Microscopic lesions of placenta and Doppler velocimetry related to fetal growth restriction

Arch Gynecol Obstet. 2011 Nov;284(5):1087-93. doi: 10.1007/s00404-010-1781-x. Epub 2010 Dec 14.

Abstract

Purpose: The purpose of the study was to find an association between the uterine and umbilical arteries blood flow patterns in growth-restricted (FGR) and normal fetuses and placental microscopic lesions.

Methods: Fifty women with prenatally suspected and post-delivery confirmed FGR of singleton fetuses were enrolled in a case-controlled follow-up study from May 2007 to December 2008. Unselected patients with appropriately growing fetuses, matched for gestational age, served as controls. Uterine and umbilical Doppler waveforms were recorded before delivery.

Results: Compared with control group with normal Doppler, FGR women with abnormal Doppler velocimetry of uterine and umbilical arteries had more intervillous thrombi (p = 0.01 and p < 0.0001, respectively) and villous infarctions (p = 0.02 and p = 0.0003, respectively). Thickening of the basal membrane and villitis was clearly linked to the FGR (p = 0.006 and p = 0.01). Vasculitis, on the other hand, is linked to normal growth, without affecting Doppler velocities.

Conclusions: Abnormal Doppler may predict hemorrhagic and ischemic placental lesions in FGR pregnancies and may lead to future improvement of the management of current and subsequent pregnancies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Female
  • Fetal Growth Retardation / diagnostic imaging
  • Fetal Growth Retardation / physiopathology*
  • Gestational Age
  • Humans
  • Placenta / blood supply*
  • Placenta / diagnostic imaging
  • Placenta / physiopathology
  • Pregnancy
  • Rheology
  • Ultrasonography, Doppler / methods
  • Ultrasonography, Prenatal / methods
  • Umbilical Arteries / diagnostic imaging
  • Umbilical Arteries / physiopathology
  • Uterine Artery / diagnostic imaging
  • Uterine Artery / physiopathology