Date of Award

January 2020

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Harvey Kliman

Abstract

The placenta is essential to the proper development of the human embryo as placental functions are instrumental in the entire process of embryonic development. In case the placenta is defective, there are higher chances of insufficiency in fetal growth. This study aimed to develop normative curves for Estimated Placental Volumes across various gestational ages using a validated method for determining placental volume using 2-D ultrasound in two centers in Dakar, Senegal. Ultimately, we hope this will help reduce the risk of intrauterine growth restriction (IUGR), intrauterine fetal demise (IUFD), and preterm delivery. The study was conducted in two maternity centers in Dakar, Senegal. From September 2018 to May 2019, a total of 1570 ultrasounds were performed at Philippe Maguilen Senghor and Hopital Militaire de Ouakam using Phillips Lumify portable ultrasound. The inclusion criteria were as followed: any pregnant women between 8 and 42 weeks, singleton gestation, 18 years old or greater (parental consent if <18 years old). The gestational ages ranged from 5.4 weeks to 42 weeks. EPVs were then calculated using an ultrasound image of the placenta and the formula: V=(πT/6)×[4H(W-T)+W(W-4T)+4T^2] where V = volume, T= thickness at maximal height, H = height at maximal height, W = maximal width. An EPV vs. Gestational Age curve was generated. The best fit curve was a parabolic curve with the best fit equation: EPV = (0.387GA – 0.0043GA^2)^3.Two similar studies were conducted at Yale New Haven Hospital and Weill Cornell Medicine also resulting in parabolic best fit curves for EPV vs gestational age. When superimposing all three curves it was apparent that they overlapped almost perfectly, especially up to 30 weeks of gestation. We concluded that placental volumes increase in a predictable manner throughout pregnancy regardless of geographical location.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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