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Cerebroplacental Doppler ratio and placental histopathological features in pregnancies complicated by fetal growth restriction

  • Arsenio Spinillo EMAIL logo , Barbara Gardella , Silvia Bariselli , Alessandro Alfei , Enrico Maria Silini and Barbara Dal Bello
Published/Copyright: November 12, 2013

Abstract

Objective: To correlate placental pathologic lesions, as defined by the Society for Pediatric Pathology, to the severity of the ratio of the pulsatility Doppler index (PI) of the fetal middle cerebral artery to that of the umbilical artery (cerebroplacental ratio, CPR).

Study design: A cohort-study of 176 singleton pregnancies complicated by fetal growth restriction (FGR).

Results: The mean values of gestational age, birth weight and CPR of the entire cohort were 33.9±3.6 weeks, 1552±561 g, and 1.33±0.68, respectively. In ordered logistic regression analysis, after adjustment for potential confounders, muscularised arteries (Odds Ratio [OR]=3.14; 95% confidence intervals [CI]=1.58–6.28, P=0.001), mural hypertrophy (OR=2.35; 95% CI=1.26–4.4, P=0.008), immature intermediate trophoblast (OR=2.0; 95% CI=1.07–3.71, P=0.03) and maternal vascular underperfusion (OR=2.32; 95% CI=1.25–4.23, P=0.007) were the only parameters associated with severity of CPR.

Conclusions: The correlation between placental histological findings indicating maternal underperfusion and placental occlusion suggest that forced centralization of fetal circulation in FGR could be at least partially attributable to the hemodynamic consequences of increased placental vascular resistance.


Corresponding author: Arsenio Spinillo, Department of Obstetrics and Gynecology, University of Pavia, IRCCS Policlinico San Matteo, Viale Golgi, 19, Pavia, Italy, Tel.: +39 382 526215, Fax: +39 382 423233, E-mail:

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-6-6
Accepted: 2013-10-9
Published Online: 2013-11-12
Published in Print: 2014-5-1

©2014 by Walter de Gruyter Berlin Boston

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