Assessment of intertwin placental vascularity discordance using MV-flow imaging in twin pregnancies with fetal growth restriction

초록

Objectives: This study aimed to compare placental microvascular flow indices, specifically the intertwin disparity, between twin pregnancies without Fetal Growth Restriction (FGR) and those where one fetus is affected by FGR. Methods: A total of 40 twin pregnancies were included in the study, with 15 classified into the ‘‘no FGR’’ group and 25 into the ‘‘1 baby FGR’’ group. Placental microvascular structure ultrasound imaging by MV-flow was performed. A placental vascular index (VIMV) was acquired by application of MV-flow, using both 2D and 3D imaging techniques to obtain VIMV (2D) and VIMV (3D), respectively. The VIMV gap, representing the disparity in microvascular flow indices between the two placentas within each twin pair, was calculated. Statistical analysis was performed using the student’s t-test to compare continuous variables between groups and the chi-square test for categorical data. Results: There were no significant differences in gestational age, maternal age, height, or weight between the two groups. Similarly, the VIMV (2D) gap did not show a statistically significant difference between the ‘‘no FGR’’ and ‘‘1 baby FGR’’ groups. However, the VIMV (3D) gap was significantly larger in the ‘‘1 baby FGR’’ group compared to the ‘‘no FGR’’ group (10.62 ± 7.03 vs 4.84 ± 3.97, P = 0.002). Conclusions: The significant increase in the VIMV (3D) gap observed in twin pregnancies with one FGR fetus suggests that FGR is associated with distinct changes in placental microvascular flow disparity. MV-flow technology, capable of quantifying placental microvascular architecture, serves as an accurate tool for assessing tissue vascularity. This technology offers a promising approach to exploring placental perfusion and may provide new insights into the pathophysiology of pregnancy-related conditions like FGR.