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Ultrasound/Imaging

Poster Session 1

(207) An assessment of the relation between first trimester placental microcalcifications and adverse pregnancy outcomes

Tuesday, February 13, 2024

10:30 AM – 12:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

RH

Rebecca Horgan, MBBCH

MFM Fellow
Eastern Virginia Medical School
Norfolk, VA, United States

Coauthor(s)

Elena Sinkovskaya, RDMS,MD,PhD,RDCS

Professor of Obstetrics and Gynecology and Director of Ultrasound Research and Education
Eastern Virginia Medical School
Norfolk, Virginia, United States
EK

Erkan Kalafat, MD, MS

Koc University School of Medicine
Istanbul, Istanbul, Turkey
George R. Saade, MD (he/him/his)

Professor & Chair of Ob-Gyn
Eastern Virginia Medical School
Norfolk, VA, United States
Alfred Abuhamad, MD

President, Provost and Dean
Eastern Virginia Medical School
Norfolk, VA, United States

Objective: To evaluate the relation between placental microcalcifications in early pregnancy and subsequent adverse pregnancy outcomes.

Study Design: Patients with non-anomalous pregnancies at < 13+6 weeks gestation without umbilical cord or placental abnormalities were enrolled in a longitudinal cohort study to evaluate the relation between placental novel sonographic markers and pregnancy outcomes. Ultrasounds were performed and data were ascertained by certified and trained sonographers and research coordinators. Micropure ultrasound technology was used to assess the presence of placental microcalcifications on first trimester ultrasound. Data was compared between patients who developed subsequent adverse pregnancy complications including preterm prelabor rupture of membranes (PPROM), fetal growth restriction (FGR) or preeclampsia (cases) and normal low risk patients (controls aged 18-35 years, with a body mass index (BMI) < 30, without existing comorbidities, who conceived spontaneously and had an uncomplicated pregnancy, with delivery >37 weeks’ gestation). Multinominal logistic regression tests were used for statistical analysis, with p < 0.05 used to denote statistical significance (R for Statistical Computing v.4.2.0).

Results: Amongst the 610 included pregnancies, 125 patients (20.5%) developed one of our adverse pregnancy outcomes: PPROM (n=30), preeclampsia (n=60) and FGR (n=45). Microcalcifications on first trimester ultrasound were noted in 13.3% (4/30) of patients who developed PPROM (OR 12.1, 95% CI 1.59-341.7, p=0.003), 6.7% (3/45) patients who developed FGR (OR 5.77, 95% CI 0.65-168.9, p=0.072) and 1.7% (1/60) of patients who developed preeclampsia (OR 1.5, 95% CI 0.04-59.4, p=0.771) compared to 1.1% (1/90) in the control group.

Conclusion: Compared to normal pregnancies, placentas in pregnancies who ultimately develop PPROM are more likely to demonstrate the presence of placental microcalcifications in early pregnancy.