The purpose of this study to determine if measurement of maternal serum biomarkers and evaluation of the placenta by ultrasound can improve prediction of adverse pregnancy outcomes.

The placenta is known to play a vital role in maintaining a healthy pregnancy. Placental dysfunction is believed to be a driving factor in a variety of adverse obstetric outcomes, including fetal growth restriction and preeclampsia. Advances in 3D ultrasound have allowed for measurement of placental volumes during pregnancy. It may be that quantitative assessment of early placental growth can help identify pregnancies at risk for adverse outcome. Furthermore, various novel serum analytes have been proposed as predictors of adverse outcome. The investigators seek to prospectively measure placental volume and diameter at 11-14 weeks and 18-24 weeks to determine if placental growth can predict adverse outcome. In addition, the investigators seek to investigate the relationship between placental growth and serum levels of various biomarkers to see if improved detection of adverse outcome can be achieved.

Inclusion Criteria:

• All singleton gestations presenting for Sequential Screen testing at HUP
• patients competent to provide verbal informed consent

Exclusion Criteria:

• Multiple gestations
• patients not competent to provide informed consent
• patients found to be too late for the Sequential Screen
• pregnancy losses 20 weeks gestation
• major fetal anomalies
• patient delivering outside of the UPHS

Singleton pregnancies presenting for Sequential Screen prior to 14 weeks gestation