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Estimated Placental Volume

Dr. Harvey Kliman, working with his father, mathematician Merwin Kliman, has developed a technique to measure Estimated Placental Volume (EPV) during pregnancy. This information has the potential to improve patients' prenatal care and pregnancy outcomes, as small placentas can lead to intrauterine growth restriction, and in severe cases, even intrauterine fetal demise.

Information for Providers

EPV can be measured from 7 to 40 weeks. Use widest angle probe for large placentas. Beyond 36 weeks the placenta may be too large to visualize the entire width.

Ideal measurements: Freeze a perpendicular cross section at the maximal width of placenta. Take Width measurements from edge to edge. Start at apex and measure Height and Thickness down to baseline along same line (at right angles to Width line). Height is always greater or equal to thickness.

To download the simple two-page manual click here

Illustrated by Harvey J. Kliman
The Merwin's EPV Calculator app is designed to calculate the Estimated Placental Volume (EPV) from three measurements collected at the time of a 2-D prenatal ultrasound. Once the provider measures the width, height and thickness of the placenta, the results can be entered into the data entry screen.
Photo by Harvey J. Kliman
Anterior crescent shaped placenta with Width line placed.

Steps to perform an EPV. If the placenta is an obvious crescent, find the maximum width while holding the probe perpendicular to the placenta surface. Start with the baseline Width measurement by creating a line from one tip of the placenta to the other, as shown by the (+) yellow line.

Photo by Harvey J. Kliman
Width and Height lines now in place.

Find the maximal apex point of the crescent, place a point for a second line at this apex. The Height is measured by dragging the line from the apex to baseline (⸭), yellow line, making sure the Height line is perpendicular when it touches the Width line.

Photo by Harvey J. Kliman
Thickness line placed by starting at Apex point and extending alone preexisting Height line to edge of placenta.

The Thickness is measured by starting from same apex point as Height and then measuring along the same line down to edge of placenta (✕), orange line.

Photo by Harvey J. Kliman
Flat placenta showing marks for width and height. Thickness equals height in this case.

If the placenta is flat, without any evidence of curvature, the above steps will not work. This most often happens with early first trimester placentas. In this case, first determine the maximal Width by measuring from tip to tip (yellow). The Height and Thickness lines (orange) are the same and are measured once to obtain both values. Simply plug the W, H and T values into the calculator and the correct EPV will be outputted.

Do's and Don'ts for doing EPV measurements
EPV Calculator apps

See Azpurua et al. (2010) Determination of placental weight using two-dimensional sonography and volumetric mathematic modeling, Am J Perinatology, 27, 151-155 for details.

Find the iPhone Merwin's EPV Calculator here.

Find the Mac Desktop calculator here.

Find the Android calculator here.

EPV Web Calculator

Collect the Width, Height and Thickness measurements as described in the instructions above. Enter data into the calculator below. Click on Submit button. The calculated EPV in cc is presented. Use the graph above to estimate an approximate percentile based on estimated gestational age. A very accurate calculator using a graphical interface with a resultant graph and percentile can be found here for individuals with an iPhone.