Preeclampsia Clinical Trial
Official title:
Utero-placental Vascularisation in Normal and Preeclamptic and Intra-uterine Growth Restriction Pregnancies: Third Trimester Quantification Using 3D Power Doppler With Comparison to Placental Vascular Morphology
Introduction
Preeclampsia (PE) and intra-uterine growth restriction (IUGR) are two major pregnancy
complications related to chronic utero-placental hypoperfusion. Three-dimensional power
Doppler (3DPD) angiography has been used for the evaluation of utero-placental
vascularisation and three vascular indices have been calculated: the vascularisation index
(VI), flow index (FI) and vascularisation-FI (VFI). However, several technical endpoints
hinder the clinical use of 3DPD as physical characteristics and machine settings may affect
3DPD indices, and so its clinical significance is not yet clear.
Objectives
The primary objective is to better understand the clinical significance of 3DPD indices by
evaluating the relationship between these indices and placental morphometry. Secondary
objectives are (i) to determine the impact of machine settings and physical characteristics
on 3DPD indices, and (ii) to evaluate physio-pathological placental vascularisation
patterns.
Methods and analysis
This is a prospective controlled study. We expect to include 112 women: 84 with normal
pregnancies and 28 with PE and/or IUGR (based on our former cohort study on 3DPD indices for
PE and/or IUGR prediction (unpublished data)). Within 72 h before planned or semi-urgent
caesarean section, utero-placental 3DPD images with five different machine settings will be
acquired. Placentas will be collected and examined after surgery and stereological indices
(volume density, surface density, length density) calculated. The 3DPD indices (VI, FI and
VFI) of the placenta and adjacent myometrium will be calculated. Correlation between Doppler
and morphological indices will be evaluated by Pearson or Spearman tests. Agreement between
3DPD indices and morphological indices will be assessed by Bland and Altman plots. The
impact of Doppler settings and maternal characteristics on 3DPD indices will be evaluated
with a multivariate linear regression model.
n/a
Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Basic Science
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