Current Topics on Fetal 3D/4D Ultrasound

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Placental Volume and Circulation: The New Concept of ‘Virtual Placental Biopsy’

Pp. 192-211 (20)

Luis T. Merce and Maria J. Barco

Abstract

Three-dimensional power Doppler angiography allows villous vessels to be evaluated ‘directly’, and in this way should be able to establish both normal development characteristics and anomalies. The study of placental circulation is of interest because the fetal growth restriction has been associated with deficient development of the placental vascular tree. Placental vascular patterns acquired using 3D color angiography at various stages of pregnancy reflects the development of the villous tree and intervillous space in vivo faithfully. ‘Virtual placental biopsy’ consists of taking a sample of the thickness of the placenta using 3D power Doppler angiography to study the volume and circulation of the placenta. Placental volume increases gradually and significantly with gestational age. 3D power Doppler indices are also significantly related to gestational age, though it is the flow index which shows the best correlation (r = 0.58). 3D power Doppler indices are decreased in IUGR when umbilical Doppler is altered, and we should be evaluated if these indices are predictive markers of this fetal growth abnormality.

Affiliation:

Department of Obstetrics and Gynaecology, International Ruber Hospital, Madrid, Spain.