Characterisation of placental, fetal brain and maternal cardiac structure and function in pre-eclampsia using MRI.

Autor:	Hall M; Department of Women and Children's Health, King's College London, UK.; Centre for the Developing Brain, King's College London, UK., de Marvao A; Department of Women and Children's Health, King's College London, UK.; School of Cardiovascular Medicine, King's College London, UK.; MRC London Institute of Medical Sciences, Imperial College London, UK., Schweitzer R; School of Cardiovascular Medicine, King's College London, UK.; MRC London Institute of Medical Sciences, Imperial College London, UK., Cromb D; Centre for the Developing Brain, King's College London, UK., Colford K; Centre for the Developing Brain, King's College London, UK., Jandu P; GKT School of Medical Education, King's College London, UK., O'Regan DP; MRC London Institute of Medical Sciences, Imperial College London, UK., Ho A; Department of Women and Children's Health, King's College London, UK.; Centre for the Developing Brain, King's College London, UK., Price A; Centre for the Developing Brain, King's College London, UK.; Centre for Medical Engineering, King's College London, UK., Chappell LC; Department of Women and Children's Health, King's College London, UK., Rutherford MA; Centre for the Developing Brain, King's College London, UK., Story L; Department of Women and Children's Health, King's College London, UK.; Centre for the Developing Brain, King's College London, UK., Lamata P; Centre for Medical Engineering, King's College London, UK., Hutter J; Centre for the Developing Brain, King's College London, UK.; Centre for Medical Engineering, King's College London, UK.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2023 Apr 25. Date of Electronic Publication: 2023 Apr 25.
DOI:	10.1101/2023.04.24.23289069
Abstrakt:	Background: Pre-eclampsia is a multiorgan disease of pregnancy that has short- and long-term implications for the woman and fetus, whose immediate impact is poorly understood. We present a novel multi-system approach to MRI investigation of pre-eclampsia, with acquisition of maternal cardiac, placental, and fetal brain anatomical and functional imaging. Methods: A prospective study was carried out recruiting pregnant women with pre-eclampsia, chronic hypertension, or no medical complications, and a non-pregnant female cohort. All women underwent a cardiac MRI, and pregnant women underwent a fetal-placental MRI. Cardiac analysis for structural, morphological and flow data was undertaken; placenta and fetal brain volumetric and T2* data were obtained. All results were corrected for gestational age. Results: Seventy-eight MRIs were obtained during pregnancy. Pregnancies affected by pre-eclampsia demonstrated lower placental and fetal brain T2*. Within the pre-eclampsia group, three placental T2* results were within the normal range, these were the only cases with normal placental histopathology. Similarly, three fetal brain T2* results were within the normal range; these cases had no evidence of cerebral redistribution on fetal Dopplers. Cardiac MRI analysis demonstrated higher left ventricular mass in pre-eclampsia with 3D modelling revealing additional specific characteristics of eccentricity and outflow track remodelling. Conclusions: We present the first holistic assessment of the immediate implications of pre-eclampsia on the placenta, maternal heart, and fetal brain. As well as having potential clinical implications for the risk-stratification and management of women with pre-eclampsia, this gives an insight into disease mechanism. Competing Interests: Disclosures The authors declare no conflicts of interest.
Databáze:	MEDLINE
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