• Researchers have developed a new MRI imaging technique to assess the health of the placenta in developing fetuses in early pregnancy.
  • They found that the technique can reliably predict developmental complications and pregnancy risks.
  • According to the study authors, the technique could be adapted to most MRI scanners, and thus be used to screen for placental health.

Ultrasound is currently used to assess fetal growth and blood flow. However, it is limit to predict long-term comorbidity.

Atypical development of the placenta is linked to many adverse effects. These include:

Existing methods for assessing placental function are often ineffective or limited in their ability to reliably detect pregnancy risks.

Recently, researchers developed a new imaging method using magnetic resonance imaging (MRI) to assess placental health. They discovered that their new method could strongly predict pregnancy outcomes related to placental insufficiency.

“This new methodology provides an additional tool that healthcare providers can use to assess placental vascular function,” Victoria HJ RobertsPhD, a research assistant professor in the Division of Developmental and Reproductive Sciences at the Oregan National Primate Research Center, one of the study’s authors, said Medical News Today.

“The ability to detect a placenta-related problem early in pregnancy can create a more targeted approach to clinical management, allowing clinicians to provide better treatment options to mothers and developing babies,” she said. added.

The study was published in the journal PLOS ONE.

The researchers followed 316 pregnancies between weeks 11 and 38 of gestation for the study. Of the pregnancies, 62.6% were considered “low risk,” while the remaining 37.4% were considered high risk for complications, including:

  • low birth weight
  • stillbirth
  • fetal death
  • fetal anomalies
  • premature birth

Pregnant women underwent up to three MRI scans to detect a signal in the blood related to oxygen availability and placental blood flow called T2*.

To test the validity of the T2* measurements under different environmental conditions, the researchers recruited participants from Oregon Health and Science University (OHSU), at an elevation of 450 feet above sea level, and the University of Utah, 4,840 feet above sea level.

After analyzing the data, they found that T2* levels were significantly lower in the high-risk pregnancy group than in the low-risk pregnancy group from 15 to 33 weeks pregnant.

They further found that T2* readings as early as 10 to 20 weeks of gestation could potentially identify at-risk pregnancies.

The researchers also noted that the results were similar in Oregon and Utah, meaning the method could be used in different environmental settings.

They added, however, that small differences in the predictive power of T2* readings between sites mean they should be based on altitude-specific standards.

The researchers concluded that their new technique could be easily implemented on virtually any modern MRI scanner and could therefore be easily adapted to assess placental function in antenatal care settings.

The study authors noted that their findings may be limited because they included a small number of adverse outcomes. They also noted that because the participants included in their study were mostly of the same ethnicity and race, their findings might not apply to other demographics.

When asked what these results might mean for the treatment and prevention of placental problems, Dr. Angela Martinmedical director of labor and delivery at the University of Kansas Medical Center, not involved in the study, said DTM:

Not much right now. This is an interesting article describing a potential new tool that may be useful in predicting adverse effects in the future. However, at present it is unclear whether T2*BOLD-MRI is a better screening tool than using risk factors, medical history and ultrasound to screen for adverse pregnancy outcomes. .

Dr. Katherine S. Koharian OB/GYN and assistant professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine, not involved in the study, also said DTM:

“The results of this study are certainly exciting as they indicate that the use of T2* MRI may allow the identification of patients at increased risk of poor pregnancy outcome.”

“However, MRI is an expensive modality and therefore not likely to be used in routine pregnancy management at this time. [This comes] especially since we have no intervention to offer these patients identified as having a higher risk of complication apart from increased ultrasound monitoring, which many of these patients probably already receive. – Dr. Katherine S. Kohari

Dr. G. Thomas RuizOB/GYN lead at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif., not involved in the study, said placenta repair is not yet possible.

When asked what interventions can still protect the developing fetus and the health of the person carrying the pregnancy, he answered DTM:

“At this stage, our interventions are somewhat limited [to] patients with pre-existing hypertension, high risk of developing preeclampsia, history of a child born with intrauterine growth restriction, or history of previous stillbirth. We start these patients on daily baby aspirin from 13 weeks gestation. These high-risk patients also have a growth ultrasound every 3 to 4 weeks starting at 20 weeks gestation.

“Antepartum testing can start as early as 32 weeks gestation, which includes a non-stress test and measurement of fluid around the baby. Some of these patients will also undergo weekly umbilical cord flow studies. We will also put a certain percentage of these patients on bed rest, so that they spend most of their day lying on their left side. Lying on the left side increases placental perfusion.

– Dr. G. Thomas Ruiz

Dr. Ruiz added that people with preexisting hypertension or who develop gestational hypertension are usually given antihypertensive medications.

“If the patient is at high risk of early delivery before [to] 37 weeks, we give the mother a course of prenatal steroids to accelerate the lung maturity of the fetus,” Dr. Ruiz said.

Dr Sherry RossOB/GYN and women’s health expert at Providence Saint John’s Health Center in Santa Monica, Calif., not involved in the study, agreed that repairing the placenta is not possible, but added that having more Placental health information could help prevent negative outcomes.

“The placenta is the heart of a pregnancy and the source of many dangerous complications associated with pregnancy. Abnormalities associated with a malfunctioning placenta are often unpredictable and unstoppable,” she said.

“Placental repair is unlikely to actually happen, but knowing ahead and delaying potential complications can save lives.”

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