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Early first‐trimester trophoblast volume in pregnancies that result in live birth or miscarriage
Author(s) -
Reus A. D.,
ElHarbachi H.,
Rousian M.,
Willemsen S. P.,
SteegersTheunissen R. P. M.,
Steegers E. A. P.,
Exalto N.
Publication year - 2013
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.13197
Subject(s) - trophoblast , miscarriage , medicine , obstetrics , pregnancy , gestational age , gestation , gynecology , intraclass correlation , crown rump length , fetus , first trimester , biology , placenta , clinical psychology , genetics , psychometrics
Objectives To assess the validity of trophoblast volume measurements on three‐dimensional ultrasound ( 3D‐US ) with Virtual Organ Computer‐aided AnaLysis ( VOCAL TM ), to create reference values between 6 and 12 weeks of gestation and to compare trophoblast volume between pregnancies ending in miscarriage and those resulting in live birth . Methods In a prospective periconceptional cohort, we performed weekly 3D‐US in 112 singleton pregnancies resulting in a non‐malformed live birth and in 56 ending in miscarriage. Scans were performed between 6 and 12 weeks. Trophoblast volumes were calculated by subtracting the gestational sac volume from the volume of the total pregnancy. The interobserver and intraobserver agreement of measurements were determined to assess validity. Reference values were created for trophoblast volume in relation to crown–rump length and gestational age . Results A total of 722 3D‐US examinations were available for offline VOCAL measurements, but measurements could be performed in only 53% of these due to non‐targeted scanning and incomplete framing. Interobserver and intraobserver agreement for trophoblast volume measurements were excellent, with intraclass correlation coefficients > 0.97. Trophoblast volumes of pregnancies ending in miscarriage were significantly smaller ( P < 0.01) than were those of pregnancies that resulted in live birth. Trophoblast growth in pregnancies ending in miscarriage was also reduced compared with that in pregnancies that resulted in live birth . Conclusion VOCAL is a valid technique for measuring trophoblast volume during the early first trimester of pregnancy. Pregnancies ending in miscarriage have smaller trophoblast volumes as well as reduced trophoblast growth compared with those that result in live birth. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd .