Placental morphology in relation to umbilical artery blood velocity waveforms

Nordenvall, Margareta; Ullberg, Ulla; Laurin, Jan; Lingman, Göran; Sandstedt, Bengt; Ulmsten, Ulf

doi:10.1016/0028-2243(91)90115-2

Cited by 55 publications

(29 citation statements)

References 20 publications

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“…In addition to the typical uteroplacental and fetoplacental ‘vascular' lesions described above, several studies have reported an excess frequency of VUE in FGR, with widely varying rates ranging from 8 to 90% [5,11,13,16,19,69,70,71,72]. VUE is characterised by patchy villous infiltration by chronic inflammatory cells, mainly histiocytes and lymphocytes, especially in basal/maternal floor villi, in the absence of an identifiable infective cause.…”

Section: Other Placental Histological Lesions Associated With Fgrmentioning

confidence: 99%

Placental Pathology in Early-Onset and Late-Onset Fetal Growth Restriction

2014

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Several histopathological features are found more frequently in placentas from pregnancies complicated by fetal growth restriction (FGR), including villous infarction, maternal vascular changes and villous morphological alterations, although around one quarter of placentas associated with FGR lack any morphological abnormality on routine examination. Since similar changes may also affect clinically uncomplicated pregnancies, the positive predictive value of such findings for pathological FGR in an unselected case remains low. However, the pattern of placental pathologies varies with clinical subgroup. The combination of placental bed and parenchymal lesions in FGR with abnormal uterine artery Doppler velocimetry is essentially identical to preterm pre-eclampsia (PET), and there is an association between FGR with abnormal umbilical artery Doppler findings and lesions of fetal stem arteries and terminal villous hypovascularity. Conversely, placentas from pregnancies complicated by PET or FGR presenting at or near term have a significantly lower frequency of histological abnormalities compared to early-onset disease and absence of a distinctive biochemical profile. The histological placental findings in FGR are therefore varied, from morphologically unremarkable through to severe uteroplacental vasculopathy, with no single pathological feature associated with high sensitivity or specificity. Severe early-onset FGR, overlapping with severe early-onset PET, is mainly associated with features of impaired maternal uteroplacental perfusion secondary to defective extravillous trophoblast invasion, and its consequences. Late-onset FGR probably represents a more heterogeneous group with less characteristic histological changes. Future research using histopathological assessment of aggregated data from multiple studies into larger datasets with centralised pathology review will allow delineation of distinctive clinicopathological associations and further understanding of pathophysiology.

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Section: Other Placental Histological Lesions Associated With Fgrmentioning

confidence: 99%

Placental Pathology in Early-Onset and Late-Onset Fetal Growth Restriction

2014

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“…We previously found a relationship between intrauterine growth retardation and abnormal placental vascular pattern associated with marginal cord insertion and extrachorial placentation (13). It seems reasonable that this reflects placental growth and migration governed by the uterine vascular supply with consequences for the cotyledonary as well as the allantochorial vascular pattern.…”

Section: Discussionmentioning

confidence: 99%

“…The placental vascular architecture is often abnormal in intrauterine growth retardation (12)(13)(14), suggesting also that the anastomosis might differ in small for gestational age (SGA) placentas, being hypothetically more important in this condition associated with decreased placental capacity.…”

Section: Original Articlementioning

confidence: 99%

“…After thawing, the arterial tree of each placenta was filled with barium X-ray contrast medium and angiograms achieved in two perpendicular projections as described in earlier work (1,13). The anastomosis was measured and characterized in the angiograms according to our previous study in placentas from full-term AGA infants with normal umbilical artery blood flow (1).…”

Section: <0001mentioning

confidence: 99%

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Hyrtl's anastomosis is normally developed in placentas from small for gestational age infants

Ullberg¹,

Lingman²,

Ekman-Ordeberg³

et al. 2003

Acta Obstet Gynecol Scand

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Hyrtl's anastomosis is normally developed in placentas from small for gestational age infants.Ullberg, Ulla; Lingman, Göran; Ekman-Ordeberg, Gunvor; Sandstedt, Bengt Link to publication Citation for published version (APA): Ullberg, U., Lingman, G., Ekman-Ordeberg, G., & Sandstedt, B. (2003). Hyrtl's anastomosis is normally developed in placentas from small for gestational age infants. Acta Obstetricia et Gynecologica Scandinavica, 82(8), 716-721. DOI: 10.1034/j.1600-0412.2003 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Background. The aim of this study was to investigate the occurrence and appearance of the anastomosis between the two umbilical arteries in placentas from infants small for gestational age (SGA). Methods. The arterial systems of 64 placentas from singleton pregnancies resulting in SGA infants were visualized by angiography. The method allowed study of the anastomosis between the umbilical arteries and calculation of the relative placental area supplied by each artery. The results were compared with findings in a previous study of appropriate for gestational age (AGA) infants. One-way analysis of variance (ANOVA) and w 2 -analyses were used for statistics. Results. In 56 placentas the anastomosis was represented by a true vessel, in two by a fenestration, and in another two cases by fusion of the umbilical arteries. The anastomosis was absent in one case and another three cases had a single umbilical artery (SUA). When the diameter of the anastomosis was thinner than that of the umbilical arteries, their supply areas were significantly (p 0.001) more symmetrical than in cases with a wider anastomosis.The anatomy of the anastomosis and the relationship between its width and the symmetry between the supply areas of each umbilical artery did not differ in placentas from SGA and AGA infants, despite various types of cord insertion and placentation. Conclusion. Static measurements of Hyrtl's anastomosis do not indicate a contributing part for intrauterine growth retardation.

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“…Observou-se ocorrência de óbito fetal em 20% dos casos, resultado semelhante ao obtido por NOMURA et al (2001) Quanto às características anatomopatológicas, observou-se que o peso da placenta variou entre 20g e 480g, com média de 219,2g, concordante com dados de literatura médica (NORDENVALL et al, 1991, KRECZY et al, 1995, SILVA, 2000, e justificando-se, possivelmente, pelas altas taxas de prematuridade observadas nos casos de DZ e DR, conforme discutido anteriormente.…”

Section: Os Resultadosunclassified

"Estudo histopatológico comparativo de placentas oriundas de gestações com diástole zero ou reversa à dopplervelocimetria das artérias umbilicais"

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Placental morphology in relation to umbilical artery blood velocity waveforms

Cited by 55 publications

References 20 publications

Placental Pathology in Early-Onset and Late-Onset Fetal Growth Restriction

Placental Pathology in Early-Onset and Late-Onset Fetal Growth Restriction

Hyrtl's anastomosis is normally developed in placentas from small for gestational age infants

"Estudo histopatológico comparativo de placentas oriundas de gestações com diástole zero ou reversa à dopplervelocimetria das artérias umbilicais"

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