A decreased placental vascularization could be an adjunct sonographic marker in the diagnosis of diabetic pregnancy in mid-gestation and late gestation.
The object of the study was to investigate the outcome in growth-retarded newborns who were diagnosed with fetal renal hyperechogenicity without anatomical abnormality during any stage of pregnancy. Depending on the fetal renal ultrasonography result, the cases were divided into two study groups. There was an intrauterine growth-retarded group with fetal renal medullary hyperechogenicity and another group without fetal renal medullary hyperechogenicity. The renal parenchyma was observed after birth, within the first 5 days of life, and several times until the 14th postpartum day in positive cases. Hyperechogenic renal medullae were detected in 25 of 90 cases with intrauterine growth retardation during the 8-month study period. This may be an in utero cause of subsequent intrauterine and neonatal complications, such as cesarean section because of fetal distress (36%), perinatal infection (24%), treatment in a neonatal intensive care unit (52%), or increased perinatal mortality (8%). The results demonstrate that fetuses with hyperechoic medullae had 1.5 times the risk of an abnormal outcome compared with fetuses with normal echoic kidneys and intrauterine growth retardation. Detailed ultrasound examinations of renal parenchyma appear to be useful for the prenatal diagnosis of intrauterine hypoxia, allowing the detection of possible pathological fetal conditions in utero.
Objective: To investigate the placental and umbilical cord histopathology in intrauterine growth restriction (IUGR) and their relation to second-trimester maternal hematological parameters. Materials and Methods: Patients were selected for the IUGR group based on estimated fetal weight below the 10th percentile. Patients were recruited into the control group randomly. Patients were followed up with ultrasound, and blood samples were taken between the 20th and 24th gestational weeks. After delivery and formalin fixation, weight and volume of the placenta were recorded and histologic samples were processed. Results: Maternal platelet count strongly correlates with placental weight (r = 0.766). On the other hand, neonatal weight correlates with placental volume (r = 0.572) rather than with placental weight (r = 0.469). Umbilical arterial lumen cross-sectional area correlates with birth weight (r = 0.338). Conclusions: Maternal hematological parameters do not seem to affect neonatal outcome. Our main findings are the correlation of maternal platelet count with placental weight, the correlation of placental volume with birth weight being stronger than the correlation of placental weight with birth weight, and the correlation of umbilical artery lumen cross-sectional area with neonatal weight. Mild histopathologic alterations might occur in normal pregnancies; however, sufficient fetal nutrition can be maintained. This compensatory function of the placenta seems to be insufficient when two or more pathologies are present, which is characteristic for IUGR.
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