Figure 1
Representative ultrasound images of hardness of tissue (HT) score (A) The HT score was 1 when the blue area in the ROI was 50% or less. A strain graph, used to assess proper application of compression, is indicated in the lower right (B) The blue and green areas are shown mixed together in relatively equal percentages in the placenta (C) Most of the placenta is indicated in blue. In the left image, the strain ratio is calculated from the region of interest of the fat and placental tissue. In this case, the placental index is 19.83.
Table 1
Population features between the Normal group and SGA group
| Normal group | SGA group | P | |
|---|---|---|---|
| Number | 101 | 10 | |
| Maternal age (years) | 34.4 (±5.6) | 33.6 (±4.7) | NS |
| Gravidity | 0.9 (±1.2) | 1.3 (±1.3) | NS |
| Parity | 0.5 (±0.9) | 0.6 (±0.7) | NS |
| Gestational age (weeks) | 31.7 (±6.3) | 32.8 (±4.2) | NS |
| EFW (SD) | +0.11 (±0.74) | -2.33 (±0.84) | P<0.01 |
| Placental Index | 8.8 (±10.0) | 44.3 (±29.4) | P<0.01 |
| HT score | 1.56 (±0.68) | 2.70 (±0.67) | P<0.01 |
| Birth weight (SD) | 0.11 (±1.13) | -2.19 (±1.07) | P<0.01 |
| Placenta weight (g) | 562.3 (±119.7) | 366 (±120.0) | P<0.01 |
[i] The above values represent the mean (standard deviation).
EFW = estimated fetal weight; HT = score hardness of tissue score; SGA = small for gestational age
Figure 2
The correlation between the placental index (PI) and z score for estimated fetal weight at prenatal examination (EFW) . There is a significant correlation between the PI and z score for EFW (correlation coefficient, r = -0.55; p < 0.01).
Figure 3
A significant positive correlation was observed between the placental index (PI) and z score of birth weight (correlation coefficient, r = -0.39; p < 0.01).
Table 2
HT score and pathological findings related to placental ischemia after delivery
| HT score | 1 | 2 | 3 |
|---|---|---|---|
| (n = 15) | (n = 16) | (n = 9) | |
| Accelerated maturation of villi (+), (n) | 1 | 2 | 2 |
| Infarction (+), (n) | 2 | 1 | 3 |
| Villous inflammation (+), (n) | 0 | 1 | 1 |
| Total, n, (%) | 3 (20) | 4 (25) | 6 (67) |
[i] HT scores were evaluated during elastography. The presence and absence of pathological findings of the placenta after delivery are shown.
Figure 4
Gross pathological findings of the placenta. A macro-photograph of the placenta after delivery. The neonate had fetal growth restriction, diagnosed during elastography evaluation at week 28 of pregnancy. White placental infarction is observed at the bottom right of the photo.
Figure 5
Histopathological findings of the placenta. Objective lens with 4× magnification. A micro-photograph of the same case as that shown in Figure 4. Complete infarction and incomplete infarction with remaining nuclear stainability are observed. The outlines of the villus remain in the upper right area.