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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 ( R  growth  = −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.

frontiers in physiology

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