Microscopic lesions of placenta and Doppler velocimetry related to fetal growth restriction

The purpose of the study was to find an association between the uterine and umbilical arteries blood flow patterns in growth-restricted (FGR) and normal fetuses and placental microscopic lesions.

Fifty women with prenatally suspected and post-delivery confirmed FGR of singleton fetuses were enrolled in a case-controlled follow-up study from May 2007 to December 2008. Unselected patients with appropriately growing fetuses, matched for gestational age, served as controls. Uterine and umbilical Doppler waveforms were recorded before delivery.

Compared with control group with normal Doppler, FGR women with abnormal Doppler velocimetry of uterine and umbilical arteries had more intervillous thrombi (p = 0.01 and p < 0.0001, respectively) and villous infarctions (p = 0.02 and p = 0.0003, respectively). Thickening of the basal membrane and villitis was clearly linked to the FGR (p = 0.006 and p = 0.01). Vasculitis, on the other hand, is linked to normal growth, without affecting Doppler velocities.

Abnormal Doppler may predict hemorrhagic and ischemic placental lesions in FGR pregnancies and may lead to future improvement of the management of current and subsequent pregnancies.