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Early pregnancy imaging predicts ischemic placental disease.
Lee, Brian; Janzen, Carla; Aliabadi, Arya R; Lei, Margarida Y Y; Wu, Holden; Liu, Dapeng; Vangala, Sitaram S; Devaskar, Sherin U; Sung, Kyunghyun.
Afiliación
  • Lee B; Department of Pediatrics, David Geffen School of Medicine, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA. Electronic address: brianrlee90@gmail.com.
  • Janzen C; Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA. Electronic address: cjanzen@mednet.ucla.edu.
  • Aliabadi AR; Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA. Electronic address: aryaaliabadi@gmail.com.
  • Lei MYY; Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA. Electronic address: YLei@mednet.ucla.edu.
  • Wu H; Department of Radiological Sciences, David Geffen School of Medicine, University of California, 300 Medical Plaza, B119, Los Angeles, CA 90095, USA. Electronic address: HoldenWu@mednet.ucla.edu.
  • Liu D; Department of Radiological Sciences, David Geffen School of Medicine, University of California, 300 Medical Plaza, B119, Los Angeles, CA 90095, USA. Electronic address: dliu48@jhmi.edu.
  • Vangala SS; Department of Medicine Statistical Core, David Geffen School of Medicine, University of California, 1100 Glendon Ave Suite 1820, Los Angeles, CA, 90095, USA. Electronic address: svangala@mednet.ucla.edu.
  • Devaskar SU; Department of Pediatrics, David Geffen School of Medicine, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA. Electronic address: SDevaskar@mednet.ucla.edu.
  • Sung K; Department of Radiological Sciences, David Geffen School of Medicine, University of California, 300 Medical Plaza, B119, Los Angeles, CA 90095, USA. Electronic address: ksung@mednet.ucla.edu.
Placenta ; 140: 90-99, 2023 09 07.
Article en En | MEDLINE | ID: mdl-37549442
INTRODUCTION: To characterize early-gestation changes in placental structure, perfusion, and oxygenation in the context of ischemic placental disease (IPD) as a composite outcome and in individual sub-groups. METHODS: In a single-center prospective cohort study, 199 women were recruited from antenatal clinics between February 2017 and February 2019. Maternal magnetic resonance imaging (MRI) studies of the placenta were temporally conducted at two timepoints: 14-16 weeks gestational age (GA) and 19-24 weeks GA. The pregnancy was monitored via four additional study visits, including at delivery. Placental volume, perfusion, and oxygenation were assessed at both MRI timepoints. The primary outcome was defined as pregnancy complicated by IPD, with group assignment confirmed after delivery. RESULTS: In early gestation, mothers with IPD who subsequently developed fetal growth restriction (FGR) and/or delivered small-for gestational age (SGA) infants showed significantly decreased MRI indices of placental volume, perfusion, and oxygenation compared to controls. The prediction of FGR or SGA by multiple logistic regression using placental volume, perfusion, and oxygenation revealed receiver operator characteristic curves with areas under the curve of 0.81 (Positive predictive value (PPV) = 0.84, negative predictive value (NPV) = 0.75) at 14-16 weeks GA and 0.66 (PPV = 0.78, NPV = 0.60) at 19-24 weeks GA. DISCUSSION: MRI indices showing decreased placental volume, perfusion and oxygenation in early pregnancy were associated with subsequent onset of IPD, with the greatest deviation evident in subjects with FGR and/or SGA. These early-gestation MRI changes may be predictive of the subsequent development of FGR and/or SGA.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placenta / Enfermedades Placentarias Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Infant / Newborn / Pregnancy Idioma: En Revista: Placenta Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placenta / Enfermedades Placentarias Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Infant / Newborn / Pregnancy Idioma: En Revista: Placenta Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos