Ricerc@Sapienza

Intrauterine growth restriction (IUGR) is defined as the pathologic inhibition of intrauterine fetal growth and the failure of the fetus to achieve its growth potential. Identification, proper management and possible prevention of IUGR are important objectives of fetal medicine. The etiology of the disease is likely multifactorial, involving both fetal adaptation responses and impaired placentation leading to decrease transfer of oxygen and nutrients from the mother to the fetus secondary to defective extravillous trophoblast invasion. This pathophysiological mechanism may be responsible for the early onset IUGR. Nevertheless, IUGR is a process that starts before a pathologically small fetal size can be identified. Currently, no combination of markers performs well as a screening test for IUGR at first trimester of pregnancy. Umbilical vein blood flow, closely related to the mass of placental cotyledons and placental volume as well as placental vascular indices have been investigated in the first trimester but studies are scarce and contradictory.
Given the importance of being able to prevent and treat promptly IUGR fetuses, the main objective of the present prospective observational study is therefore to analyze placental volume and placenta vascular index using of 3-dimensional power Doppler at gestational ages of 11 weeks to 13 weeks 6 days, to relate these results to umbilical vein blood flow and secondarily to investigate whether these parameters are useful to predict the subsequent appearance of intrauterine growth restriction.