{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T02:12:32Z","timestamp":1779934352327,"version":"3.53.1"},"reference-count":37,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["301664"],"award-info":[{"award-number":["301664"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023312","name":"Wellcome EPSRC Centre for Medical Engineering","doi-asserted-by":"publisher","award":["WT203148\/Z\/16\/Z"],"award-info":[{"award-number":["WT203148\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/501100023312","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["201374\/Z\/16\/Z"],"award-info":[{"award-number":["201374\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["MR\/T018119\/1"],"award-info":[{"award-number":["MR\/T018119\/1"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009360","name":"King's College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009360","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,12]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To utilise combined diffusion\u2010relaxation MRI techniques to interrogate antenatal changes in the placenta prior to extreme preterm birth among both women with PPROM and membranes intact, and compare this to a control group who subsequently delivered at term.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Observational study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Tertiary Obstetric Unit, London, UK.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n Cases: pregnant women who subsequently spontaneously delivered a singleton pregnancy prior to 32\u2009weeks' gestation without any other obstetric complications. Controls: pregnant women who delivered an uncomplicated pregnancy at term.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n All women consented to an MRI examination. A combined diffusion\u2010relaxation MRI of the placenta was undertaken and analysed using fractional anisotropy, a combined T2*\u2010apparent diffusion coefficient model and a combined T2*\u2010intravoxel incoherent motion model, in order to provide a detailed placental phenotype associated with preterm birth. Subgroup analyses based on whether women in the case group had PPROM or intact membranes at time of scan, and on latency to delivery were performed.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n Fractional anisotropy, apparent diffusion coefficients and T2* placental values, from two models including a combined T2*\u2010IVIM model separating fast\u2010 and slow\u2010flowing (perfusing and diffusing) compartments.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n This study included 23 women who delivered preterm and 52 women who delivered at term. Placental T2* was lower in the T2*\u2010apparent diffusion coefficient model (\n p<\/jats:italic>\n \u2009<\u20090.001) and in the fast\u2010 and slow\u2010flowing compartments (\n p<\/jats:italic>\n \u2009=\u20090.001 and\n p<\/jats:italic>\n \u2009<\u20090.001) of the T2*\u2010IVIM model. This reached a higher level of significance in the preterm prelabour rupture of the membranes group than in the membranes intact group. There was a reduced perfusion fraction among the cases with impending delivery.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Placental diffusion\u2010relaxation reveals significant changes in the placenta prior to preterm birth with greater effect noted in cases of preterm prelabour rupture of the membranes. Application of this technique may allow clinically valuable interrogation of histopathological changes before preterm birth. In turn, this could facilitate more accurate antenatal prediction of preterm chorioamnionitis and so aid decisions around the safest time of delivery. Furthermore, this technique provides a research tool to improve understanding of the pathological mechanisms associated with preterm birth in\u00a0vivo.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.17901","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:06:40Z","timestamp":1719965200000},"page":"1782-1792","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Placental multimodal\n MRI<\/scp>\n prior to spontaneous preterm birth <32\u2009weeks' gestation: An observational study"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2756-6365","authenticated-orcid":false,"given":"Megan","family":"Hall","sequence":"first","affiliation":[{"name":"Centre for the Developing Brain, St Thomas' Hospital King's College London London UK"},{"name":"Department of Women and Children's Health, St Thomas' Hospital King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Suff","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health, St Thomas' Hospital King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paddy","family":"Slator","sequence":"additional","affiliation":[{"name":"Cardiff University Brain Research Imaging Centre Cardiff University Cardiff UK"},{"name":"School of Computer Science and Informatics Cardiff University Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Rutherford","sequence":"additional","affiliation":[{"name":"Centre for the Developing Brain, St Thomas' Hospital King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Shennan","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health, St Thomas' Hospital King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3476-3500","authenticated-orcid":false,"given":"Jana","family":"Hutter","sequence":"additional","affiliation":[{"name":"Centre for the Developing Brain, St Thomas' Hospital King's College London London UK"},{"name":"Smart Imaging Lab, Radiological Institute University Hospital Erlangen Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9328-9592","authenticated-orcid":false,"given":"Lisa","family":"Story","sequence":"additional","affiliation":[{"name":"Centre for the Developing Brain, St Thomas' Hospital King's College London London UK"},{"name":"Department of Women and Children's Health, St Thomas' Hospital King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,2]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"World Health 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