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# Multi-modal MRI reveals changes in placental function following preterm premature rupture of membranes

Hutter, Jana;

Avena Zampieri, Carla;

Hall, Megan;

Rutherford, Mary;

Story, Lisa;

(2022)

Multi-modal MRI reveals changes in placental function following preterm premature rupture of membranes.

Magnetic Resonance in Medicine

10.1002/mrm.29483.

(In press).

 Text Multi modal MRI reveals changes in placental function following preterm.pdf – Published Version Download (3MB)

## Abstract

PURPOSE: Preterm premature rupture of membranes complicates up to 40% of premature deliveries. Fetal infection may occur in the absence of maternal symptoms, delaying diagnosis and increasing morbidity and mortality. A noninvasive antenatal assessment of early signs of placental inflammation is therefore urgently required. METHODS: Sixteen women with preterm premature rupture of membranes < 34 weeks gestation and 60 women with uncomplicated pregnancies were prospectively recruited. A modified diffusion-weighted spin-echo single shot EPI sequence with a diffusion preparation acquiring 264 unique parameter combinations in < 9 min was obtained on a clinical 3 Tesla MRI scanner. The data was fitted to a 2-compartment T 2 * $${\mathrm{T}}_2^{\ast }$$ -intravoxel incoherent motion model comprising fast and slowly circulating fluid pools to obtain quantitative information on perfusion, density, and tissue composition. Z values were calculated, and correlation with time from between the rupture of membranes and the scan, gestational age at delivery, and time between scan and delivery assessed. RESULTS: Placental T 2 * $${\mathrm{T}}_2^{\ast }$$ was significantly reduced in preterm premature rupture of membranes, and the 2-compartmental model demonstrated that this decline is mainly linked to the perfusion component observed in the placental parenchyma. Multi-modal MRI measurement of placental function is linked to gestational age at delivery and time from membrane rupture. CONCLUSION: More complex models and data acquisition can potentially improve fitting of the underlying etiology of preterm birth compared with individual single-contrast models and contribute to additional insights in the future. This will need validation in larger cohorts. A multi-modal MRI acquisition between rupture of the membranes and delivery can be used to measure placental function and is linked to gestational age at delivery.