Placental microvascular flow ımaging as a predictor of disease severity and adverse perinatal outcomes in preeclampsia: An observational study

Abstract Objective The aim of this study is to predict the severity of preeclampsia (PE) using the microvascular flow (MV‐Flow) imaging technique, to examine the placental microvascular structure of PE patients, and to evaluate whether placental microvascular findings are associated with adverse outcomes in PE. Methods This study was designed as a single‐center, prospective observational study including a total of 90 patients, comprising 30 cases of PE and 60 healthy pregnant women. Placental microvascularization was evaluated using MV‐Flow imaging technology in both groups, and the vascular index (VI mv ) was automatically calculated for each patient. First, the perinatal outcomes of patients with PE and healthy controls were compared, followed by subgroup analyses comparing non‐severe versus severe PE and early‐onset (<34 weeks) versus late‐onset (≥34 weeks) PE. Results In the preeclampsia group, placental VI mv values were lower compared to the control group at all gestational ages ( P < 0.001). There were more preterm births ( P < 0.001) and more admissions to the neonatal intensive care unit in the preeclampsia group ( P < 0.001). In the subgroup analysis, placental VI vm was found to be lower in severe PE patients ( P = 0.012). Low placental VI vm values in patients with preeclampsia were associated with disease severity, preterm delivery, and neonatal intensive care unit admission. Conclusion By applying MV‐Flow imaging technology in patients with PE, we demonstrated that in vivo placental vascularity was reduced compared to healthy pregnancies. The ease of clinical applicability and high efficiency of this ultrasound‐based technology might provide preliminary insight into identifying patients at higher risk of severe disease and adverse perinatal outcomes in patients with preeclampsia.