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CME Credit Offered
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Poster Session 2

(484) First-trimester virtual placental biopsy to estimate vascularization and risk of preeclampsia : a prospective study

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: While preliminary studies have suggested its effectiveness (Dar et al. AJOG 2010), we aimed to assess whether 3-dimensional power Doppler (3DPD) of the uteroplacental circulation space (UPCS) or of the whole placenta, measured in the first trimester was able to predict preeclampsia.

Study Design: A prospective observational study of singleton pregnancies between 11 and 14 weeks. The 3DPD indices, vascularization index (VI), flow index (FI), and vascularization flow index (VFI), were determined on a UPSC sphere biopsy with the virtual organ computer-aided analysis (VOCAL) program. We also studied the vascularization of the entire placenta and the Doppler of the uterine arteries. Non-parametric and ROC curve analyses were performed.

Results: Among 12,424 women recruited, 498 (4%) had preeclampsia, including 33 (0.3%) with early-onset preeclampsia (< 34 weeks). We were able to determine that all vascularization indices, but particularly the VI and the VFI of the whole placenta and UPCS were largely decreased in early-onset preeclampsia (all with p< 0.01). Taken alone, biopsy sphere VFI is faster to measure than uterine artery Doppler and has a sensitivity of 50% for early preeclampsia with a false-positive rate of 15% (p< 0.001).

Conclusion: First-trimester vascularization indices are decreased among women who will develop early-osnet preeclampsia. Rapid assessment of placental vascularity by virtual UPCS biopsy, as proposed by Dar et al., is feasible on large populations, and is effective in predicting early-onset preeclampsia.