Using prenatal ultrasound to predict placental condition at birth.

Prenatal Sonographic Prediction of Placental Histology and Function

This project will try to use ultrasound images during pregnancy to see if they can predict placental problems at delivery for people with fetal growth restriction or other pregnancy complications.

Quick facts

• Study type: Observational
• Enrollment: 320 (estimated)
• Ages: 18 Years to 60 Years
• Sex: Female
• Sponsor: Endeavor Health (Academic / other)
• Locations: 1 site (Evanston, Illinois)
• Trial ID: NCT06022458 on ClinicalTrials.gov

What this trial studies

This two-phase observational project first analyzes archived prenatal ultrasounds and linked placental pathology from past deliveries to develop image-processing markers of placental injury. In the prospective phase, researchers will enroll pregnant people with singleton gestations who have fetal growth restriction at 20–28 weeks and a matched group with normal growth at 36–38 weeks to collect standardized ultrasounds and compare findings to placental histology at delivery. The team will search for ultrasound signatures associated with Amsterdam-classified placental lesions such as maternal or fetal vascular malperfusion and inflammation. The overall aim is to determine whether antepartum ultrasound can identify placental injury patterns that predict adverse outcomes.

Who should consider this trial

Good fit: Ideal candidates are pregnant people delivering at NorthShore with available prenatal ultrasound images and placental pathology, and for the prospective arm specifically those with singleton pregnancies and fetal growth restriction at 20–28 weeks or matched normal-growth pregnancies presenting for late-pregnancy ultrasound.

Not a fit: People with multiple gestations, major fetal anomalies, chronic hypertension or diabetes (for the unexposed arm), or those who will not deliver at NorthShore or lack suitable ultrasound images are unlikely to benefit from participation.

Why it matters

Potential benefit: If successful, this could help clinicians detect placental injury before delivery and better target monitoring or interventions to reduce adverse pregnancy outcomes.

How similar studies have performed: Prior research has linked some ultrasound findings to placental problems, but applying automated image-processing to predict detailed placental histology before delivery is relatively new and not widely validated.

Eligibility criteria

Retrospective Phase

Inclusion criteria:

* Patients with delivery in NorthShore University HealthSystem,
* Ultrasound available within 4 weeks of delivery with adequate placental images
* Placental pathology available

Exclusion criteria:

* Multiple gestation

Prospective Phase Inclusion criteria

* Exposed: Patients with singleton gestation with fetal growth restriction at 20-28 weeks with a plan to deliver at NorthShore Highland Park Hospital Evanston Hospital. Patients must have a first-trimester ultrasound (\<14 weeks) to confirm pregnancy dating available in the electronic medical record.
* Unexposed: Patients who present for routine ultrasound evaluation at 36-38 weeks with normal fetal growth with a plan to deliver at NorthShore Highland Park Hospital or NorthShore Evanston Hospital.

Exclusion criteria:

* Exposed: Multiple gestation, major fetal anomaly
* Unexposed: Multiple gestation, history of chronic hypertension, gestational or pregestational diabetes, major fetal anomaly antiphospholipid syndrome, known thrombophilia

Where this trial is running

Evanston, Illinois

• NorthShore University HealthSystem — Evanston, Illinois, United States (Recruiting)

Study contacts

• Principal investigator: Sunitha Suresh — Endeavor Health
• Study coordinator: Sunitha Suresh

Conditions Pregnancy Complications; placenta pathology; adverse pregnancy outcomes