Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction

Med Princ Pract. 2019;28(2):101-108. doi: 10.1159/000497240. Epub 2019 Jan 27.

Abstract

Objective: To investigate the placental and umbilical cord histopathology in intrauterine growth restriction (IUGR) and their relation to second-trimester maternal hematological parameters.

Materials and methods: Patients were selected for the IUGR group based on estimated fetal weight below the 10th percentile. Patients were recruited into the control group randomly. Patients were followed up with ultrasound, and blood samples were taken between the 20th and 24th gestational weeks. After delivery and formalin fixation, weight and volume of the placenta were recorded and histologic samples were processed.

Results: Maternal platelet count strongly correlates with placental weight (r = 0.766). On the other hand, neonatal weight correlates with placental volume (r = 0.572) rather than with placental weight (r = 0.469). Umbilical arterial lumen cross-sectional area correlates with birth weight (r = 0.338).

Conclusions: Maternal hematological parameters do not seem to affect neonatal outcome. Our main findings are the correlation of maternal platelet count with placental weight, the correlation of placental volume with birth weight being stronger than the correlation of placental weight with birth weight, and the correlation of umbilical artery lumen cross-sectional area with neonatal weight. Mild histopathologic alterations might occur in normal pregnancies; however, sufficient fetal nutrition can be maintained. This compensatory function of the placenta seems to be insufficient when two or more pathologies are present, which is characteristic for IUGR.

Keywords: Intrauterine growth restriction; Placental histopathology; Placental morphology; Two-dimensional Doppler ultrasound; Umbilical arteries.

MeSH terms

  • Adult
  • Case-Control Studies
  • Female
  • Fetal Growth Retardation / diagnostic imaging
  • Fetal Growth Retardation / physiopathology*
  • Fetus / blood supply
  • Humans
  • Placenta / blood supply
  • Placenta / physiopathology*
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimester, Second
  • Prospective Studies
  • Ultrasonography, Prenatal
  • Umbilical Arteries / diagnostic imaging
  • Umbilical Arteries / physiopathology*
  • Umbilical Cord / diagnostic imaging
  • Umbilical Cord / growth & development*
  • Umbilical Cord / physiopathology*
  • Young Adult