Publication:

Placental stiffness assessment using shear wave elastography in normal and preeclamptic pregnancies: a cross-sectional analytical study

Background Preeclampsia is a multisystem hypertensive disorder associated with abnormal placentation and increased placental stiffness. Shear wave elastography (SWE) is a non-invasive imaging modality that quantitatively evaluates tissue elasticity. This study aimed to compare placental stiffness in normal and preeclamptic pregnancies and determine an optimal diagnostic cut-off value.

Methods This hospital-based cross-sectional analytical study was conducted in the Department of Radiodiagnosis at Dr. S.N. Medical College, Jodhpur between January 2025 and December 2025. A total of 120 pregnant women between 27-40 weeks of gestation were enrolled: 60 normotensive controls and 60 preeclamptic patients. Placental SWE measurements were obtained using a Philips Affiniti 70 ultrasound system. Nine readings were taken from fetal, central, and maternal placental regions. Receiver operating characteristic (ROC) curve analysis was performed to determine diagnostic performance.

Results Mean SWE was significantly higher in preeclamptic women compared to controls (4.59±0.41 m/s vs 2.51±0.10 m/s; p=0.068). Median SWE values yielded an AUC of 0.968. A cut-off value of 4.32 kPa demonstrated sensitivity of 86.7% and specificity of 96.7%. Central placental regions showed significantly higher stiffness in preeclamptic pregnancies.

Conclusions Placental stiffness measured by SWE is significantly increased in preeclampsia. SWE may serve as a reliable, safe, and non-invasive adjunct tool for evaluating placental pathology and identifying pregnancies at risk.