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Magnetic resonance imaging measurement of placental perfusion and oxygen saturation in early-onset fetal growth restriction

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R. Aughwane, N. Mufti, D. Flouri, K. Maksym, R. Spencer, M. Sokolska, G. Kendall, D. Atkinson, A. Bainbridge, J. Deprest, T. Vercauteren, S. Ourselin, A. L. David, A. Melbourne

Original languageEnglish
Early online date30 Jun 2020
Publication statusPublished - 5 Aug 2020

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Objective: We hypothesised that a multi-compartment magnetic resonance imaging (MRI) technique that is sensitive to fetal blood oxygenation would identify changes in placental blood volume and fetal blood oxygenation in pregnancies complicated by early-onset fetal growth restriction (FGR). Design: Case–control study. Setting: London, UK. Population: Women with uncomplicated pregnancies (estimated fetal weight [EFW] >10th centile for gestational age [GA] and normal maternal and fetal Doppler ultrasound, n = 12) or early-onset FGR (EFW <3rd centile with or without abnormal Doppler ultrasound <32 weeks GA, n = 12) were studied. Methods: All women underwent MRI examination. Using a multi-compartment MRI technique, we quantified fetal and maternal blood volume and feto-placental blood oxygenation. Main outcome measures: Disease severity was stratified according to Doppler pulsatility index and the relationship to the MRI parameters was investigated, including the influence of GA at scan. Results: The FGR group (mean GA 27 +5 weeks, range 24 +2 to 33 +6 weeks) had a significantly lower EFW compared with the control group (mean GA 29 +1 weeks; −705 g, 95% CI −353 to −1057 g). MRI-derived feto-placental oxygen saturation was higher in controls compared with FGR (75 ± 9.6% versus 56 ± 16.2%, P = 0.02, 95% CI 7.8–30.3%). Feto-placental oxygen saturation estimation correlated strongly with GA at scan in controls (r = −0.83). Conclusion: Using a novel multimodal MRI protocol we demonstrated reduced feto-placental blood oxygen saturation in pregnancies complicated by early-onset FGR. The degree of abnormality correlated with disease severity defined by ultrasound Doppler findings. Gestational age-dependent changes in oxygen saturation were also present in normal pregnancies. Tweetable abstract: MRI reveals differences in feto-placental oxygen saturation between normal and FGR pregnancy that is associated with disease severity.

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