Correlation of Doppler Velocimetry of Uterine and Umbilical Arteries with Placental Pathology in Pregnancy Associated with Intrauterine Growth Restriction

Abstract

To correlate histomorphology of the placenta with Doppler studies of uterine and umbilical arteries. A comparative observational study conducted on 75 pregnant women divided into 2 groups: Group 1 included 25 women with appropriate for gestational age fetuses. Group 2 included 50 women with FGR. Uterine and umbilical artery Doppler, study of placental pathology and immunohistochemistry of placental villous tissues were evaluated. There was a significant difference between the two study groups regarding both abnormal uterine (0 vs. 58%) and umbilical artery (0 vs. 58%) Doppler (p \ 0.001). Syncytial knots [ 30% (44 vs. 60%), fibrinoid necrosis [ 5% (8 vs. 46.7%), placental infarction [ 5% (0 vs. 15%), perivillous fibrinoid deposition [ 5% (1.8 vs. 16.7%) (p \ 0.001) but not calcifications (56 vs. 60%, p = 0.121) were significantly higher in FGR placentas. A statistically significant (p \ 0.001) increase in the expression of VEGF in FGR placentas when compared with normal placentas. Abnormal uterine artery but not umbilical artery Doppler was significantly associated with abnormal placental pathology. Women with both abnormal uterine and umbilical artery Doppler velocimetries were delivered earlier and their babies had lower mean birth and placental weight (p \ 0.001). Incidence of abnormal placental pathology was significantly higher in this specific group of FGR pregnancies (p \ 0.001). There is high association between abnormal uterine and umbilical artery Doppler and placental pathology in FGR associated pregnancies.Trial Registration NCT03081754.