Publication: Effect of malaria on placental volume measured
using three-dimensional ultrasound: a pilot study
Issued Date
2012
Resource Type
Language
eng
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Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
Malaria Journal. Vol.11, (2012), 5
Suggested Citation
Rijken, Marcus J, Moroski, William E,, Suporn Kiricharoen, Noaeni Karunkonkowit, Stevenson, Gordon, Ohuma, Eric O, Noble, J Alison, Kennedy, Stephen H, McGready, Rose, Papageorghiou, Aris T, Nosten, François H Effect of malaria on placental volume measured
using three-dimensional ultrasound: a pilot study. Malaria Journal. Vol.11, (2012), 5. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/3099
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Title
Effect of malaria on placental volume measured
using three-dimensional ultrasound: a pilot study
Abstract
Background: The presence of malaria parasites and histopathological changes in the placenta are associated with
a reduction in birth weight, principally due to intrauterine growth restriction. The aim of this study was to examine
the feasibility of studying early pregnancy placental volumes using three-dimensional (3D) ultrasound in a malaria
endemic area, as a small volume in the second trimester may be an indicator of intra-uterine growth restriction
and placental insufficiency.
Methods: Placenta volumes were acquired using a portable ultrasound machine and a 3D ultrasound transducer
and estimated using the Virtual Organ Computer-aided AnaLysis (VOCAL) image analysis software package. Intraobserver
reliability and limits of agreement of the placenta volume measurements were calculated. Polynomial
regression models for the mean and standard deviation as a function of gestational age for the placental volumes
of uninfected women were created and tested. Based on these equations each measurement was converted into a
z -score. The z-scores of the placental volumes of malaria infected and uninfected women were then compared.
Results: Eighty-four women (uninfected = 65; infected = 19) with a posterior placenta delivered congenitally
normal, live born, single babies. The mean placental volumes in the uninfected women were modeled to fit 5th,
10th, 50th, 90th and 95th centiles for 14-24 weeks’ gestation. Most placenta volumes in the infected women were
below the 50th centile for gestational age; most of those with Plasmodium falciparum were below the 10th centile.
The 95% intra-observer limits of agreement for first and second measurements were ? 37.0 mL and ? 25.4 mL at
30 degrees and 15 degrees rotation respectively.
Conclusion: The new technique of 3D ultrasound volumetry of the placenta may be useful to improve our
understanding of the pathophysiological constraints on foetal growth caused by malaria infection in early
pregnancy.