Shear Wave Elastography In Measurement Of Placenta In Gestational Diabetes Mellitus

Objective To establish the normal reference range of elasticity in placenta,analysis its relationship with different gestational age and placental mature grading.To compare the difference between gestational diabetes mellitus and nomal pregnancy in placental elasticity.Methods Shear wave elastography was used to measure the placental elasticity of fetuses between 21 and 40 gestational weeks,the mean,min and max of Young modulus were recorded.20 fetuses collected randomly was examined to analyzed the repeatability and consistency reliability by two doctors with different seniority.Totally 174 normal singleton fetuses were enrolled in this study,regions of interest were detected in the center and the two opposite sides of each placenta,the mean,min and max of Young modulus were recorded.The correlation between all measurements and the gestational weeks or placental maturity grading was analyzed.The same technique was used to obtain the placental elasticity of 22 gestational diabetes diet control group(A1 group)and 14 gestational diabetes insulin control group(A2 group).The mann-whitney U test was used to assess the normal group with the A1 group,the normal group with the A2 group,and the A1 group with the A2 group.Results(1)The repeatability and consistency reliability of the datas obtained by the same or two different operator were good.(2)In all healthy controls,placental elasticity had no relationship with gestational age and placental mature grading.(3)Young’s modulus in normal placenta were 4.04±0.83 kPa(mean),2.03±0.83 kPa(min)and 6.71±1.44 kPa(max),Young’s modulus in A1 gestational diabetes mellitus placenta were 6.39±1.74 kPa(mean),2.95±1.05 kPa(min)and 10.78±2.94 kPa(max),Young’s modulus in A2 gestational diabetes mellitus placenta were 11.96±7.29 kPa(mean),6.79±4.70 kPa(min)and 18.94±11.61 kPa(max),the median were 10.67(6.54~15.02)kPa(mean),5.88(2.58~10.97)kPa(min)and 15.3(10.43~27.29)kPa(max).The measurements of both A1 and A2 were higher than healthy controls(P<0.05),and the measurements of A2 were higher than those of A1(P<0.05).Conclusion Placental elasticity had no relationship with gestational age and placental mature grading;Shear wave elastography can be used to measure the elasticity of placenta in nomal and gestational diabetes mellitus.