Objective  To explore the value of three-dimensional energy Doppler ultrasound parameters combined with placental growth factor (PLGF) in predicting early-onset fetal growth restriction (FGR).

Methods  Eighty pregnant women with early-onset FGR were selected as FGR group, and another 50 healthy pregnant women with prenatal examination were selected as control group. Three-dimensional energy Doppler ultrasonography was performed for all subjects at 11 to 13 weeks plus 6 days of gestation, and placental volume (PV), vascularization index (VI), flow index (FI) and vascularization-flow index (VFI) were collected. Serum PLGF level was measured in all subjects at 14 to 16 weeks plus 6 days of gestation.

Results  The PV, VI, FI, VFI and serum PLGF level in the FGR group were significantly lower than those in the control group (P < 0.05). Multiple Logistic regression analysis showed that low PV, VI, FI and VFI as well as serum PLGF level were risk factors for early-onset FGR (P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that PV, VI, VFI and serum PLGF had certain predictive value for early-onset FGR, with areas under the curve of 0.723 (95%CI, 0.629 to 0.817), 0.776 (95%CI, 0.693 to 0.860), 0.746 (95%CI, 0.653 to 0.839) and 0.799 (95%CI, 0.713 to 0.884) respectively. The predictive value of FI for early-onset FGR was moderate, with an area under the curve of 0.625 (95%CI, 0.524 to 0.725). Analysis showed that the combination of PLGF and VI as well as PLGF and VFI had good predictive values for early-onset FGR, the sensitivity, specificity and Youden index of PLGF combined with VI were 86.25%, 76.00% and 0.623 respectively, while those of PLGF combined with VFI were 81.25%, 80.00% and 0.613 respectively.

Conclusion  The combination of three-dimensional energy Doppler ultrasound parameters and PLGF has certain predictive value for early-onset FGR, and can be used for clinical screening of high-risk populations with early-onset FGR.