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MRI Measurement of Placental Perfusion and Oxygen Saturation in Early Onset Fetal Growth Restriction

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Rosalind Aughwane, Nada Mufti, Dimitra Flouri, Kasia Maksym, Rebecca Spencer, Magdalena Sokolska, Giles Kendall, David Atkinson, Alan Bainbridge, Jan Deprest, Tom Vercauteren, Sebastien Ourselin, Anna L David, Andrew Melbourne

Original languageEnglish
JournalBJOG
DOIs
Publication statusE-pub ahead of print - 30 Jun 2020

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King's Authors

Abstract

OBJECTIVE: We hypothesized that a multi-compartment 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 US<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 investigated, including the influence of gestational age at scan.

RESULTS: The FGR group (mean GA:27+5wks, range:24+2 to 33+6wks) had a significantly lower estimated fetal weight compared to the control group (mean GA:29+1wks) (-705g 95%CI=(-353, -1057g)). MR-derived feto-placental oxygen saturation was higher in controls compared to FGR (75 (±9.6)% vs 56 (±16.2)%, p=0.02, 95%CI=(7.8-30.3)%). Feto-placental oxygen saturation estimation correlated strongly with gestational age 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.

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