Relationship between Plasma D-Dimer Concentration and Three-Dimensional Ultrasound Placental Volume in Women at Risk for Placental Vascular Diseases: A Monocentric Prospective Study.
BACKGROUND
The aim of this study was to correlate placental volumes deduced from three-dimensional ultrasound and virtual organ computer-aided analysis (VOCAL) software with systemic concentrations of D-dimer and soluble endothelial protein C receptor (sEPCR).


METHODS
This was a monocentric experimental prospective study conducted from October 2008 to July 2009. Forty consecutive patients at risk of placental vascular pathology (PVP) recurrence or occurrence were included. Placental volumes were systematically measured three times (11-14, 16-18 and 20-22 weeks of gestation (WG)) by two independent sonographers. D-dimers and sEPCR plasma concentrations were measured using ELISA kits (Enzyme Linked ImmunoSorbent Assay).


RESULTS
Eleven patients had a PVP. The plasma D-dimer level was positively correlated with placental volume (r = 0.45, p < 0.001). A smaller placental volume and placental quotient was evidenced in women who developed a PVP at the three gestational ages, and the difference was more pronounced during the third exam (20 WG). No obvious correlation could be demonstrated between the development of a PVP and the levels of D-dimer and sEPCR. There was no significant difference in the values of placental volumes measured by the two sonographers.


CONCLUSIONS
The placenta growth could be a major determinant of the elevation of D-dimer during pregnancy. Consideration of placental volume could allow for modulation of the D-dimer concentrations for restoring their clinical interest.
Department of Gynecology and Obstetrics, University Hospital, Saint Etienne, France.
Cécile
C
Fanget
Department of Gynecology and Obstetrics, University Hospital, Saint Etienne, France.|Research Unit EA3065, Saint Etienne University Jean Monnet F 42023, Saint Etienne, France.
Céline
C
Chauleur
Department of Gynecology and Obstetrics, University Hospital, Saint Etienne, France.
Amandine
A
Stadler
Research Unit EA3065, Saint Etienne University Jean Monnet F 42023, Saint Etienne, France.
Emilie
E
Presles
Department of Gynecology and Obstetrics, University Hospital, Saint Etienne, France.
Marie-Noëlle
MN
Varlet
Laboratory of Haematology, University Hospital, Nîmes, France.|Research Unit EA2992, Montpellier University, Montpellier, France.
Jean-Christophe
JC
Gris
Department of Gynecology and Obstetrics, University Hospital, Saint Etienne, France.|Research Unit EA3065, Saint Etienne University Jean Monnet F 42023, Saint Etienne, France.
Tiphaine
http://orcid.org/0000-0002-4408-6075
T
Raia-Barjat
D000328:Adult; D015703:Antigens, CD / Q000097:blood; D015415:Biomarkers / Q000097:blood; D000074283:Endothelial Protein C Receptor; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005865:Gestational Age; D006801:Humans; D021621:Imaging, Three-Dimensional; D008137:Longitudinal Studies; D010920:Placenta / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D010922:Placenta Diseases / Q000097:blood / Q000175:diagnosis*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000175:diagnosis*; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000097:blood; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014652:Vascular Diseases / Q000097:blood / Q000175:diagnosis
D015703:Antigens, CD; D015415:Biomarkers; D000074283:Endothelial Protein C Receptor; D005338:Fibrin Fibrinogen Degradation Products; C478370:PROCR protein, human; D011956:Receptors, Cell Surface; C036309:fibrin fragment D