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Characterizing placental stiffness using ultrasound shear-wave elastography in healthy and preeclamptic pregnancies

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To measure the stiffness of the placenta in healthy and preeclamptic patients in the second and third trimesters of pregnancy using ultrasound shear-wave elastography (SWE). We also aimed to evaluate the effect of age, gestational age, gravidity, parity and body mass index (BMI) on placental stiffness and a possible correlation of stiffness with perinatal outcomes.

Methods

In a case–control study, we recruited a total of 47 singleton pregnancies in the second and third trimesters of which 24 were healthy and 23 were diagnosed with preeclampsia. In vivo placental stiffness was measured once at the time of recruitment for each patient. Pregnancies with posterior placentas, multiple gestation, gestational hypertension, chronic hypertension, diabetes, autoimmune disease, fetal growth restriction and congenital anomalies were excluded.

Results

The mean placental stiffness was significantly higher in preeclamptic pregnancies compared to controls in the third trimester (difference of means = 16.8; 95% CI (9.0, 24.5); P < 0.001). There were no significant differences in placental stiffness between the two groups in the second trimester or between the severe preeclampsia and preeclampsia without severe features groups (difference of means = 9.86; 95% CI (−5.95, 25.7); P ≥ 0.05). Peripheral regions of the placenta were significantly stiffer than central regions in the preeclamptic group (difference of means = 10.67; 95% CI (0.07, 21.27); P < 0.05), which was not observed in the control group (difference of means = 0.55; 95% CI (− 5.25, 6.35); P > 0.05). We did not identify a correlation of placental stiffness with gestational age, maternal age, gravidity or parity. However, there was a statistically significant correlation with BMI (P < 0.05). In addition, pregnancies with higher placental stiffness during the 2nd and 3rd trimesters had significantly reduced birth weight (2890 ± 176 vs. 2420 ± 219 g) and earlier GA (37.8 ± 0.84 vs. 34.3 ± 0.98 weeks) at delivery (P < 0.05).

Conclusion

Compared to healthy pregnancies, placentas of preeclamptic pregnancies are stiffer and more heterogeneous. Placental stiffness is not affected by gestational age or the severity of preeclampsia but there is a correlation with higher BMI and poor perinatal outcomes.

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Funding

This research was funded by the Sheikh Zayed Institute for Pediatric Surgical Innovation of Children’s National Health System, and the National Institute of Biomedical Imaging and Bioengineering/National Institutes of Health (NIBIB/NIH) Center for Engineering Complex Tissues (P41 EB023833).

Author information

Author notes

  1. Michail Spiliopoulos, Che-Ying Kuo and Avinash Eranki contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, D.C., USA

    Michail Spiliopoulos, Sara N. Iqbal & Melissa H. Fries

  2. Fischell Department of Bioengineering, University of Maryland, College Park, MD, USA

    Che-Ying Kuo & John P. Fisher

  3. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, Washington, D.C., USA

    Che-Ying Kuo & Avinash Eranki

  4. Center for Engineering Complex Tissues, University of Maryland, College Park, MD, USA

    Che-Ying Kuo & John P. Fisher

  5. Clinical and Translational Science Institute at Children’s National, Children’s National Health System, Washington, D.C., USA

    Marni Jacobs

  6. Department of Pathology, Children’s National Health System, Washington, D.C., USA

    Christopher T. Rossi

  7. School of Medicine and Health Sciences, The George Washington University, Washington, D.C., USA

    Peter C. W. Kim

Authors
  1. Michail Spiliopoulos
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Contributions

MS: protocol/project development, data collection or management, data analysis, manuscript writing/editing; CYK and AE: protocol/project development, data analysis, manuscript writing/editing; MJ: data analysis; CTR and JPF: Protocol/project development; SNI, MHF and PCWK: protocol/project development, manuscript review.

Corresponding author

Correspondence to Michail Spiliopoulos.

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Conflict of interest

The authors declare no conflict of interest.

Ethics approval

This study was approved by the Institutional Review Board (MedStar Health Research Institute IRB# 2015-130).

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Written informed consent was obtained from all patients who participated in the study.

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Spiliopoulos, M., Kuo, CY., Eranki, A. et al. Characterizing placental stiffness using ultrasound shear-wave elastography in healthy and preeclamptic pregnancies. Arch Gynecol Obstet 302, 1103–1112 (2020). https://doi.org/10.1007/s00404-020-05697-x

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  • DOI: https://doi.org/10.1007/s00404-020-05697-x

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