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

• DOI: 10.1002/uog.20350
• Publication Date: 2019-05-22T09:35:26Z
• Authors: C. Paules; L. Youssef; C. Rovira; F. Crovetto; A. Nadal; A. Peguero; F. Figueras; E. Eixarch; F. Crispi; J. Miranda; E. Gratacós
• Keywords: Umbilical artery; Univariate analysis

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