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


METHODS
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.
Arsenio
A
Spinillo
Barbara
B
Gardella
Silvia
S
Bariselli
Alessandro
A
Alfei
Enrico Maria
EM
Silini
Barbara Dal
BD
Bello
D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000473:pathology* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D017078:Laser-Doppler Flowmetry; D008297:Male; D020768:Middle Cerebral Artery / Q000503:physiopathology; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D014469:Umbilical Arteries / Q000503:physiopathology