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Shearwave elastography (SWE) to detect hyperglycaemic changes in the placenta (a pilot feasibility study).

Akhil Gupta1, Raiyomand Dalal2, Vincent Ho3

  • 1School of Medicine, Western Sydney University, Campbelltown, Sydney, NSW, 2751, Australia; Blacktown Hospital, Department of Diabetes and Endocrinology, Sydney, Australia; Campbelltown Hospital, Department of Diabetes and Endocrinology, Sydney, Australia.

Placenta
|May 15, 2026
PubMed
Summary

This pilot study found no significant difference in placental stiffness between women with diabetes and controls. Two-dimensional shear-wave elastography (2D-SWE) did not correlate placental stiffness with HbA1c levels in diabetic pregnancies.

Keywords:
DiabetesElastographyPlacentaStiffnessUltrasound

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Area of Science:

  • Obstetrics and Gynecology
  • Medical Imaging
  • Endocrinology

Background:

  • Diabetes mellitus can cause histopathological changes in the placenta.
  • Assessing placental stiffness in vivo using quantitative methods like elastography is an emerging area of research.
  • Current methods for quantifying placental stiffness in diabetic pregnancies are experimental.

Purpose of the Study:

  • To evaluate the utility of two-dimensional shear-wave elastography (2D-SWE) in measuring placental stiffness in women with diabetes in pregnancy.
  • To investigate the correlation between placental stiffness and glycemic control (HbA1c) in different types of diabetes.
  • To compare placental stiffness between women with Type 1, Type 2, gestational diabetes, and non-diabetic controls.

Main Methods:

  • 2D-SWE was employed to measure placental stiffness in kilopascals (kPa) in 27 pregnant women.
  • Participants included those with Type 1 Diabetes Mellitus (T1DM), Type 2 Diabetes Mellitus (T2DM), Gestational Diabetes Mellitus (GDM), and controls.
  • Statistical analysis involved mixed-effects models to assess the correlation between HbA1c and placental stiffness, with secondary regression analysis for subgroup comparisons.

Main Results:

  • No significant differences in mean placental stiffness were observed between the T1DM, T2DM, GDM, and control groups (p > 0.05).
  • Placental stiffness measurements did not show a significant correlation with HbA1c levels across all participants (p > 0.05).
  • High intra-individual variability in placental stiffness measurements was noted, ranging from 7.9% to 52.3%.

Conclusions:

  • 2D-SWE did not establish a correlation between HbA1c and placental stiffness in this pilot study.
  • Placental stiffness was not significantly elevated in any diabetes subtype compared to controls.
  • Novel markers are required to identify the detrimental effects of hyperglycemia on placental function and structure.