Placental Perfusion in the Entire Placenta and With Sonobiopsy by Ultrasound

Experimental: Normal placenta-entitle

The 3-DPD indices was measured in the entire placenta volume.

Diagnosetest: 3 dimensional ultrasound investigation

Images that contributed to the determination of placental volume and 3-DPD indices were obtained at the time of visit. All 3-D scans ultrasound measurements were performed by a Voluson 730 Expert ultrasound machine equipped with a multifrequency probe (2-5 MHz) to acquire images. Each sample was examined using 3-D rendering mode, in which the colour and gray value information was processed and combined to supply 3-D image. For laterally located placentas, the investigator positioned the transducer on a slight lateral inclination to obtain proper images. Power Doppler window was placed over the placenta to map the vascular tree from basal to chorionic plates. The 3-D static volume box was placed over the entire placenta volume. The sweep angle was set at maximum 70°. Each image was recovered from the disk in succession for processing. During gestation, the investigator recorded one sample from each patient.

Diagnosetest: 2 dimensional ultrasound investigation

The two-dimensional (2-D) transabdominal conventional study provided data about fetal position, biometry, body movements and fetal heart rate as well as placental localization. The factorial default setting 'Obstetrics' was applied in 2-D mode.

Experimental: Normal placenta-sonobyopsy

The 3-DPD indices was measured at cord insertion in placenta by sonobiopsy

Diagnosetest: 3 dimensional ultrasound investigation

Images that contributed to the determination of placental volume and 3-DPD indices were obtained at the time of visit. All 3-D scans ultrasound measurements were performed by a Voluson 730 Expert ultrasound machine equipped with a multifrequency probe (2-5 MHz) to acquire images. Each sample was examined using 3-D rendering mode, in which the colour and gray value information was processed and combined to supply 3-D image. For laterally located placentas, the investigator positioned the transducer on a slight lateral inclination to obtain proper images. Power Doppler window was placed over the placenta to map the vascular tree from basal to chorionic plates. The 3-D static volume box was placed over the entire placenta volume. The sweep angle was set at maximum 70°. Each image was recovered from the disk in succession for processing. During gestation, the investigator recorded one sample from each patient.

Diagnosetest: 2 dimensional ultrasound investigation

The two-dimensional (2-D) transabdominal conventional study provided data about fetal position, biometry, body movements and fetal heart rate as well as placental localization. The factorial default setting 'Obstetrics' was applied in 2-D mode.

Maternal characteristics (BMI)

The pre-pregnancy body mass index (BMI) registered at the initial visit during prenatal care was calculated as the body weight (kg) per height (m2).

Neonatal outcome 1; based on gestational age

The participants were recorded by gestational age et birth

Neonatal outcome 2, based on maturation of neonates

Neonates were investigatied by maturation ( gestational age before 36+6 week) (prematurity

Neonatal outcome 3, (birth weight of newborns)

Neonates birth weight calculation (gram)

Neonatal outcome 4; Apgar score

Neonates poor adaptation status (Apgar score (<7) at 5 minutes)

Neonatal outcome 5, (umbilical cord pH)

Neonates poor adaptation status (umbilical cord pH <7.2)

Neonatal outcome 6; delivery complication

Delivery complication ( cesarean section due to fetal distress)

Neonatal outcome 7, necessary of intensive care unit

Neonates transfer to neonatal intensive care unit (NICU)

2D ultrasound investigaiotn of gestation (fetal biometry, placentation)

Routine ultrasound examination, based on Guideline of Hungarian Obstetrics and gynecologists (fetal biometry: biparietal diameter, head circumference, abdominal circumference, femur length; investigation of the placenta, place of placentation, Grannum staging)