(788) Early Placental Morphometric Parameters Predict Preeclampsia with Severe Features over Clinical Risk Factors

Objective:
Gross placental development may reflect placental health, with novel automated tools now enabling extraction of early morphometric measures from 3D ultrasound. Our primary objective was to identify early placental morphometric differences associated with the development of hypertensive disorders of pregnancy (HDP). The secondary objective was to evaluate whether these parameters, combined with placental volume, improve prediction of HDP.

Study Design:
This is secondary analysis of a prospective cohort of singleton pregnancies that had 3DUS volumes of the placenta obtained at 11–16 weeks. A validated convolutional neural network generated automated placental segmentations and placental volume measurements. Deformable medial modeling was used to extract standardized 3D morphologic parameters, including fetal and maternal surface areas, thickness, circumference, medial surface diameter, and placental volume. Parameters were normalized by gestational age and compared between normotensive and HDP pregnancies using Student’s t-tests or Mann-Whitney U tests. Logistic regression and receiver operator curves were used to evaluate the predictive value of clinical risk factors, morphometric parameters, and placental volume for HDP.

Results:
A total of 74 patients had analyzable placental segmentations that were obtained at an average gestational age of 14.0 ± 1.0 weeks. HDP developed in 19 (26.4%) patients (gestational hypertension (GHTN): 14; preeclampsia with severe features (PEC-SF): 5). Morphometric parameters did not differ between normotensive and GHTN groups, but patients with PEC-SF had significantly reduced placental surface areas, circumference, and medial surface diameter (Table 1). Placental thickness was stable across all groups. Placental volume and morphometric parameters outperformed clinical risk factors in predicting PEC-SF only (Figure 1).

Conclusion:
Reduced placental surface area, circumference, and mean diameter in early pregnancy may serve as an early indicator of PEC-SF. These parameters show promise for PEC-SF prediction but require validation in larger studies.