Abstract
Objective The study aims to evaluate first-trimester vascularization of the placenta and subplacental
myometrium in women who subsequently develop preeclampsia.
Study Design A case–control study nested in a prospective cohort was conducted in women with singleton
pregnancy between 11 and 14 weeks' gestation. Three-dimensional standardized acquisition
of the placenta and subplacental myometrium volumes with and without power Doppler
was undertaken, and all participants were followed up until delivery. Each woman diagnosed
with preeclampsia was matched with three controls who delivered at term without pregnancy
complications. First-trimester volume, vascularization index (VI), flow index (FI),
and vascular flow index (VFI) of the entire placenta and subplacental myometrium were
measured separately. The results were stratified for preterm and term preeclampsia,
respectively.
Results A total of 1,034 women were recruited, including 16 (1.5%) who developed term preeclampsia
and 4 (0.4%) who developed preterm preeclampsia. Preeclampsia was associated with
a significantly lower placental VI, placental VFI, subplacental VI, and subplacental
VFI in the first trimester than with the controls (all p < 0.05). All cases (4/4) of preterm preeclampsia, 56% (9/16) of term preeclampsia,
and 28% (17/60) of the controls had a subplacental VI below 18% (p < 0.01).
Conclusion First-trimester placental and subplacental myometrium vascularizations are significantly
reduced in women who subsequently develop preeclampsia.
Keywords
pregnancy - preeclampsia - placenta - ultrasound - Doppler
