IMR Press / CEOG / Volume 49 / Issue 8 / DOI: 10.31083/j.ceog4908177
Open Access Original Research
Intra- and Interobserver Reliability of Superb Microvascular Imaging (SMI) Doppler for Assessing Placental Microvasculature
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1 Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, Spain
2 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Seville, 41009 Seville, Spain
3 Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, 41014 Seville, Spain
*Correspondence: jgmejido@us.es (José Antonio García-Mejido)
Academic Editor: Valerio Gaetano Vellone
Clin. Exp. Obstet. Gynecol. 2022, 49(8), 177; https://doi.org/10.31083/j.ceog4908177
Submitted: 11 March 2022 | Revised: 27 April 2022 | Accepted: 6 May 2022 | Published: 28 July 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Objective: Superb Microvascular Imaging (SMI) Doppler is a novel technique. We aim to evaluate intra- and interobserver reliability of SMI Doppler for the assessment of normal placental microvasculature. Materials and Methods: A prospective observational study was conducted including 11 pregnant patients. Ultrasonography placental assessment was performed on 28-weeks pregnant patients, by two expert examiners using SMI Doppler in one single visit. To evaluate interobserver reliability, the first examiner took measurements using SMI Doppler, followed then by the second examiner. Afterwards, the first examiner performed a second evaluation, in order to assess intraobserver reliability. Intraclass correlation coefficients (ICC) and Cohen’s Kappa coefficient, and their 95% confidence intervals, were estimated for quantitative and qualitative parameters, respectively. Results: Intraobserver reliability was found to be excellent for all quantitative parameters, with all ICC values above 0.97. For qualitative variables, excellent reliability was obtained for the number of secondary villi, while the number of tertiary villi had an adequate reliability with a Cohen’s Kappa coefficient of 0.792 (95% CI 0.38–1.17; p = 0.007). Interobserver ICCs ranged from 0.92 to 1.00 for all quantitative parameters, thus finding excellent interobserver reliability for all of them. An excellent reliability was also obtained for the number of secondary villi, while the reliability for the number of tertiary villi was found to be adequate. Conclusions: Our findings show that placental microvasculature measurements obtained by a single or two different examiners are reliable and reproducible. The good intra- and interobserver reliability results of SMI Doppler showed in our study stress the value of this technique in the evaluation of placental microvasculature, and thus research in this field is the step forward for the assessment of placental insufficiency.

Keywords
superb microvascular imaging
SMI Doppler
placental microvasculature
reproducibility
reliability
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