Quantitative assessment of placental perfusion by contrast-enhanced ultrasound in macaques and human subjects

Victoria Roberts, Jamie Lo, Jennifer A. Salati, Katherine S. Lewandowski, Jonathan Lindner, Terry Morgan, Antonio Frias

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

BACKGROUND: The uteroplacental vascular supply is a critical determinant of placental function and fetal growth. Current methods for the in vivo assessment of placental blood flow are limited.

OBJECTIVE: We demonstrate the feasibility of the use of contrast-enhanced ultrasound imaging to visualize and quantify perfusion kinetics in the intervillous space of the primate placenta.

STUDY DESIGN: Pregnant Japanese macaques were studied at mid second trimester and in the early third trimester. Markers of injury were assessed in placenta samples from animals with or without contrast-enhanced ultrasound exposure (n = 6/group). Human subjects were recruited immediately before scheduled first-trimester pregnancy termination. All studies were performed with maternal intravenous infusion of lipid-shelled octofluoropropane microbubbles with image acquisition with a multipulse contrast-specific algorithm with destruction-replenishment analysis of signal intensity for assessment of perfusion.

RESULTS: In macaques, the rate of perfusion in the intervillous space was increased with advancing gestation. No evidence of microvascular hemorrhage or acute inflammation was found in placental villous tissue and expression levels of caspase-3, nitrotyrosine and heat shock protein 70 as markers of apoptosis, nitrative, and oxidative stress, respectively, were unchanged by contrast-enhanced ultrasound exposure. In humans, placental perfusion was visualized at 11 weeks gestation, and preliminary data reveal regional differences in intervillous space perfusion within an individual placenta. By electron microscopy, we demonstrate no evidence of ultrastructure damage to the microvilli on the syncytiotrophoblast after first-trimester ultrasound studies.

CONCLUSIONS: Use of contrast-enhanced ultrasound did not result in placental structural damage and was able to identify intervillous space perfusion rate differences within a placenta. Contrast-enhanced ultrasound imaging may offer a safe clinical tool for the identification of pregnancies that are at risk for vascular insufficiency; early recognition may facilitate intervention and improved pregnancy outcomes.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume214
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Macaca
Perfusion
Placenta
First Pregnancy Trimester
Pregnancy
Blood Vessels
Ultrasonography
Microbubbles
HSP70 Heat-Shock Proteins
Trophoblasts
Third Pregnancy Trimester
Second Pregnancy Trimester
Pregnancy Outcome
Microvilli
Fetal Development
Intravenous Infusions
Caspase 3
Primates
Electron Microscopy
Oxidative Stress

Keywords

  • contrast-enhanced ultrasound imaging
  • Japanese macaque
  • placenta
  • placental perfusion

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Quantitative assessment of placental perfusion by contrast-enhanced ultrasound in macaques and human subjects. / Roberts, Victoria; Lo, Jamie; Salati, Jennifer A.; Lewandowski, Katherine S.; Lindner, Jonathan; Morgan, Terry; Frias, Antonio.

In: American Journal of Obstetrics and Gynecology, Vol. 214, No. 3, 01.03.2016.

Research output: Contribution to journalArticle

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