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PFM.09 Reduced glutamate: choline ratio by 1H MRS as a Biomarker for Placental Insufficiency in the Growth Restricted Fetus
  1. G MacMaught1,
  2. S Semple1,2,
  3. C Gray1,
  4. M Simpson3,4,
  5. JE Norman4,
  6. J Walker5,
  7. FC Denison4
  1. 1Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
  2. 2Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
  3. 3Wellcome Trust Clinical Research Facility, University of Edinburgh, Edinburgh, UK
  4. 4Tommy’s Centre for Maternal and Fetal Health, University of Edinburgh, MRC Centre for Reproductive, Edinburgh, UK
  5. 5Simpson Centre for Reproductive Health, Edinburgh Royal Infirmary, Edinburgh, UK


Background Current diagnostic tests for uteroplacental insufficiency are limited. Glutamine and glutamate (Glx) play a vital role in the production of the nucleotides and amino sugars required for cell proliferation in the placenta. Choline (Cho) is a marker of cell turn-over. Proton spectroscopy magnetic resonance spectroscopy (1H MRS) is a safe, non-invasive imaging technique which can detect Glx and Cho. We hypothesised that placenta Glx:Cho ratio could be a useful biomarker of placental function in pregnancies complicated by FGR.

Objective To undertake a proof-of-concept study assessing placental Glx:Cho ratio in women with healthy pregnancies compared to suspected FGR.

Study design In vivo placental 1H MRS was performed in 7 pregnancies with FGR and matched to healthy controls. MRI placental volumes were measured. Oxygenation and acid-base balance were determined at birth where possible.

Results Figure 1 demonstrates an exemplar spectra. The Glx:Cho ratios are shown in Table 1. In each case the Glx/Cho ratio for the FGR placentas are lower than in that of their matched control (p < 0.003).

Abstract PFM.09 Table 1

Conclusion This preliminary study demonstrates that Glx/Cho ratio may be a potential biomarker of placental insufficiency. Future studies need to establish normal ranges for gestation and explore the clinical implication of a low Glx/Cho ratio for perinatal outcome.

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