Assessment of doppler ultrasonography and placental shear wave elastography findings in pregnancies complicated by preeclampsia: a prospective observational comparative study

Objective To evaluate Doppler ultrasonography and placental shear wave elastography findings in pregnancies complicated by preeclampsia.Methods This prospective observational comparative study included 60 pregnant women, consisting of 30 patients with preeclampsia and 30 healthy controls. Bilateral uterine artery and umbilical artery Doppler ultrasonography was performed, and peak systolic velocity, pulsatility index, and resistance index values were recorded. Placental shear wave elastography was obtained from the right peripheral, central, and left peripheral placental regions on both fetal and maternal surfaces. Elastography measurements were expressed as stiffness values in kilopascals and velocity values in meters per second. Perinatal outcomes, including gestational age at birth, Apgar scores, and umbilical cord blood gas parameters, were recorded.Results Right uterine artery PI (1.19 ± 0.65 vs 0.74 ± 0.24, p = 0.003) and left uterine artery PI (1.35 ± 0.57 vs 0.84 ± 0.26, p < 0.001) were significantly higher in the preeclampsia group than in controls. All placental shear wave elastography parameters were significantly increased in the preeclampsia group, including right peripheral fetal placental stiffness (22.42 ± 11.36 vs 4.16 ± 1.45 kPa, p < 0.001) and central fetal placental stiffness (17.89 ± 6.60 vs 4.86 ± 2.73 kPa, p < 0.001). Gestational age at birth was lower in the preeclampsia group (35.0 ± 3.3 vs 37.2 ± 2.1 weeks, p = 0.002), with lower first- and fifth-minute Apgar scores and higher cord lactate levels. Right peripheral fetal placental shear wave velocity showed the highest apparent discriminatory performance in ROC analysis (AUC = 0.998).Conclusion Placental shear wave elastography may complement Doppler ultrasonography in assessing placental involvement in preeclampsia.