Placental morphometry and Doppler flow velocimetry in cases of chronic human fetal hypoxia.
OBJECTIVE
To investigate the structural basis of abnormal Doppler waveforms in the utero-placental circulations in cases of chronic fetal hypoxia.


METHODS
Morphometric analysis was performed on placental samples from 58 pregnancies with abnormal Doppler waveforms in the uterine, placental and umbilical circulations at 32-34 weeks, and 10 pregnancies with normal waveforms.


RESULTS
The volume of placental villi reduced from 350.5 cm3 in controls to 286.4 cm3 (P<0.05) in the severest cases. The volume of the fetal capillaries reduced from 59.7 cm3 to 20.5 cm3 (P<0.05). These reductions were associated with increased placental infarction. The myometrial segments of the spiral arteries were severely constricted, demonstrating failure of physiological conversion secondary to deficient trophoblast invasion.


CONCLUSIONS
The placental vascular bed is greatly reduced in cases of chronic fetal hypoxia. We propose impaired placental perfusion causes oxidative stress and regression of the fetal vasculature, leading to fetal growth retardation and distress.
Kuzmina
Irina Y
IY
Department of Obstetrics and Gynecology and Pathological Anatomy, Kharkhov State Medical University, St. Vesnina, 7-A, ap.13, Kharkov 61023, Ukraine. kuzmina@is.kh.ua
Hubina-Vakulik
Galina I
GI
Burton
Graham J
GJ
D001034:Apgar Score; D002196:Capillaries / Q000473:pathology; D002908:Chronic Disease; D005260:Female; D005316:Fetal Distress / Q000209:etiology; D005311:Fetal Hypoxia / Q000209:etiology / Q000473:pathology*; D005865:Gestational Age; D006801:Humans; D017078:Laser-Doppler Flowmetry; D009215:Myometrium / Q000098:blood supply / Q000473:pathology; D010920:Placenta / Q000098:blood supply* / Q000473:pathology*; D021041:Placental Circulation; D011247:Pregnancy; D014599:Uterus / Q000098:blood supply