Document Detail

Magnetic Resonance Imaging of the Placenta identifies Placental Vascular Abnormalities independent of Doppler Ultrasound.
MedLine Citation:
PMID:  21105016     Owner:  NLM     Status:  Publisher    
OBJECTIVE:: To evaluate the relationship between placental vascular pathology detected by prenatal MRI and perinatal outcome. METHODS:: In our retrospective, hospital-based, cross-sectional study all fetal MRI examinations of singleton pregnancies with vascular placental pathology (i.e. infarction with/without hemorrhage, subchorionic thrombi/hemorrhages, intervillous thrombi/hemorrhages, or retroplacental hematoma) in the last 6 years were included. The extent of the pathology was expressed as the percentage of abnormality related to the whole placental volume. Abnormalities of umbilical artery (UA) Doppler ultrasound examinations within seven days between MRI and ultrasound examination were noted. Death in utero or postnatally was the primary outcome. Gestational age at MRI and at birth and the occurrence of intrauterine growth retardation (IUGR) were noted. A logistic regression was performed to assess the impact of gestational age at MR performance, extent of the vascular lesion, and presence of pathologic Doppler ultrasound measurements on the prediction of mortality. RESULTS:: 59 structurally normal singleton pregnancies were included into the analysis. Mortality rate was 36%, among the survivors 87% were born before gestational week 37+0, and 50% suffered from IUGR. In 55% of the pregnancies pathologic UA Doppler results were identified, of these 27% were non-survivors. Mortality was predicted by placental abnormalities at earlier gestational age at the performance of fetal MRI (p<0,05) and increasing extent of the vascular lesion (p<0,05), but not by presence of pathologic Doppler ultrasound measurements. The accuracy of the prediction was 82%, the sensitivity 67% and the specificity 89%, respectively. CONCLUSIONS:: MR detected vascular placental pathologies may help to identify at-risk pregnancies for adverse outcome and fetal death independent of umbilical artery Doppler status. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Agnes Messerschmidt; Ahmet Baschat; Nina Linduska; Gregor Kasprian; Peter C Brugger; Antonia Bauer; Michael Weber; Daniela Prayer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-11-23
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria.
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