OC14.01: Imaging Markers of the First Trimester Uteroplacental Vascular Development Are Associated with Maternal Serum Biomarkers of Placental Development

To validate the uteroplacental vascular skeleton (uPVS), a promising new imaging marker of the first trimester uteroplacental vascular development, by investigating the associations between the uPVS and known maternal serum biomarkers of placental development. In 185 ongoing pregnancies included in the Rotterdam Periconception cohort, three-dimensional power Doppler (PD) volumes of the gestational sac and placenta were obtained at 7-9-11 weeks of gestation. We applied Virtual Reality segmentation and a skeletonisation algorithm to the PD volumes to generate the uteroplacental vascular skeleton (uPVS). Uteroplacental vascular morphology was quantified by assigning a morphologic feature to each voxel in the uPVS (end-, bifurcation- crossing- or vessel point) and calculating total vascular length. At 11 weeks of gestation, two serum biomarkers reflecting placental (vascular) development were assessed: placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1). Linear regression analysis with adjustments for confounders was used to estimate associations between trajectories of the uPVS and serum biomarkers. The first trimester uPVS development was positively associated with maternal serum PlGF (end points: β = 1.45, 95% CI=-0.10; 3.00; bifurcation points: β = 1.10, 95% CI=-0.03; 2.23; crossing points: β = 1.69, 95% CI = 0.12; 3.26; vessel points: β = 0.49, 95% CI = 0.01; 0.97, total vascular length: β = 0.69, 95% CI = 0.13; 3.26, all p-values < 0.05). We observed no associations between the uPVS development and sFlt-1. The first trimester uteroplacental vascular skeleton is positively associated with PIGF. These results suggest that the uPVS can be used as a reliable imaging marker of uteroplacental vascular development during the first trimester of pregnancy.