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Measuring intrauterine growth in healthy pregnancies using quantitative magnetic resonance imaging

Journal of Perinatology volume 42, pages 860–865 (2022)Cite this article

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Abstract

Objective

The aim of this study was to determine in utero fetal-placental growth patterns using in vivo three-dimensional (3D) quantitative magnetic resonance imaging (qMRI).

Study design

Healthy women with singleton pregnancies underwent fetal MRI to measure fetal body, placenta, and amniotic space volumes. The fetal-placental ratio (FPR) was derived using 3D fetal body and placental volumes (PV). Descriptive statistics were used to describe the association of each measurement with increasing gestational age (GA) at MRI.

Results

Fifty-eight (58) women underwent fetal MRI between 16 and 38 completed weeks gestation (mean = 28.12 ± 6.33). PV and FPR varied linearly with GA at MRI (rPV,GA = 0.83, rFPR,GA = 0.89, p value < 0.001). Fetal volume varied non-linearly with GA (p value < 0.01).

Conclusions

We describe in-utero growth trajectories of fetal-placental volumes in healthy pregnancies using qMRI. Understanding healthy in utero development can establish normative benchmarks where departures from normal may identify early in utero placental failure prior to the onset of fetal harm.

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Fig. 1: In vivo placental volumes across gestation in a cohort of healthy, singleton pregnancies.
Fig. 2: In vivo measures of the fetal-placental ratio (ratio of fetal volume to placental volume) across gestation in a cohort of healthy, singleton pregnancies.
Fig. 3: In vivo amniotic fluid volumes across gestation in a cohort of healthy, singleton pregnancies.
Fig. 4: In vivo fetal body volumes across gestation in a cohort of healthy, singleton pregnancies.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to acknowledge our funding sources: Supported by National Institutes of Health (1U54HD090257, R01-HL116585, K23HD092585-01A1).

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Authors and Affiliations

  1. School of Medicine, Georgetown University, 3900 Reservoir Road, NW, Washington, DC, 20057, USA

    Ariunzaya Amgalan

  2. Division of Diagnostic Imaging & Radiology, Children’s National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA

    Kushal Kapse, Dhineshvikram Krishnamurthy, Nicole R. Andersen, Jessica Quistorff & Catherine Limperopoulos

  3. Division of Biostatistics & Study Methodology, Children’s National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA

    Rima Izem

  4. Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, 21287, USA

    Ahmet Baschat

  5. Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, George Washington University, Washington, DC, 20037, USA

    Alexis C. Gimovsky & Homa K. Ahmadzia

  6. Department of Pediatrics, George Washington University, Washington, DC, 20037, USA

    Catherine Limperopoulos & Nickie N. Andescavage

  7. Division of Neonatology, Children’s National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA

    Nickie N. Andescavage

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Contributions

AA was responsible for the manual data collection and providing original draft and final review of the manuscript. KK and NRA were responsible for MRI data collection, critical review and editing of the manuscript along with final review. DK was responsible for the semi-automated process in MR image analysis, critical review and editing of the manuscript along with final review. RI was responsible for statistical analysis and creating figures, critical review and editing of the manuscript along with final review. AB and CL were responsible for study design and objectives, interpreting results, critical review and editing of the manuscript along with final review. JQ was responsible for screening, approaching and enrolling eligible subjects, critical review and editing of the manuscript along with final review. ACG and HKA were responsible for identifying and arbitrating potentially eligible subjects, interpreting results, critical review and editing of the manuscript along with final review. NNA was responsible for study design and objectives, oversight of data collection and analysis, interpreting results, critical review and editing of the manuscript along with final review.

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Correspondence to Catherine Limperopoulos.

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Amgalan, A., Kapse, K., Krishnamurthy, D. et al. Measuring intrauterine growth in healthy pregnancies using quantitative magnetic resonance imaging. J Perinatol 42, 860–865 (2022). https://doi.org/10.1038/s41372-022-01340-6

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