title: First-Trimester Placental and Myometrial Blood Perfusion Measured by Three-Dimensional Power Doppler in Preeclampsia.
abstract: OBJECTIVE
  The study aims to evaluate first-trimester vascularization of the placenta and subplacental myometrium in women who subsequently develop preeclampsia.
  
  
  METHODS
  A case-control study nested in a prospective cohort was conducted in women with singleton pregnancy between 11 and 14 weeks' gestation. Three-dimensional standardized acquisition of the placenta and subplacental myometrium volumes with and without power Doppler was undertaken, and all participants were followed up until delivery. Each woman diagnosed with preeclampsia was matched with three controls who delivered at term without pregnancy complications. First-trimester volume, vascularization index (VI), flow index (FI), and vascular flow index (VFI) of the entire placenta and subplacental myometrium were measured separately. The results were stratified for preterm and term preeclampsia, respectively.
  
  
  RESULTS
  A total of 1,034 women were recruited, including 16 (1.5%) who developed term preeclampsia and 4 (0.4%) who developed preterm preeclampsia. Preeclampsia was associated with a significantly lower placental VI, placental VFI, subplacental VI, and subplacental VFI in the first trimester than with the controls (all p < 0.05). All cases (4/4) of preterm preeclampsia, 56% (9/16) of term preeclampsia, and 28% (17/60) of the controls had a subplacental VI below 18% (p < 0.01).
  
  
  CONCLUSIONS
  First-trimester placental and subplacental myometrium vascularizations are significantly reduced in women who subsequently develop preeclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Demers
authors.affiliation: Centre de recherche, Centre hospitalier universitaire de Québec (CHUQ), Québec, Canada.
authors.forename: Mario
authors.initials: M
authors.lastname: Girard
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec, Canada.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Roberge
authors.affiliation: Centre de recherche, Centre hospitalier universitaire de Québec (CHUQ), Québec, Canada.
authors.forename: Amélie
authors.initials: A
authors.lastname: Tétu
authors.affiliation: Centre de recherche, Centre hospitalier universitaire de Québec (CHUQ), Québec, Canada.
authors.forename: Yves
authors.initials: Y
authors.lastname: Giguère
authors.affiliation: Centre de recherche, Centre hospitalier universitaire de Québec (CHUQ), Québec, Canada.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Forest
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Québec, Canada.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bujold
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D021621:Imaging, Three-Dimensional; D009215:Myometrium / Q000098:blood supply / Q000000981:diagnostic imaging*; D018919:Neovascularization, Physiologic; D010920:Placenta / Q000098:blood supply / Q000000981:diagnostic imaging*; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D047928:Premature Birth; D011446:Prospective Studies; D047929:Term Birth; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal