Quantitative evaluation of placental vascularization using MV-Flow imaging for predicting small-for-gestational-age...

Area of Science:

• Perinatal Medicine
• Medical Imaging
• Fetal Development

Background:

• Small-for-gestational-age (SGA) neonates are at increased risk for adverse outcomes.
• Accurate assessment of placental function is crucial for identifying at-risk pregnancies.
• Microvascular Flow (MV-Flow) imaging offers a novel method to evaluate placental vascularization.

Purpose of the Study:

• To investigate the association between third-trimester placental vascularization using MV-Flow imaging and the risk of SGA neonates.
• To determine if MV-Flow imaging can improve the prediction of SGA compared to conventional Doppler parameters.

Main Methods:

• A prospective cohort study involving 207 women with singleton pregnancies at 30-32 weeks' gestation.
• MV-Flow ultrasound was used to quantify placental vascular indices (VI).
• Maternal characteristics, fetoplacental Doppler parameters (UtA-PI, MCA-PI, CPR), and MV-Flow-derived VI were analyzed in relation to pregnancy outcomes.

Main Results:

• Pregnancies resulting in SGA neonates (9.7%) showed significantly lower placental VI across all regions compared to appropriate-for-gestational-age (AGA) neonates.
• SGA group had higher UtA-PI and lower MCA-PI and CPR.
• Mid-placental VI, UtA-PI, and CPR were independently associated with SGA, with a combined model achieving an AUC of 0.866 for SGA prediction.

Conclusions:

• Reduced placental vascularization index measured by MV-Flow ultrasonography is significantly associated with SGA.
• Integrating MV-Flow-derived VI with conventional Doppler parameters may enhance risk stratification for SGA.
• MV-Flow imaging shows potential clinical value in assessing placental microcirculation and fetal growth.