First-trimester 3D Power Doppler of Uteroplacental Circulation and Placental Volume for the Prediction of Preeclampsia: A Prospective Cohort Study

Aim and objective:To evaluate the role of first-trimester 3D power Doppler of placental circulation and placental volume in the prediction of poor pregnancy outcomes.Materials and methods: This prospective cohort study included 375 pregnant women.3D scans for the determination of placental volume and vascularization indices were performed.The primary outcome was the occurrence of preeclampsia (PE).Results: Placental 3D power Doppler indices were significantly lower in women who developed PE [vascularization index (VI) = 3.13 ± 2.1, flow index (FI) = 14.9 ± 9.3, vascularization flow index (VFI) = 0.1 ± 0.9] and fetal growth restriction (FGR) (VI = 4.5 ± 2.4, FI = 15.3 ± 7.9, VFI = 0.3 ± 0.6) compared with those who did not (VI = 9.7 ± 1.9, FI = 28.9 ± 4.6, VFI = 1.8 ± 1.4) (VI = 10.9 ± 1.6, FI = 30.9± 7.6, VFI = 1.9 ± 0.9), respectively (p < 0.001).The cutoff values for the prediction of PE were VI ≤ 3.22, FI ≤ 17.73, and VFI ≤ 0.5, while those for the prediction of intrauterine FGR were VI ≤ 4.12, FI ≤ 15.93, and VFI ≤ 0.3.Conclusion: First-trimester evaluation of placental bed vasculature with 3D power Doppler can be used as a good predictor of PE.Clinical significance: First-trimester 3D power Doppler of placental bed vasculature can help early prediction of PE and FGR allowing early intervention giving opportunity for better pregnancy outcomes.