Role of Two-Dimensional Ultrasonographic Placental Biometry in Prediction of Small for Gestational Age Fetuses
Creators
- 1. Senior Resident, Department Of Radiodiagnosis, Government Medical College, Thrissur, Kerala, India
- 2. Associate Professor, Department of Radiodiagnosis, Government Medical College, Kozhikode, Kerala, India
- 3. Associate Professor, Department of Radiodiagnosis, Government Medical College, Manjeri, Kerala, India
- 4. Associate Professor, Department of Radiodiagnosis, Government Medical College, Thrissur, Kerala, India.
Description
Background: Placental insufficiency is a major contributor to the pathophysiology in small for gestational age babies. Small for gestational age refers to those foetuses whose birth weight is less than tenth centile for gestational age Early prediction and detection of foetal growth restriction is important for increased foetal surveillance. The objectives of this study were to assess the placental biometry (placental diameter and placental thickness) between 18 weeks to 22 weeks 6days gestation and compare with birth weight centiles and to analyse whether placental biometry can be used as a predictor for the development of small for gestational age babies. Objectives: (1) To assess the placental biometry (placental diameter and placental thickness) between 18 weeks to 22 weeks 6 days gestation and compare with birth weight centiles. (2) To analyse whether placental biometry can be used as a predictor for the development of small for gestational age babies. Methods: Prospective study was conducted at the Department of Radiodiagnosis, Government Medical College, Thrissur from January 2019 to January 2020 in singleton pregnancies at 18-22 weeks of gestation, placental biometry (in two dimensions) was performed. Maximal placental diameter (Max PD) and Maximal placental thickness (Max PT) was recorded in two orthogonal planes. Mean placental diameter (MPD) and mean placental thickness (MPT) was calculated. At the time of delivery, as per the birth weight the neonate was classified into appropriate for gestational age (AGA) / small for gestational age (SGA) / large for gestational age (LGA).MPD and MPT were analysed as predictors of SGA. Results: Both the Max PDs and MPD were significantly smaller in SGA pregnancies (all with p values <0.001) and Max PT and MPT also were significantly smaller (p values <0.001) in SGA babies. ROC curve plotted for MPD and MPT showed significant area under curve (AUC) 0.87 and 0.80 respectively. Conclusion: Placental measurements taken in mid-gestation are a valuable predictor of SGA. Measurement of placental diameter and thickness is quick and simple. This approach should be explored in future to develop a predictive model for growth restricted foetuses.
Abstract (English)
Background: Placental insufficiency is a major contributor to the pathophysiology in small for gestational age babies. Small for gestational age refers to those foetuses whose birth weight is less than tenth centile for gestational age Early prediction and detection of foetal growth restriction is important for increased foetal surveillance. The objectives of this study were to assess the placental biometry (placental diameter and placental thickness) between 18 weeks to 22 weeks 6days gestation and compare with birth weight centiles and to analyse whether placental biometry can be used as a predictor for the development of small for gestational age babies. Objectives: (1) To assess the placental biometry (placental diameter and placental thickness) between 18 weeks to 22 weeks 6 days gestation and compare with birth weight centiles. (2) To analyse whether placental biometry can be used as a predictor for the development of small for gestational age babies. Methods: Prospective study was conducted at the Department of Radiodiagnosis, Government Medical College, Thrissur from January 2019 to January 2020 in singleton pregnancies at 18-22 weeks of gestation, placental biometry (in two dimensions) was performed. Maximal placental diameter (Max PD) and Maximal placental thickness (Max PT) was recorded in two orthogonal planes. Mean placental diameter (MPD) and mean placental thickness (MPT) was calculated. At the time of delivery, as per the birth weight the neonate was classified into appropriate for gestational age (AGA) / small for gestational age (SGA) / large for gestational age (LGA).MPD and MPT were analysed as predictors of SGA. Results: Both the Max PDs and MPD were significantly smaller in SGA pregnancies (all with p values <0.001) and Max PT and MPT also were significantly smaller (p values <0.001) in SGA babies. ROC curve plotted for MPD and MPT showed significant area under curve (AUC) 0.87 and 0.80 respectively. Conclusion: Placental measurements taken in mid-gestation are a valuable predictor of SGA. Measurement of placental diameter and thickness is quick and simple. This approach should be explored in future to develop a predictive model for growth restricted foetuses.
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Additional details
Dates
- Accepted
-
2023-01-15
Software
References
- 1. Jindal M, Gupta S. Placental biometry for prediction of small for gestational age fetuses in low resource setting. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;6(12):5266 2. Schwartz N, Wang E, Parry S. Twodimensional sonographic placental measurements in the prediction of small-for-gestational-age infants. Ultrasound in Obstetrics & Gyneco logy. 2012;40(6):674-679 3. Schwartz N, Coletta J, Pessel C, Feng R, Timor-Tritsch I, Parry S et al. Novel 3- Dimensional Placental Measurements in Early Pregnancy as Predictors of Adverse Pregnancy Outcomes. Journal of Ultrasound in Medicine. 2010;29(8):1203-1212 4. Robinson J, Chidzanja S, Kind K, Lok F, Owens P, Owens J. Placental control of fetal growth. Reproduction, Fertility and Development. 1995;7(3):333 5. Higgins L, Simcox L, Sibley C, Heazell A, Johnstone E. Third trimester placental volume and biometry measurement: A methoddevelopment study. Placenta. 2016; 42: 51-58 6. Wolf H, Oosting H, Treffers P. A longitudinal study of the relationship between placental and fetal growth as measured by ultrasonography. International Journal of Gynecology & Obstetrics. 1990;32(3):300-300 7. Gilbert W, Danielsen B. Pregnancy outcomes associated with intrauterine growth restriction. American Journal of Obstetrics and Gynecology. 2003; 188(6):1596- 1601 8. Alberry M, Soothil P. Management of fetal growth restriction. 2007;92(1): F6 2– F67 9. Lees C, Visser G, Hecher K. Placentalfetal growth restriction. 1st ed. Britain: Cambridge university press; 2018. 10. Raio L, Ghezzi F, Cromi A, Nelle M, Dürig P, Schneider H. The thick heterogeneous(jellylike) placenta: a strong predictor of adverse pregnancy outcome. Prenatal Diagnosis. 2004;24 (3):182-188. 11. Roland MCP, Friis CM, Voldner N, Godang K, Bollerslev J, Haugen G, et al. Fetal Growth versus Birthweight: The Role of Placenta versus Other Determinants. PLOS ONE. 2012 Jun 18;7(6):e39324. 12. Baldwin V. Book Review Disorders of the Placenta, Fetus, and Neonate: Diagnosis and clinical significance By Richard L. Naeye. 375 pp., illustrated. St. Louis, Mosby-Year Book, 1992. $79. ISBN 0–8016–3352–4 . New England Journal of Medicine. 1992; 32 7(27):1958-1959. 13. Thame M, Osmond C, Bennett F, Wilks R, Forrester T. Fetal growth is directly related to maternal anthropometry and placental volume. European Journal of Clinical Nutrition. 2004 Jun;58(6):894–900. 14. Mital P, Hooja N, Mehndiratta K. Placental thickness : a sonographic parameter for estimating gestational age of the fetus. Indian J Radiol Imaging. 2002 Nov 1;12(4):553 15. Egbor M, Ansari T, Morris N, Green CJ, Sibbons PD. Pre-eclampsia and Fetal Growth Restriction: How Morphometrically Different is the Placenta? Placenta. 2006 Jun;27(6–7): 727–34 16. Almasry SM, Elfayomy AK. Morphometric analysis of terminal villi and gross morphological changes in the placentae of term idiopathic intrauterine growth restriction. Tissue Cell. 2012 Aug;44(4):214–9 17. Mayhew TM, Manwani R, Ohadike C, Wijesekara J, Baker PN. The Placenta in Pre-eclampsia and Intrauterine Growth Restriction: Studies on Exchange Surface Areas, Diffusion Distances and Villous Membrane Diffusive Conductances. Placenta. 2007 Feb;28(2–3):233–8.