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

Research output: Contribution to journalArticlepeer-review

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
Pages (from-to)337-345
Number of pages9
JournalBJOG
Volume128
Issue number2
Early online date30 Jun 2020
DOIs
E-pub ahead of print30 Jun 2020
PublishedJan 2021

Bibliographical note

Funding Information: Dr Atkinson reports grants from Wellcome Trust/UK EPSRC, during the conduct of the study; Dr Spencer reports grants from Wellcome Trust, grants from Radiological Research Trust during the conduct of the study. Prof. David reports grants from Wellcome Trust (203148/Z/16/Z; 203145Z/16/Z; WT101957) and the Engineering and Physical Sciences Research Council (NS/A000049/1; NS/A000050/1; NS/A000027/1; EP/L016478/1) during the conduct of the study. The remaining authors have no disclosures. Completed disclosure of interests forms are available to view online as supporting information. Prof. Ourselin reports grants from Wellcome, grants from EPSRC, during the conduct of the study. Funding Information: This research was supported by the Wellcome Trust (210182/Z/18/Z and Wellcome Trust/EPSRC NS/A000027/1) and the Radiological Research Trust. The funders had no direction in the study design, data collection, data analysis, manuscript preparation or publication decision. Funding Information: This research was supported by the Wellcome Trust (210182/Z/18/Z and Wellcome Trust/EPSRC NS/A000027/1) and the Radiological Research Trust. The funders had no direction in the study design, data collection, data analysis, manuscript preparation or publication decision. This research was supported by the Wellcome Trust (210182/Z/18/Z and Wellcome Trust/EPSRC NS/A000027/1) and the Radiological Research Trust. The funders had no direction in the study design, data collection, data analysis, manuscript preparation or publication decision. Publisher Copyright: © 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

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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