The prognostic value of biometric data in placentation at the end of the first trimester

L. J. Turos, L. K. Bereczky, F. F. Rozsnyai, S. L. Kiss, L. Puscasiu, B. Szabo

Abstract: The placenta has an important role in the further development of the pregnancy. In our study we followed up 300 monofetal pregnancies. The aim of our study was to develop methods for early diagnosis (first trimester) of high-risk pregnancies. We measured the ratio between gestational sac diameter and crown-rump length (GSD/CRL), placental volume and crown-rump length (PV/CRL), the ratio between the distance from the umbilical cord insertion site at the placenta and fundical edge of placentation and the distance between the umbilical cord insertion site at the placenta and cervical edge of placentation (F/C ratio). We measured also the impedance to flow in both uterine arteries at the end of the first trimester, average of the pulsatility index (PI). We used Chi-test for processing the data. Pregnancies with a smaller amount of amniotic fluid (GSD/CRL ratio<10th centile), with eccentric umbilical cord insertion at the placenta (F/C ratio <0.33 or >3) and with a smaller placental volume (PV/CRL ratio < 10th centile) at the end of the first trimester show a significantly higher risk for fetal malformation (OR=4.17; OR=12.09; OR=4.17, p<0.05) and second trimester spontaneous abortion (OR=4.94; OR=7.4; OR=9.89, p<0.05). Pregnancies with a larger placental volume (PV/CRL ratio>90th centile) and with a smaller impedance to flow (PI values < 10th centile) at the end of the first trimester show a significantly higher risk for fetal macrosomia (OR=2.98; OR=2.98, p<0.05). Biometric data at the end of the first trimester could provide new information about the outcome of pregnancy.
Keywords: amniotic fluid volume, placental volume, umbilical cord, high-risk pregnancy