Suspected Fetal Growth Restriction at 37 Weeks: A Comparison of Doppler and Placental Pathology

Curtin, William M.; Millington, Karmaine A.; Ibekwe, Tochi; Ural, Serdar H.

doi:10.1155/2017/3723879

Cited by 7 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a retrospective cohort study on 100 term FGR pregnancies, 46 and 54 were in the abnormal and normal doppler groups. 15 Placental pathology was more prevalent with any abnormal doppler that included umbilical, middle cerebral and uterine artery (84.8% versus 55.6%, p=0.002) which was similar to our study. Abnormal MCA Doppler had a higher prevalence of placental pathology (96.2% versus 54.8%, OR 20.7, 95% CI: 2.54, 447.1, and p <0.001).…”

Section: Discussionsupporting

confidence: 90%

“…However there was a higher prevalence of SGA fetuses in the group with placental lesions. 15 A study compared placental histomorphology of 126 IUGR pregnancies and their perinatal outcome and found that 84 (66.7%) of them had signs of placental under perfusion. Incidence of low birth weight, NICU admissions were significantly high in the placental under perfusion group similar to our study.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Correlation of placental histomorphology with doppler velocimetry in preeclampsia and IUGR and their perinatal outcome

Solipuram

Vasudeva

Adiga

et al. 2021

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Though numerous placental ischemic changes are described in relation to placental insufficiency, universally accepted criteria are unavailable till date leading to under or over reporting. Present study is an attempt to define standardized grading system for placental dysmorphology and correlate it with Doppler changes. The objective was to study placental histomorphology in preeclampsia and IUGR (Intrauterine Growth Restriction), to correlate the placental histomorphology with multivessel Doppler findings and their perinatal outcome in preeclampsia and IUGR.Methods: Prospective study was done over 2 years, 64 antenatal women with preeclampsia and/or IUGR were recruited, their multivessel Doppler measurements were recorded and placental histomorphological changes were studied post-delivery which were graded as either low or high grade placentas considering degree and number of ischemic changes observed.Results: Out of 64 cases, 33 (51.5%) cases had low grade changes and 31 (48.5%) had high grade changes. Out of 33 patients with low grade placentas 24 (73%) had normal Doppler, 20 (65%) out of 31 high grade placenta had abnormal Doppler. Placental histomorphology correlated well with Doppler abnormality (Coefficient of Kappa test). Syncytial knots>50%, presence of hypermature villi, infarcts, fibrin deposits were significantly associated with abnormal Doppler. High grade placenta group had significantly poor perinatal outcome (Chi square test).Conclusions: We formulated a grading system of placental dysmorphology in preeclampsia and IUGR which correlated well with clinical Doppler abnormality and perinatal outcome. Further studies are warranted to develop preventive strategies aimed at specific high grade placental changes seen in pregnancies with abnormal Doppler and develop strategies to improve perinatal outcome.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Correlation of placental histomorphology with doppler velocimetry in preeclampsia and IUGR and their perinatal outcome

Solipuram

Vasudeva

Adiga

et al. 2021

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…In addition, abnormal CPR was associated with mural hypertrophy and maternal vascular underperfusion in FGR 58 . However, abnormal Doppler flow cannot be explained solely by altered uteroplacental histopathology [59][60][61] . On the other hand, SGA cases with normal fetoplacental Doppler exhibited a higher prevalence of placental findings than did uncomplicated pregnancies 35 .…”

Section: Discussionmentioning

confidence: 99%

Distinctive patterns of placental lesions in pre‐eclampsia vs small‐for‐gestational age and their association with fetoplacental Doppler

Paulés

Youssef

Rovira

et al. 2019

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

Objectives To describe placental histopathological findings in a large cohort of pregnancies complicated by pre‐eclampsia (PE) and/or small‐for‐gestational age (SGA), and to investigate their association with fetoplacental Doppler parameters. Methods This was a prospective observational study of normotensive pregnancies with SGA (defined as birth weight < 10th centile) (n = 184), PE pregnancies with a normally grown fetus (n = 102), pregnancies with both PE and SGA (n = 120) and uncomplicated pregnancies (n = 202). Uterine (UtA), umbilical (UA) and fetal middle cerebral (MCA) artery pulsatility indices (PI) were assessed. The cerebroplacental ratio (CPR) was calculated by dividing MCA‐PI by UA‐PI. Doppler parameters were considered abnormal when UtA‐PI or UA‐PI was > 95th centile or MCA‐PI or CPR was < 5th centile. Placental lesions were categorized as vascular (maternal or fetal side), immunoinflammatory or other, according to the 2014 Amsterdam Placental Workshop Group Consensus Statement. Comparison between the study groups was performed using univariate and multiple regression analysis, and logistic regression was used to determine the relationship between abnormal Doppler parameters and placental lesions. Results Maternal‐side vascular lesions were significantly more common in PE pregnancies with SGA than in the other groups (PE + SGA, 73% vs PE, 46% vs SGA, 38% vs controls, 31%; P = 0.01) and included mainly two types of lesion: developmental (PE + SGA, 13% vs PE, 5% vs SGA, 3% vs controls, 1.5%; P < 0.001) and malperfusion (PE + SGA, 70% vs PE, 39% vs SGA, 32% vs controls, 25%; P = 0.001). In contrast, the incidence of fetal‐side developmental lesions was significantly higher in normotensive SGA pregnancies than in controls and PE pregnancies (PE + SGA, 0% vs PE, 3% vs SGA, 8% vs controls, 2%; P = 0.001). All cases displayed a lower prevalence of infectious lesions than did controls, with the highest prevalence of immune lesions observed in pregnancies with both PE and SGA (PE + SGA, 18% vs PE, 8% vs SGA, 10% vs controls, 9%; P = 0.001). All fetoplacental Doppler parameters evaluated were associated with maternal‐side vascular lesions, mainly malperfusion (mean UtA‐PI: odds ratio (OR), 2.45 (95% CI, 1.51–3.97); UA‐PI: OR, 2.05 (95% CI, 1.02–4.47); MCA‐PI: OR, 2.75 (95% CI, 1.40–5.42); CPR: OR, 1.75 (95% CI, 1.04–2.95)). This association was evident mainly in the normotensive SGA group, being non‐significant in controls or PE pregnancies without SGA. No significant associations were observed between fetoplacental Doppler parameters and other placental lesions in any of the study groups. Conclusions PE and SGA are associated with different patterns of placental histopathological lesions in accordance with the clinical manifestation of the placental disorder (maternal vs fetal). Fetoplacental Doppler findings show an association with placental malperfusion lesions on the maternal side, supporting the use of abnormal Doppler as a surrogate for placental insufficiency. Copyright © 2019 ISUOG. Publishe...

show abstract

“…Curtis et al, found that abnormal Doppler parameters in the umbilical artery and MCA were associated with more placental pathology than those of fetuses that had normal Doppler results. In addition, abnormal MCA Doppler had a higher positive predictive value in predicting placental injury 13 . In our study, the effect of permanent damage in the placenta due to viral infection on feto-placental circulation and fetal Doppler parameters could not be demonstrated.…”

Section: Discussionmentioning

confidence: 91%

Effects of permanent placental injury due to severe acute respiratory syndrome coronavirus 2 infection during pregnancy on the feto-placental circulation: a cross-sectional study

Kılçar,

Turgut,

Bozkurt

et al. 2024

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

SUMMARY OBJECTIVE: The aim of this study was to evaluate the effects of permanent placental injury due to a severe acute respiratory syndrome coronavirus 2 infection during pregnancy on feto-placental circulation. METHODS: In this cross-sectional study, 83 pregnant women with planned deliveries were divided into two groups according to their severe acute respiratory syndrome coronavirus 2 infection statuses during pregnancy. Their demographic parameters, obstetric histories, and prenatal risks were evaluated. A prenatal fetal Doppler ultrasound examination was performed for all participants, and umbilical artery and middle cerebral artery Doppler parameters were obtained. Postpartum placentas were examined for pathological findings under appropriate conditions. All placentas were evaluated according to the Amsterdam consensus criteria. Mann-Whitney U test, Student’s t-test, and chi-square test were used for comparisons. RESULTS: Demographic parameters were statistically similar, except that they were borderline significant for gestational weeks at delivery (p=0.044). In the pathological examination of the placenta, regardless of the trimester of exposure to viral infection, perivillous fibrin deposition and villus dystrophic calcification were more common in group 2 (p=0.016 and p=0.048, respectively) than in group 1. In the prenatal Doppler examination between the groups, no statistically significant difference was found for all of the umbilical artery pulsatile index, middle cerebral artery pulsatile index, and cerebro-placental ratio values. CONCLUSION: Severe acute respiratory syndrome coronavirus 2 infection during pregnancy causes an increase in perivillous fibrin deposition and villus dystrophic calcification in the placenta. Placental injury caused by the severe acute respiratory syndrome coronavirus 2 virus does not affect fetal Doppler parameters.

show abstract

Suspected Fetal Growth Restriction at 37 Weeks: A Comparison of Doppler and Placental Pathology

Cited by 7 publications

References 27 publications

Correlation of placental histomorphology with doppler velocimetry in preeclampsia and IUGR and their perinatal outcome

Correlation of placental histomorphology with doppler velocimetry in preeclampsia and IUGR and their perinatal outcome

Distinctive patterns of placental lesions in pre‐eclampsia vs small‐for‐gestational age and their association with fetoplacental Doppler

Effects of permanent placental injury due to severe acute respiratory syndrome coronavirus 2 infection during pregnancy on the feto-placental circulation: a cross-sectional study

Contact Info

Product

Resources

About