The Relationship of Intrauterine Growth Restriction with Placental Pathologic Changes in Newborns

2020 ◽  
Author(s):  
Hossein Dalili ◽  
Fatemeh Sadat Nayeri ◽  
Seyed Reza Mirjalili ◽  
Seyyed Nasrollah Hossein ◽  
Alireza Abdollahi ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Pathological Examination ◽  
Histological Changes ◽  
Intrauterine Growth ◽  
Study Population ◽  
The Mean ◽  
Relationship Of ◽  
The Relationship ◽  
Restriction Group

Introduction: Intrauterine growth restriction is a multifaceted problem and is associated with a significant increase in the level of morbidity and perinatal mortality. According to some studies, failure of the placenta is responsible for the most cases of intrauterine growth restriction. The aim of this study was to evaluate the placental pathologic changes in the intrauterine growth restriction (IUGR) samples and compare them with normal cases.   Methods: A study population consisted of 60 intrauterine growth restriction neonates and 60 normalized neonates born at Tehran Imam Khomeini Hospital between June 2016 and July 2017. The placenta was weighed, immediately after delivery, and the umbilical cord was separated, then stored in 10% formalin and sent for pathological examination as soon as possible. Data collection was performed according to the following items: the pathologist's report, the results of the infants' examination, and the data in the neonatal cases.   Results: The intrauterine growth restriction group showed a high frequency of placenta infarction (P < 0.001), inflammation of the villous (P < 0.001), villous fibrosis (P = 0.044), villous vascularization disorder (P = 0.001), prevalence of chorioamnionitis (P = 0.027), prevalence of Syncytiotrophoblastic knots (P < 0.001) and placental necrosis (P = 0.048) than normal group. However, the mean weight of the placenta (P < 0.001), the length and width of the macroscopic placenta changes was less (P < 0.001).   Conclusion: The results of the current study showed that a major part of the macroscopic and histological changes are detectable in the intrauterine growth restriction samples, which are considerably more common than normal, although they are not pathognomonic, but in the future, more accurate results can be obtained from more extensive studies.

Is ProBNP a New Marker for Predicting Intrauterine Growth Restriction?

2021 ◽  
Vol 225 (02) ◽  
pp. 125-128
Author(s):  
Hasan Eroğlu ◽  
Nazan Vanlı Tonyalı ◽  
Gokcen Orgul ◽  
Derya Biriken ◽  
Aykan Yucel ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Final Analysis ◽  
First Trimester ◽  
Maternal Serum ◽  
Growth Restriction ◽  
Control Group ◽  
Aneuploidy Screening ◽  
Intrauterine Growth ◽  
Potential Marker ◽  
The Mean

Abstract Purpose To evaluate the usability of first-trimester maternal serum ProBNP levels in the prediction of intrauterine growth restriction (IUGR). Methods In this prospective study, blood samples taken from 500 women who applied to our polyclinic for routine serum aneuploidy screening between the 11–14th gestational weeks were centrifuged. The obtained plasma samples were placed in Eppendorf tubes and stored at −80+°C. For the final analysis, first-trimester maternal serum ProBNP levels of 32 women diagnosed with postpartum IUGR and 32 healthy women randomly selected as the control group were compared. FGR was defined as estimated fetal weight below the 10th percentile for the gestational age. Results The mean ProBNP levels were statistically and significantly higher in the women with intrauterine growth restriction (113.73±94.69 vs. 58.33±47.70 pg/mL, p<0.01). At a cut-off level of 50.93, ProBNP accurately predicted occurrence of IUGR (AUC+= 0.794 (95% confidence interval 0.679–0.910), p+= 0.001) with sensitivity and specificity rates of 78.1 and 69.0%, respectively. Conclusion First-trimester serum ProBNP level was significantly higher in women who developed IUGR compared to healthy controls. First-trimester ProBNP level can be used as a potential marker to predict the development of IUGR in pregnant women.

Mean Platelet Volume is Affected in Term Fetuses with Intrauterine Growth Restriction

2020 ◽  
Author(s):  
Gul Nihal Buyuk ◽  
Z.Asli Oskovi-Kaplan ◽  
Aysegul Oksuzoglu ◽  
H.Levent Keskin
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Mean Platelet Volume ◽  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Control Group ◽  
Platelet Volume ◽  
Intrauterine Growth ◽  
Potential Marker ◽  
The Mean

Abstract Objectives The aim of our study was to analyze the mean platelet volume levels as a potential marker of altered placentation in intrauterine growth restriction (IUGR) cases. Methods A total of 126 term singleton pregnant women with IUGR fetuses and 345 healthy pregnant controls were recruited and compared. Results The mean platelet volume was significantly higher in the IUGR group (10.8±0.9 fl) than the control group (9.9±1.1 fl) (p=0.03). The mean hemoglobin was lower in IUGR group (11.3 (8.3–14.5) g/dl) than the control group (11.9 (8.2–13.0) g/dl) (p=0.04). The optimal cut-off MPV for prediction of IUGR was ≥10.55 fl, with a sensitivity of 59% and a specificity of 75%. Conclusion Increased MPV levels in term pregnant women may be particularly helpful for discrimination and prediction of high-risk fetuses when IUGR is suspected.

Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction

2019 ◽  
Vol 47 (8) ◽  
pp. 841-846 ◽  
Author(s):  
Murat Akbas ◽  
Faik M. Koyuncu ◽  
Burcu Artunç-Ulkumen
Keyword(s):  
Pregnant Women ◽  
Shear Wave ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcomes ◽  
Shear Wave Elastography ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
The Mean ◽  
Adverse Perinatal Outcomes ◽  
Doppler Indices

Abstract Background Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). Methods A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. Results The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. Conclusion The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods.

Weights of Fetal Membranes and Umbilical Cords: Correlation With Placental Pathology

2019 ◽  
Vol 23 (4) ◽  
pp. 249-252 ◽  
Author(s):  
Lucy X Ma ◽  
Daniel Levitan ◽  
Rebecca N Baergen
Keyword(s):  
Umbilical Cord ◽  
Intrauterine Growth Restriction ◽  
Maternal Diabetes ◽  
Growth Restriction ◽  
Placental Weight ◽  
Fetal Membranes ◽  
Fetal Demise ◽  
Intrauterine Growth ◽  
The Mean ◽  
Umbilical Cords

Introduction Proper placental gross examination requires weighing the placental disc trimmed of fetal membranes and the umbilical cord. However, untrimmed placental weights are often reported, both in cases submitted for consultation and in publications. Thus, determining the contribution of membranes and cords to untrimmed placental weights would be helpful in estimating the true trimmed weight of placentas. We sought to report the average weights of membranes and cord in term placentas and to correlate these weights with common placental pathologies. Methods A total of 500 consecutive placentas delivered between 36 and 42 weeks gestational age were subjected to a modified grossing protocol, in which the weight of the trimmed and untrimmed placentas, fetal membranes, and umbilical cords were recorded. Acute chorioamnionitis, meconium, maternal vascular malperfusion, and fetal vascular malperfusion were included as pathologic correlates. Clinical data such as the presence of fetal hydrops, intrauterine growth restriction, intrauterine fetal demise, and maternal diabetes were also recorded. Results The mean weights of the trimmed placenta, fetal membranes, and umbilical cords were 442 g (180–805 g), 47.2 g (16–108 g), and 37.9 g (9–126 g), respectively. The fetal membranes and umbilical cord weights contributed a mean of 16% to the total untrimmed placental weight. Meconium was associated with heavier fetal membranes. Fetal vascular malperfusion was associated with longer umbilical cord and thus also with heavier umbilical cords. Maternal vascular malperfusion and intrauterine growth restriction were associated with lighter placentas. Discussion The trimmed placental disc weight may be estimated by subtracting 16% (ie, weight of the fetal membranes and umbilical cord) from the untrimmed placental weight, or alternatively by subtracting the mean weight of the membranes and umbilical cord. It is important to consider the effects of meconium, fetal and maternal vascular malperfusion, and intrauterine growth restriction on membrane and cord weights when estimating the trimmed placental disc weight.

CORRELATION BETWEEN CEREBROPLACENTAL RATIO AND ADVERSE OUTCOMES IN INTRAUTERINE GROWTH RESTRICTION

2018 ◽  
Vol 8 (3) ◽  
pp. 82-89
Author(s):  
Tran Thao Nguyen Nguyen ◽  
Van Duc Vo ◽  
Ngoc Thanh Cao
Keyword(s):  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Adverse Outcomes ◽  
Growth Restriction ◽  
Fetal Weight ◽  
Intrauterine Growth ◽  
Cerebroplacental Ratio ◽  
Gestational Age At Delivery ◽  
The Mean ◽  
Estimated Fetal Weight

Objectives: To identify the values of CPR in intrauterine growth restriction and evaluate the correlation between cerebroplacental ratio and adverse outcomes in intrauterine growth restriction. Material and methods: A prospective study was conducted on 74 cases of intrauterine growth restriction with an estimated fetal weight less than 10th percentile, at Departement of Obstetric and Gynecology of Hue University of Medicine and Pharmacy from 05/2016 – 05/2017. CPR was calculated by PIMCA/PIUA.. The adverse outcomes included gestational age at delivery, methods used to delivery, APGAR score below 7 at 1 minutes and 5 minutes, admission at NICU, perinatal deaths, neonatals deaths. Results: The mean of CPR in group of early IUGR and late IUGR were 0.55 ± 0.14, 1.59 ± 0.69, respectively. The mean of CPR in group IUGR with an estimated fetal weight under the 3th percentile was 1.49 ± 0.76, lower than the mean of CPR in group IUGR with an estimated fetal weight from 3th percentile to 10th percentile. With cut – off at 1, CPR < 1 had the higher prevalence in group of early IUGR, in group IUGR with the estimated fetal weight below the 3th percentile, in group IUGR with hypoamniotic or oligohydramnios. The mean of gestational age at delivery of group IUGR with CPR < 1 and CPR >1 were 37.00 ± 3.18, and 38.59 ± 1.76, respectively. The rate of emergency cesarean section deliveries in the CPR < 1 and CPR > 1 group were 68.75% and 39.65%, respectively (p <0.05). Percentage of neonatal with APGAR ≤ 7 at 1 minute in the group with CPR < 1 and CPR > 1 were 56.25% and 22.41%, respectively. Rate of prenatal death was 12.5 in group IUGR with CPR < 1. Conclusion: There was a strong correlation between CPR and adverse outcomes in intrauterine growth restriction. Key words: intrauterine growth restriction, CPR ratio, middle cerebro artery, umbilical artery

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