Effect of malaria on placental volume measured using three-dimensional ultrasound: a pilot study

Marcus J Rijken; William E Moroski; Suporn Kiricharoen; Noaeni Karunkonkowit; Gordon Stevenson; Eric O Ohuma; J Alison Noble; Stephen H Kennedy; Rose McGready; Aris T. Papageorghiou; François H Nosten

doi:10.1186/1475-2875-11-5

Effect of malaria on placental volume measured using three-dimensional ultrasound: a pilot study

Marcus J Rijken, William E Moroski, Suporn Kiricharoen, Noaeni Karunkonkowit, Gordon Stevenson, Eric O Ohuma, J Alison Noble, Stephen H Kennedy, Rose McGready, Aris T. Papageorghiou, François H Nosten

Birth Center Obstetrics - Medical

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: The presence of malaria parasites and histopathological changes in the placenta are associated with a reduction in birth weight, principally due to intrauterine growth restriction. The aim of this study was to examine the feasibility of studying early pregnancy placental volumes using three-dimensional (3D) ultrasound in a malaria endemic area, as a small volume in the second trimester may be an indicator of intra-uterine growth restriction and placental insufficiency.

METHODS: Placenta volumes were acquired using a portable ultrasound machine and a 3D ultrasound transducer and estimated using the Virtual Organ Computer-aided AnaLysis (VOCAL) image analysis software package. Intra-observer reliability and limits of agreement of the placenta volume measurements were calculated. Polynomial regression models for the mean and standard deviation as a function of gestational age for the placental volumes of uninfected women were created and tested. Based on these equations each measurement was converted into a z -score. The z-scores of the placental volumes of malaria infected and uninfected women were then compared.

RESULTS: Eighty-four women (uninfected = 65; infected = 19) with a posterior placenta delivered congenitally normal, live born, single babies. The mean placental volumes in the uninfected women were modeled to fit 5th, 10th, 50th, 90th and 95th centiles for 14-24 weeks' gestation. Most placenta volumes in the infected women were below the 50th centile for gestational age; most of those with Plasmodium falciparum were below the 10th centile. The 95% intra-observer limits of agreement for first and second measurements were ± 37.0 mL and ± 25.4 mL at 30 degrees and 15 degrees rotation respectively.

CONCLUSION: The new technique of 3D ultrasound volumetry of the placenta may be useful to improve our understanding of the pathophysiological constraints on foetal growth caused by malaria infection in early pregnancy.

Original language	English
Pages (from-to)	5
Journal	Malaria Journal
Volume	11
DOIs	https://doi.org/10.1186/1475-2875-11-5
Publication status	Published - 5 Jan 2012

Keywords

Adult
Birth Weight
Female
Fetal Growth Retardation
Gestational Age
Humans
Imaging, Three-Dimensional
Infant
Malaria, Falciparum
Observer Variation
Pilot Projects
Placenta
Placental Insufficiency
Plasmodium falciparum
Pregnancy
Pregnancy Trimester, Second
Reproducibility of Results
Ultrasonography, Prenatal
Journal Article
Research Support, Non-U.S. Gov't

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10.1186/1475-2875-11-5

Cite this

@article{042a79718ca44de29888d998629c8094,

title = "Effect of malaria on placental volume measured using three-dimensional ultrasound: a pilot study",

abstract = "BACKGROUND: The presence of malaria parasites and histopathological changes in the placenta are associated with a reduction in birth weight, principally due to intrauterine growth restriction. The aim of this study was to examine the feasibility of studying early pregnancy placental volumes using three-dimensional (3D) ultrasound in a malaria endemic area, as a small volume in the second trimester may be an indicator of intra-uterine growth restriction and placental insufficiency.METHODS: Placenta volumes were acquired using a portable ultrasound machine and a 3D ultrasound transducer and estimated using the Virtual Organ Computer-aided AnaLysis (VOCAL) image analysis software package. Intra-observer reliability and limits of agreement of the placenta volume measurements were calculated. Polynomial regression models for the mean and standard deviation as a function of gestational age for the placental volumes of uninfected women were created and tested. Based on these equations each measurement was converted into a z -score. The z-scores of the placental volumes of malaria infected and uninfected women were then compared.RESULTS: Eighty-four women (uninfected = 65; infected = 19) with a posterior placenta delivered congenitally normal, live born, single babies. The mean placental volumes in the uninfected women were modeled to fit 5th, 10th, 50th, 90th and 95th centiles for 14-24 weeks' gestation. Most placenta volumes in the infected women were below the 50th centile for gestational age; most of those with Plasmodium falciparum were below the 10th centile. The 95% intra-observer limits of agreement for first and second measurements were ± 37.0 mL and ± 25.4 mL at 30 degrees and 15 degrees rotation respectively.CONCLUSION: The new technique of 3D ultrasound volumetry of the placenta may be useful to improve our understanding of the pathophysiological constraints on foetal growth caused by malaria infection in early pregnancy.",

keywords = "Adult, Birth Weight, Female, Fetal Growth Retardation, Gestational Age, Humans, Imaging, Three-Dimensional, Infant, Malaria, Falciparum, Observer Variation, Pilot Projects, Placenta, Placental Insufficiency, Plasmodium falciparum, Pregnancy, Pregnancy Trimester, Second, Reproducibility of Results, Ultrasonography, Prenatal, Journal Article, Research Support, Non-U.S. Gov't",

author = "Rijken, {Marcus J} and Moroski, {William E} and Suporn Kiricharoen and Noaeni Karunkonkowit and Gordon Stevenson and Ohuma, {Eric O} and Noble, {J Alison} and Kennedy, {Stephen H} and Rose McGready and Papageorghiou, {Aris T.} and Nosten, {Fran{\c c}ois H}",

year = "2012",

month = jan,

day = "5",

doi = "10.1186/1475-2875-11-5",

language = "English",

volume = "11",

pages = "5",

journal = "Malaria Journal",

issn = "1475-2875",

publisher = "BioMed Central",

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TY - JOUR

T1 - Effect of malaria on placental volume measured using three-dimensional ultrasound

T2 - a pilot study

AU - Rijken, Marcus J

AU - Moroski, William E

AU - Kiricharoen, Suporn

AU - Karunkonkowit, Noaeni

AU - Stevenson, Gordon

AU - Ohuma, Eric O

AU - Noble, J Alison

AU - Kennedy, Stephen H

AU - McGready, Rose

AU - Papageorghiou, Aris T.

AU - Nosten, François H

PY - 2012/1/5

Y1 - 2012/1/5

N2 - BACKGROUND: The presence of malaria parasites and histopathological changes in the placenta are associated with a reduction in birth weight, principally due to intrauterine growth restriction. The aim of this study was to examine the feasibility of studying early pregnancy placental volumes using three-dimensional (3D) ultrasound in a malaria endemic area, as a small volume in the second trimester may be an indicator of intra-uterine growth restriction and placental insufficiency.METHODS: Placenta volumes were acquired using a portable ultrasound machine and a 3D ultrasound transducer and estimated using the Virtual Organ Computer-aided AnaLysis (VOCAL) image analysis software package. Intra-observer reliability and limits of agreement of the placenta volume measurements were calculated. Polynomial regression models for the mean and standard deviation as a function of gestational age for the placental volumes of uninfected women were created and tested. Based on these equations each measurement was converted into a z -score. The z-scores of the placental volumes of malaria infected and uninfected women were then compared.RESULTS: Eighty-four women (uninfected = 65; infected = 19) with a posterior placenta delivered congenitally normal, live born, single babies. The mean placental volumes in the uninfected women were modeled to fit 5th, 10th, 50th, 90th and 95th centiles for 14-24 weeks' gestation. Most placenta volumes in the infected women were below the 50th centile for gestational age; most of those with Plasmodium falciparum were below the 10th centile. The 95% intra-observer limits of agreement for first and second measurements were ± 37.0 mL and ± 25.4 mL at 30 degrees and 15 degrees rotation respectively.CONCLUSION: The new technique of 3D ultrasound volumetry of the placenta may be useful to improve our understanding of the pathophysiological constraints on foetal growth caused by malaria infection in early pregnancy.

AB - BACKGROUND: The presence of malaria parasites and histopathological changes in the placenta are associated with a reduction in birth weight, principally due to intrauterine growth restriction. The aim of this study was to examine the feasibility of studying early pregnancy placental volumes using three-dimensional (3D) ultrasound in a malaria endemic area, as a small volume in the second trimester may be an indicator of intra-uterine growth restriction and placental insufficiency.METHODS: Placenta volumes were acquired using a portable ultrasound machine and a 3D ultrasound transducer and estimated using the Virtual Organ Computer-aided AnaLysis (VOCAL) image analysis software package. Intra-observer reliability and limits of agreement of the placenta volume measurements were calculated. Polynomial regression models for the mean and standard deviation as a function of gestational age for the placental volumes of uninfected women were created and tested. Based on these equations each measurement was converted into a z -score. The z-scores of the placental volumes of malaria infected and uninfected women were then compared.RESULTS: Eighty-four women (uninfected = 65; infected = 19) with a posterior placenta delivered congenitally normal, live born, single babies. The mean placental volumes in the uninfected women were modeled to fit 5th, 10th, 50th, 90th and 95th centiles for 14-24 weeks' gestation. Most placenta volumes in the infected women were below the 50th centile for gestational age; most of those with Plasmodium falciparum were below the 10th centile. The 95% intra-observer limits of agreement for first and second measurements were ± 37.0 mL and ± 25.4 mL at 30 degrees and 15 degrees rotation respectively.CONCLUSION: The new technique of 3D ultrasound volumetry of the placenta may be useful to improve our understanding of the pathophysiological constraints on foetal growth caused by malaria infection in early pregnancy.

KW - Adult

KW - Birth Weight

KW - Female

KW - Fetal Growth Retardation

KW - Gestational Age

KW - Humans

KW - Imaging, Three-Dimensional

KW - Infant

KW - Malaria, Falciparum

KW - Observer Variation

KW - Pilot Projects

KW - Placenta

KW - Placental Insufficiency

KW - Plasmodium falciparum

KW - Pregnancy

KW - Pregnancy Trimester, Second

KW - Reproducibility of Results

KW - Ultrasonography, Prenatal

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1186/1475-2875-11-5

DO - 10.1186/1475-2875-11-5

M3 - Article

C2 - 22222152

SN - 1475-2875

VL - 11

SP - 5

JO - Malaria Journal

JF - Malaria Journal

ER -

Effect of malaria on placental volume measured using three-dimensional ultrasound: a pilot study

Abstract

Keywords

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