Placental pathology in fetal growth restriction

Natalija Vedmedovska, Dace Rezeberga, Uldis Teibe, Ivars Melderis, Gilbert G.G. Donders

Research output: Contribution to journalArticlepeer-review

87 Citations (Scopus)

Abstract

Objectives: One of the causes of intrauterine fetal growth restriction (FGR) can be pathology of the placenta. The aim of this study was to compare macroscopic and microscopic changes of the placentas from intrauterine growth restricted fetuses with those from normally developed fetuses, in order to test the hypothesis that vascular damage due to decreased maternal vascular perfusion may be responsible for FGR. Study design: Between May 2007 and December 2008 we performed detailed macroscopic and histological examination of singleton placentas of 50 consecutive neonates with fetal growth restriction (FGR group) and compared them to 50 normal fetuses, born next to an FGR case, as a control group. Results: Gestational age, birth weight, spontaneous delivery rate, mean weight of the placenta and the fetal-placental weight ratio were all lower in the FGR group than in the control group (p < 0.05). Thickening of the villous trophoblastic basal membrane, incidence of villous infarction, presence of thrombi or haematomas and the incidence of villitis were more common in the FGR group than in the controls (p < 0.05). There were, however, no significant differences in perivillous fibrin deposition, stromal fibrosis and cytotrophoblast proliferation between the groups. In FGR women who smoked, intervillous haematomas and villous infarction were more common (p < 0.05) than in controls. Conclusions: All macroscopic and microscopic pathological changes associated with FGR were directly linked to reduction of placental blood flow. As smoking is a main risk factor for these placental abnormalities these results emphasize the need to persuade women to quit smoking not only during pregnancy, but even better long before pregnancy.

Original languageEnglish
Pages (from-to)36-40
Number of pages5
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Volume155
Issue number1
DOIs
Publication statusPublished - Mar 2011

Keywords

  • Fetal growth restriction
  • Histological lesions
  • Pathology
  • Placenta

Field of Science

  • 3.2 Clinical medicine

Publication Type

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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