Placental Insufficiency
Conditions
Keywords
Placenta, perfusion, MRI, spin tagging, Gadolinium, placental insufficiency, urinary tract, sexual organs and pregnancy conditions
Brief summary
To evaluate the feasibility of functional MRI method developed in an animal model and to construct normal reference ranges for in vivo placental perfusion using functional MRI. This will be based on imaging studies in patients undergoing termination of pregnancy (TOP) at 16 to 32 weeks' for fetal reason in a tertiary referral center.
Detailed description
Objective: To evaluate the feasibility of functional MRI method developed in an animal model and to construct normal reference ranges for in vivo placental perfusion using functional MRI. This will be based on imaging studies in patients undergoing termination of pregnancy (TOP) at 16 to 32 weeks' for fetal reason in a tertiary referral center. Method: All patients undergoing TOP at 16 to 32 weeks will be offered to participate in this study. 120 patients will be included. 15 per group of weeks of gestation: 16+0-17+6 SA, 18+0-19+6 SA, 20+0-21+6 SA, 22+0-23+6 SA, 24+0-25+6 SA, 26+0-27+6 SA, 28+0-29+6 SA, 30+0-31+6 WG. MRI will be performed in the same hospital, during hospital stay, within 45 minutes. Two MRI sequences will be used to measure placental perfusion: * dynamic sequences using Gd contrast agent. * " spin tagging ", which do not need any contrast agent. Perfusion will be modelled using compartmental analysis. Reference ranges will be build up by statistical modelling. Gadolinium assays will be performed on amniotic fluid and placental tissue following TOP. Duration of inclusion: 24 months. Duration of patient participation: 45 minutes. Expected results: * Feasibility in routine practice. * Reference ranges for placental perfusion. * Comparison between the two measurements methods. Adverse outcome measure: Nausea, vomiting, lack of comfort and other adverse outcome.
Interventions
MRI, 45 minutes
Sponsors
Study design
Eligibility
Inclusion criteria
* Women \> 18 years, * Undergoing TOP for fetal reason, * Informed signed consent.
Exclusion criteria
* Placental adhesion anomaly, * Growth restriction, * Contrast agent allergy, * Absent consent, * Contraindication of MRI or Gadolinium, * Renal insufficiency, * Placental abnormality at pathological examination.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Establishment of physiological reference range of placental perfusion | 45 MIN | Establishment of physiological reference range of placental perfusion |
Secondary
| Measure | Time frame |
|---|---|
| To quantify in vivo and by a not invasive way the microscopic physiological phenomena relative to the placental perfusion and in the local transcapillary exchanges of the placenta | 45 MIN |
| Comparison between the two measurements methods. | 45 MIN |
Countries
France
Contacts
Assistance Publique Hopitaux de Paris