Placental Stiffness Measured by Sonoelastography in Fetal Growth Restriction: A Systematic Review and Meta-Analysis

Area of Science:

• Obstetrics and Gynecology
• Medical Imaging
• Fetal Medicine

Background:

• Fetal growth restriction (FGR) is a critical obstetric condition often caused by placental insufficiency.
• Early and accurate detection of FGR is essential to prevent adverse neonatal outcomes.
• Placental sonoelastography, an advanced ultrasound technique, assesses placental tissue stiffness.

Purpose of the Study:

• To evaluate the diagnostic utility of placental sonoelastography in identifying FGR.
• To systematically review and meta-analyze studies on placental elastography in FGR pregnancies.
• To assess the correlation between placental stiffness and neonatal outcomes.

Main Methods:

• A systematic review and meta-analysis adhering to PRISMA guidelines.
• Searched major databases (PubMed, Embase, Scopus, Web of Science) for in-vivo studies up to January 2025.
• Pooled data using random-effects models to analyze placental stiffness (Young's modulus, shear wave velocity), correlation with birth weight, and diagnostic accuracy (sensitivity, specificity).

Main Results:

• 14 studies were included, revealing significantly increased placental stiffness in FGR pregnancies.
• Pooled analysis showed increased stiffness for Young's modulus (SMD: 2.51) and shear wave velocity (SMD: 1.55).
• High diagnostic accuracy was observed (pooled sensitivity: 92.0%, specificity: 98.9%) with a negative correlation between stiffness and birth weight (r = -0.453).

Conclusions:

• Placental sonoelastography is a powerful, non-invasive tool for assessing placental health in FGR.
• This technique accurately distinguishes FGR from healthy pregnancies and correlates with neonatal outcomes.
• It holds potential for enhanced clinical surveillance and timely intervention in high-risk pregnancies.