Changes in placental elastography in the third trimester - Analysis using a linear mixed effect model

Christopher Edwards; Erika Cavanagh; Sailesh Kumar; Vicki L Clifton; Danielle J Borg; Jacob Priddle; Marie-Luise Wille; Christopher Drovandi; Davide Fontanarosa

doi:10.1016/j.placenta.2021.09.001

Changes in placental elastography in the third trimester - Analysis using a linear mixed effect model

Placenta. 2021 Oct:114:83-89. doi: 10.1016/j.placenta.2021.09.001. Epub 2021 Sep 4.

Authors

Christopher Edwards¹, Erika Cavanagh², Sailesh Kumar³, Vicki L Clifton⁴, Danielle J Borg⁵, Jacob Priddle⁶, Marie-Luise Wille⁷, Christopher Drovandi⁶, Davide Fontanarosa⁸

Affiliations

¹ School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4000, Australia; Mater Research Institute-University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, QLD, 4000, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD, 4000, Australia. Electronic address: c8.edwards@qut.edu.au.
² School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4000, Australia; Mater Research Institute-University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, QLD, 4000, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD, 4000, Australia.
³ School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4000, Australia; Mater Research Institute-University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, QLD, 4000, Australia; Faculty of Medicine, The University of Queensland, Herston, QLD, 4006, Australia. Electronic address: Sailesh.kumar@mater.uq.edu.au.
⁴ School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4000, Australia; Mater Research Institute-University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, QLD, 4000, Australia.
⁵ Mater Research Institute-University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, QLD, 4000, Australia; Faculty of Medicine, The University of Queensland, Herston, QLD, 4006, Australia.
⁶ School of Mathematical Sciences, Faculty of Science, Queensland University of Technology, Brisbane, QLD, 4000, Australia.
⁷ School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, 4000, Australia; ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, 4000, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD, 4000, Australia.
⁸ School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4000, Australia; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD, 4000, Australia.

PMID: 34500214
DOI: 10.1016/j.placenta.2021.09.001

Abstract

Introduction: Research into the role of ultrasound elastography to assess compromised placental tissue is ongoing. There is particular interest in evaluating its potential in the investigation of changes associated with uteroplacental dysfunction. To date, there is limited data on how different maternal and fetal considerations, such as advancing gestational age, amniotic fluid Index (AFI) and maternal body mass index (BMI) may influence shear wave velocity (SWV) measurements. This study aimed to evaluate longitudinal changes in SWV throughout gestation and model these changes with other developing fetal and maternal physiological and biological characteristics.

Methods: The study utilised 238 singleton pregnancies and collected longitudinal data at repeated intervals in the 3rd trimester representing 629 individual data points. Linear mixed model regression analysis was used to identify significant predictors for SWV.

Results: From a total of ten variables selected for modelling, only gestational age, AFI, BMI, and sample depth were found to be significant predictors of placental SWV, and gestational age and AFI were found to have only a minimal impact on SWV.

Discussion: Sophisticated statistical modelling demonstrates that many of the expected maternal and fetal changes in the 3rd trimester have no or minimal impact on placental SWV. Understanding which factors influence placental SWV is essential to ascertain the technique's utility in managing pregnancies complicated by placental dysfunction in the future.

Keywords: In vivo; Placenta; Placental elasticity; Shear-wave elastography; Ultrasound; longitudinal study.

Publication types

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

MeSH terms

Adult
Amniotic Fluid
Body Mass Index
Elasticity Imaging Techniques
Female
Gestational Age
Humans
Placenta / diagnostic imaging*
Pregnancy
Pregnancy Trimester, Third*
Ultrasonography, Prenatal