MRI Angiography of Physiological and Pathological Pregnancy Placentas Ex-Vivo (MAPLE): protocol for a prospective pilot study. (Preprint)

Author:

Dap MatthieuORCID,Chen Bailiang,Banasiak Claire,Hossu Gabriella,Morel Olivier,Beaumont Marine,Bertholdt Charline

Abstract

BACKGROUND

Preeclampsia (PE) and intra-uterine growth restriction (IUGR) are two major pregnancy complications due to abnormal placental vasculogenesis. Data on whole fetoplacental vasculature are still missing to better understand these pathologies. Ex-vivo magnetic resonance imaging (MRI) angiography has been developed to characterize the human placental vasculature by injecting contrast within the umbilical cord.

OBJECTIVE

The primary objective is to compare the vascular architecture of placenta between physiological and pathological pregnancies. Secondary objectives are (i) to analyse vascularization indices and texture features according to the group and within comparable gestational age (ii) to compare de vascularization indices to histological analysis.

METHODS

This is a prospective controlled study. We expect to include 100 placentas: 40 from normal pregnancies and 60 from pathological pregnancies with 30 for IUGR and 30 for PE. Ex-vivo MRI acquisition will be performed shortly after delivery and with preparation by injection within the umbilical cord. The vascular architecture will be quantitatively described by vascularization indices measured from ex-vivo MRI angiography data. Comparisons of vascularization indices and texture features according to the group and within comparable gestational age will be also performed. After MR acquisition, placental histopathological analysis will be performed.

RESULTS

The enrolment of women began in November 2019. In view of the recruitment capacity of our institution and the availability of the MRI, the recruitment should be completed by March 2022. As of November 2021, we enrolled 70% of the population.

CONCLUSIONS

This study protocol aims to provide information about the fetal side of placental vascular architecture in normal and pathological placenta with MRI.

CLINICALTRIAL

NCT 04389099 (Clinical Trial)

Publisher

JMIR Publications Inc.

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