Larger First-Trimester Placental Volumetric Parameters Are Associated With Lower Pressure and More Flow-Mediated Vasodilation of the Fetoplacental Vasculature After Delivery.

Abstract:

Objective:To explore the correlation between in vivo placental volumetric parameters in the first trimester of pregnancy and ex vivo parameters of fetoplacental vascular function after delivery. Methods:In ten singleton physiological pregnancies, placental volume (PV) and uteroplacental vascular volume (uPVV) were measured offline in three-dimensional ultrasound volumes at 7, 9, and 11 weeks gestational age (GA) using Virtual Organ Analysis and Virtual Reality. Directly postpartum, term placentas were ex vivo dually perfused and pressure in the fetoplacental vasculature was measured to calculate baseline pressure (pressure after a washout period), pressure increase (pressure after a stepwise fetal flow rate increase of 1 mL/min up to 6 mL/min) and flow-mediated vasodilation (FMVD; reduction in inflow hydrostatic pressure on the fetal side at 6 mL/min flow rate). Correlations between in vivo and ex vivo parameters were assessed by Spearman's correlation coefficients (R). Results:Throughout the first trimester, PV was negatively correlated with pressure increase (Rgrowth = -0.84) and, at 11 weeks GA, also positively correlated with FMVD (R = 0.89). At 7 weeks GA, uPVV and uPVV/PV ratio were negatively correlated with pressure increase (R = -0.58 and R = -0.81, respectively) and positively correlated with FMVD (R = 0.62 and R = 0.90, respectively). Discussion:Mainly in the early first trimester, larger placental volumetric parameters are associated with lower pressure and more FMVD in the fetoplacental vasculature after delivery. This may suggest that larger and/or more vascularized placentas in early pregnancy have better adaptive mechanisms and possibly lead to better pregnancy outcomes.

journal_name

Front Physiol

journal_title

Frontiers in physiology

authors

Hitzerd E,Reijnders IF,Mulders AGMGJ,Koning AHJ,Reiss IKM,Danser AHJ,Steegers-Theunissen RPM,Simons SHP,Koster MPH

doi

10.3389/fphys.2020.00006

subject

Has Abstract

pub_date

2020-01-24 00:00:00

pages

6

issn

1664-042X

journal_volume

11

pub_type

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