Comparison of placental elasticity in normal and intrauterine growth retardation pregnancies by ex vivo strain elastography

Arch Gynecol Obstet. 2020 Jul;302(1):109-115. doi: 10.1007/s00404-020-05596-1. Epub 2020 May 19.

Abstract

Objective: To compare the placental elasticity in fetuses with or without intrauterine growth restriction (IUGR).

Materials and methods: One hundred pregnant women (50 IUGR and 50 healthy) with anteriorly located placenta were evaluated during the third trimester of pregnancy. Measurements were carried out by a machine that has a real-time elastographic ultrasonography feature. After obtaining the optimum image, three areas (subcutaneous tissue, center, and the edge of the placenta) were provided to identify the placental strain values. Then, the placental strain ratio (PSR) value was calculated automatically. Two groups compared in terms of their PSR values.

Results: There was a significant difference in placental elasticity between the groups (P < 0.001). PSR value was 2.8 ± 1.2 in the IUGR group and 1.3 ± 0.6 in the control group. A PSR value of 1.78 had an 86% sensitivity (OR 4.3) and 80% specificity (OR 0.17) in IUGR cases. The positive predictive value was 81.1% and the negative predictive value was 85.1% for this cut-off value.

Conclusions: We have shown that placental strain ratio is increased during the third trimester of pregnancy in fetuses with IUGR. Increased stiffness and elasticity may be responsible for the onset of IUGR in some cases.

Keywords: Intrauterine growth restriction; Placental elasticity; Pregnancy; Strain elastography; Ultrasonography.

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Elasticity Imaging Techniques / methods*
  • Female
  • Fetal Growth Retardation / physiopathology*
  • Humans
  • Placenta / physiopathology*
  • Pregnancy
  • Prospective Studies
  • Young Adult