title: The relationship between human placental morphometry and ultrasonic measurements of utero-placental blood flow and fetal growth.
abstract: BACKGROUND
  Ultrasonic fetal biometry and arterial Doppler flow velocimetry are widely used to assess the risk of pregnancy complications. There is an extensive literature on the relationship between pregnancy outcomes and the size and shape of the placenta. However, ultrasonic fetal biometry and arterial Doppler flow velocimetry have not previously been studied in relation to postnatal placental morphometry in detail.
  
  
  METHODS
  We conducted a prospective cohort study of nulliparous women in The Rosie Hospital, Cambridge (UK). We studied a group of 2120 women who had complete data on uterine and umbilical Doppler velocimetry and fetal biometry at 20, 28 and 36 weeks' gestational age, digital images of the placenta available, and delivered a liveborn infant at term. Associations were expressed as the difference in the standard deviation (SD) score of the gestational age adjusted ultrasound measurement (z-score) comparing the lowest and highest decile of the given placental morphometric measurement.
  
  
  RESULTS
  The lowest decile of placental surface area was associated with 0.87 SD higher uterine artery Doppler mean pulsatility index (PI) at 20 weeks (95% CI: 0.68 to 1.07, P < 0.001). The lowest decile of placental weight was associated with 0.73 SD higher umbilical artery Doppler PI at 36 weeks (95% CI: 0.54 to 0.93, P < 0.001). The lowest decile of both placental weight and placental area were associated with reduced growth velocity of the fetal abdominal circumference between 20 and 36 weeks (both P < 0.001).
  
  
  CONCLUSIONS
  Placental area and weight are associated with uterine and umbilical blood flow, respectively, and both are associated with fetal growth rate.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Cambridge, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, UK; Department of Obstetrics and Gynaecology, University Medical Centre of Groningen, University of Groningen, The Netherlands. Electronic address: n.salavati@umcg.nl.
authors.forename: N
authors.initials: N
authors.lastname: Salavati
authors.affiliation: Department of Obstetrics and Gynaecology, University of Cambridge, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, UK. Electronic address: us253@medschl.cam.ac.uk.
authors.forename: U
authors.initials: U
authors.lastname: Sovio
authors.affiliation: Centre for Trophoblast Research (CTR), Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK; Department of Engineering, University of Cambridge, Cambridge, UK. Electronic address: rp485@cam.ac.uk.
authors.forename: R Plitman
authors.initials: RP
authors.lastname: Mayo
authors.affiliation: Department of Obstetrics and Gynaecology, University of Cambridge, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, UK; Centre for Trophoblast Research (CTR), Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK. Electronic address: dscj1@cam.ac.uk.
authors.forename: D S
authors.initials: DS
authors.lastname: Charnock-Jones
authors.affiliation: Department of Obstetrics and Gynaecology, University of Cambridge, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, UK; Centre for Trophoblast Research (CTR), Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK. Electronic address: gcss2@cam.ac.uk.
authors.forename: G C S
authors.initials: GC
authors.lastname: Smith
mesh_terms: D001783:Blood Flow Velocity; D015331:Cohort Studies; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D009929:Organ Size; D010920:Placenta / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology*; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*
keywords: Doppler flow velocimetry; Fetal growth; Human; Morphometry; Placenta