M Chen1, K Y Leung, C P Lee, M H Y Tang, P C Ho. 1. Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
Abstract
OBJECTIVE: To evaluate the use of placental volume measured by three-dimensional (3D) ultrasound in predicting fetal homozygous alpha(0)-thalassemia (Hb-Bart's disease). METHODS: From June 2002 to May 2004 singleton pregnancies at risk of alpha(0)-thalassemia and normal controls were studied prospectively at 9-12 weeks of gestation. Affected fetuses were suspected to have alpha(0)-thalassemia by two-dimensional (2D) ultrasound and confirmed by DNA analysis. Placental volume was measured on 3D ultrasound by a multiplanar technique. Intra- and interobserver agreement of measurements was assessed. The placental volume/crown-rump length quotient of the affected fetuses was compared with that of normal fetuses. RESULTS: The final study group comprised 105 pregnancies; 43 were at risk of alpha(0)-thalassemia and 62 were normal controls. Eleven (10.5%) fetuses were affected by alpha(0)-thalassemia, all from the at-risk group, and the others were normal. Intra- and interobserver agreement of volume measurement by 3D ultrasound was relatively poor; this was reflected in the wide limits of agreement, which ranged from -10.82 to 40.86 mL. The mean +/- SD placental volume/crown-rump length quotient in affected pregnancies was larger than that in unaffected pregnancies (1.37 +/- 0.65 vs. 1.13 +/- 0.39), but this difference was not significant (P > 0.05). CONCLUSIONS: Assessment of placental volume by 3D ultrasound does not seem to be superior to 2D ultrasound in the first-trimester prediction of alpha(0)-thalassemia.
OBJECTIVE: To evaluate the use of placental volume measured by three-dimensional (3D) ultrasound in predicting fetal homozygous alpha(0)-thalassemia (Hb-Bart's disease). METHODS: From June 2002 to May 2004 singleton pregnancies at risk of alpha(0)-thalassemia and normal controls were studied prospectively at 9-12 weeks of gestation. Affected fetuses were suspected to have alpha(0)-thalassemia by two-dimensional (2D) ultrasound and confirmed by DNA analysis. Placental volume was measured on 3D ultrasound by a multiplanar technique. Intra- and interobserver agreement of measurements was assessed. The placental volume/crown-rump length quotient of the affected fetuses was compared with that of normal fetuses. RESULTS: The final study group comprised 105 pregnancies; 43 were at risk of alpha(0)-thalassemia and 62 were normal controls. Eleven (10.5%) fetuses were affected by alpha(0)-thalassemia, all from the at-risk group, and the others were normal. Intra- and interobserver agreement of volume measurement by 3D ultrasound was relatively poor; this was reflected in the wide limits of agreement, which ranged from -10.82 to 40.86 mL. The mean +/- SD placental volume/crown-rump length quotient in affected pregnancies was larger than that in unaffected pregnancies (1.37 +/- 0.65 vs. 1.13 +/- 0.39), but this difference was not significant (P > 0.05). CONCLUSIONS: Assessment of placental volume by 3D ultrasound does not seem to be superior to 2D ultrasound in the first-trimester prediction of alpha(0)-thalassemia.
Authors: Marcus J Rijken; William E Moroski; Suporn Kiricharoen; Noaeni Karunkonkowit; Gordon Stevenson; Eric O Ohuma; J Alison Noble; Stephen H Kennedy; Rose McGready; Aris T Papageorghiou; François H Nosten Journal: Malar J Date: 2012-01-05 Impact factor: 2.979