title: Placental lakes, absent umbilical artery diastolic flow and poor fetal growth in early pregnancy.
abstract: Uteroplacental insufficiency is a common cause of intrauterine growth retardation in the third trimester of pregnancy. We report a case in which placental vascular lesions, absent end-diastolic frequencies in the umbilical artery and high maternal serum levels of alpha-fetoprotein and human chorionic gonadotropin were observed from the beginning of the second trimester in a patient with a history of recurrent first- and second-trimester miscarriages. Fetal growth started to slow down from 14 weeks of gestation and no end-diastolic phase was found in the umbilical artery until 18 weeks of gestation, when the pregnancy was terminated. In apparently healthy women with or without a history of fetal death during the first half of pregnancy, the discovery of placental vascular lesions together with a high resistance to blood flow in the umbilical circulation should prompt early antepartum surveillance.
authors.affiliation: Harris Birthright Centre for Fetal Medicine, King's College School of Medicine and Dentistry, University of London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Jauniaux
authors.forename: K H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D005313:Fetal Death / Q000000981:diagnostic imaging / Q000503:physiopathology; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D006801:Humans; D021041:Placental Circulation; D010927:Placental Insufficiency / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000502:physiology*