Objectives Pre-eclampsia (PET) and intrauterine growth restriction (IUGR), often associated with impaired placental function, are among the most common conditions contributing to increased perinatal mortality and morbidity. This study investigates if three dimensional power Doppler (3DPD) of the placenta and computerised analysis of placental calcification is different between PET/IUGR and normal pregnancies.

Methods A prospective cohort study involving 50 women with PET and/or IUGR. Gestational age ranged from 24+4 weeks to 40 weeks. 3DPD ultrasound calculated placental volume, vascularisation index (VI), flow index (FI) and vascularisation-flow index (VFI). Calcification was calculated using computer analysis. Results were compared with normal (control) values and correlated with Doppler results and placental histology.

Results Volume, VI, and VFI are not influenced by gestational age in PET/IUGR pregnancies. FI, lower than normal values from 24–30 weeks gestation (P = 0.006), increased with gestational age (P = 0.009). VI and FI were less than the 50^th centile in the majority of cases of utero-placental insufficiency (P = 0.047), VI and VFI lower in cases of accelerated placental maturation (P = 0.016 and 0.041 respectively). Placental volume greater than the 50^th centile (24–30 weeks) was associated with the presence of infarction on histology. FI (P = 0.002) and VFI (P = 0.036) were lower in the presence of bilateral uterine artery notches. Calcification, similar to the control group, was related to an increasing UAPI (P = 0.041) and an MCA PI < 5^th centile (P = 0.010).

Conclusion There is a potential role for 3DPD placental assessment of volume, vascularisation and blood flow and computer analysis of placental calcification in this high-risk group.