Correlation of first trimester placental volume and second trimester uterine artery Doppler flow

Uterine artery Doppler examination can identify impaired trophoblast invasi on in the second trimester of pregnancy. High resistance and an early diast olic 'notch' show insufficient physiological conversion of the spiral arter ies. Uterine artery Doppler is routinely performed between 22-24 weeks whic h is relatively late for treatment. In this studs we wanted to find out whe ther women with increased uterine blood flow resistance at 22 weeks already have reduced placental volumes in the first trimester measured with 3D son ography. A total of 1060 women with singleton pregnancies had three dimensional (3D) volume measurements of their placentae between 11-13 weeks and uterine Dop pler scans between 21-22 weeks. Stepwise logistic and linear regression ana lyses were used to show a correlation between placental volume (PV) and a C RL dependent placental quotient (PQ) with uterine perfusion parameters. Uterine perfusion at 21-22 weeks depends significantly on PV or PQ at 11-13 weeks (P <0.0001 for both) and smoking behaviour (P=0.006). The occurrence of a notch also depends significantly on PV and PQ(P <0.0001 for both) and also on gravidity (P <0.0001) and age (P=0.0007) as well as on smoking beh aviour (P=0.0094). PV and PQ did not show any dependency on age, gravidity, BMI or smoking habits. Placentae of women with high resistance uterine per fusion in the second trimester are already remarkably small in the first tr imester. Placental volumetry is probably an efficient method for early and simple identification of impaired trophoblast invasion. (C) 2001 Harcourt P ublishers Ltd.