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Original Articles
- Pathologic Differences between Placentas from Intrauterine Growth Restriction Pregnancies with and without Absent or Reversed End Diastolic Velocity of Umbilical Arteries.
- Changyoung Yoo, Dong Gyu Jang, Yun Sung Jo, Jinyoung Yoo, Guisera Lee
- Korean J Pathol. 2011;45(1):36-44.
- DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.36
- 4,137 View
- 26 Download
- 5 Crossref
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Abstract
PDF - BACKGROUND
Abnormal umbilical artery Doppler velocimetry is one of the important findings of intrauterine growth restriction (IUGR) and IUGR is associated with high perinatal morbidity and mortality. In addition, this abnormal Doppler velocimetry is correlated with placental insufficiency. The aim of this study was to determine the pathologic differences in the placentas from IUGR pregnancies with and without the absent or reversed end diastolic velocity (AREDV).
METHODS
Among the cases that had undergone prenatal follow-up in our institute, a retrospective slide review was conducted for 18 cases of IUGR with AREDV and 17 cases with IUGR that had normal end-diastolic flow of the umbilical artery.
RESULTS
The birth weight and the other clinical parameters were not different among the two groups. Grossly, the placental weight percentiles were significantly smaller in AREDV group when they were adjusted according to gestational age. Histologically, chronic deciduitis, mural hypertrophy of the decidual arteries, an intimal fibrin cushion of the large fetal vessels, increased syncytial knots, villous agglutinations, avascular villi, villous stromal-vascular karyorrhexis, and acute atherosis were more frequently found in the AREDV group and their presence showed statistical significance.
CONCLUSIONS
These findings suggest that pathologic abnormalities due to fetal and maternal vasculopathies in the placenta may be the cornerstone for inducing AREDV in the umbilical artery. -
Citations
Citations to this article as recorded by
- Histological Evaluation of Placentas in Idiopathic Intrauterine Growth Restriction
Saadi S Barwari
Cureus.2024;[Epub] CrossRef - Defining early vs late fetal growth restriction by placental pathology
Amir Aviram, Christopher Sherman, John Kingdom, Arthur Zaltz, Jon Barrett, Nir Melamed
Acta Obstetricia et Gynecologica Scandinavica.2019; 98(3): 365. CrossRef - HISTOPATHOLOGICAL CHANGES OF PLACENTA IN PRETERM PREGNANCY WITH SPECIAL REFERENCE TO INTRAUTERINE GROWTH RESTRICTION
Prathibha S.D, Anitha N, Samikshya Ray, Jayaprakash H.T
Journal of Evidence Based Medicine and Healthcare.2016; 3(63): 3430. CrossRef - Preliminary Study on Neurodevelopmental Outcome and Placental Pathology among Extremely Low Birth Weight Infants
Seong-Hee Oh, Jong-jae Kim, Hyun-jeong Do, Byong Sop Lee, Ki-Soo Kim, Ellen Ai-Rhan Kim
Korean Journal of Perinatology.2015; 26(1): 67. CrossRef - Chronic Placental Inflammation in Twin Pregnancies
Heejin Bang, Go Eun Bae, Ha Young Park, Yeon Mee Kim, Suk-Joo Choi, Soo-young Oh, Cheong-Rae Roh, Jung-Sun Kim
Journal of Pathology and Translational Medicine.2015; 49(6): 489. CrossRef
- Histological Evaluation of Placentas in Idiopathic Intrauterine Growth Restriction
- Placental Pathology in Intrauterine Growth Retardation.
- So Young Park, Moon Young Kim, Yee Jeong Kim, Yi Kyeong Chun, Hye Sun Kim, Hee Soo Kim, Sung Ran Hong
- Korean J Pathol. 2002;36(1):30-37.
- 3,358 View
- 147 Download
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Abstract
PDF
- BACKGROUND
Histologic examination of the placentas from intrauterine growth retardation (IUGR) fetuses can supplement clinical knowledge of the cause of IUGR. The present study was undertaken to observe the pathologic findings regarding the placentas in IUGR fetuses.
METHODS
Clinicopathologic findings in 45 cases with IUGR at the third-trimester were reviewed, and they were compared with those of 24 normal control cases. An IUGR fetus was defined as one with a birth weight less than those in the 10th percentile. Of the IUGR cases, 15 were hypertensive IUGR with or without preeclampsia, and 30 were normotensive IUGR.
RESULTS
The IUGR groups had significantly shorter mean gestational ages, lower mean placental weights, and higher incidences of oligohydramnios, compared to the normal controls (p<0.05). Histologically, IUGR was characterized by increased incidence of decidual vasculopathy (31.1%, p<0.05), multiple and severe infarct (p<0.05), villous fibrosis (31.1%, p<0.05), syncytiotrophoblastic knots (86.7%, p<0.05), and higher degree of increased perivillous fibrin deposition (p<0.05). However, there were no statistically significant differences in the placental lesions between hypertensive and normotensive IUGR cases, except for the presence of decidual vasculopathy.
CONCLUSIONS
Abnormal uteroplacental vasculature and chronic uteroplacental insufficiency, coagulation-related pathology in the uteroplacental, intervillous and/or fetoplacental vasculature, and chronic inflammatory lesions may be the primary disease processes related to the placental pathology of IUGR. Although the cause of IUGR pregnancies is heterogeneous, careful cilinicopathologic correlations in individual cases are necessary in the interpretation of placental lesions of IUGR, and the total burden of several placental lesions may be more important than a single histologic feature.
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