of an early screening test. We investigated if the two techniques produced similar results when used in the first trimester. The correlation between PlaV values calculated by the two different techniques was assessed in 139 first-trimester placentas. The agreement on PlaV and derived "standardized placental volume," a dimensionless index correcting for gestational age, was explored with the Mann-Whitney test and Bland-Altman plots. Placentas were categorized into five different shape subtypes, and a subgroup analysis was performed. Agreement was poor for both PlaV and standardized PlaV (p < 0.001 and p < 0.001), with the 2-D technique yielding larger estimates for both indices compared with the 3-D method. The mean difference in standardized PlaV values between the two methods was 0.007 (95% confidence interval: 0.006-0.009). The best agreement was found for regular rectangle-shaped placentas (p = 0.438 and p = 0.408). The poor correlation between the 2-D and 3-D techniques may result from the heterogeneity of placental morphology at this stage of gestation. In early gestation, the simpler 2-D estimates of PlaV do not correlate strongly with those obtained with the validated 3-D technique.
authors.affiliation: Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Headington, Oxford, United Kingdom. Electronic address: christina.aye@obs-gyn.ox.ac.uk.
authors.forename: Christina Y L
authors.initials: CY
authors.lastname: Aye
authors.affiliation: Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Headington, Oxford, United Kingdom.
authors.forename: Gordon N
authors.initials: GN
authors.lastname: Stevenson
authors.affiliation: Fetal Medicine Unit, Women's Centre, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Impey
authors.affiliation: Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Headington, Oxford, United Kingdom; Fetal Medicine Unit, Women's Centre, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
authors.forename: Sally L
authors.initials: SL
authors.lastname: Collins
mesh_terms: D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007236:Infant, Small for Gestational Age; D009929:Organ Size; D010920:Placenta / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: 2-D; 3-D; Placental volume estimation; Screening; Small for gestational age; Ultrasound