Placental Elastography in Intrauterine Growth Restriction: A Case–control Study

Background: Intrauterine growth restriction (IUGR) is related to poor fetal outcome.Though, various tools are available for evaluation of IUGR they are notreliable inearly diagnosis of IUGR.Shear wave elastography (SWE) can be used to study the change in mechanical properties of various disease which can be a potential technique for early diagnosis of IUGR.Objective: The objective of the study was to compare the differences in SWE values of placentas between IUGR and normal pregnancies.Methodology: Normal second-and third-trimester pregnancies and IUGR pregnancies between 24 and 42 weeks period of gestation (POG), meeting the inclusion criteria were matched for age group and POG.SWE of placenta was performed in supine position during quiet respiration.The SWE of placenta was measured by placing the region of interest in relatively homogeneous area.The placental elasticity values obtained in pregnancies complicated by IUGR were compared with that of normal controls.Umbilical artery (UA) and fetal middle cerebral artery (MCA) Doppler findings were correlated with placental elasticity value of IUGR pregnancies.Results: Sixty-eight pregnant women (34 cases of IUGR and 34 controls) were evaluated for fetal biometry, amniotic fluid index (AFI), UA, and fetal MCA Doppler, and mean placental SWE.The mean age of the patients was 25.1 years (18-33 years), with no significant difference between case and control groups in regard to age.The mean SWE value of placenta was significantly higher in IUGR cases when compared to matched controls (3.85 kPa vs. 3.38 kPa, P = 0.007).There was increase in mean SWE value with POG (P = 0.005).No significant correlation of mean SWE was seen with age of mother, parity, or central and peripheral regions of placenta.There were significant correlations between AFI and UA Doppler indices with mean SWE value of placenta in IUGR cases.However, this relation was not seen with MCA Doppler indices.Conclusion: SWE of the placenta can be a useful additional US technique to increase the diagnostic confidence of IUGR.However, further studies are needed to evaluate its usefulness in earlier diagnosis and management of IUGR.