Iranian Journal of Pathology

The Histomorphological Spectrum of Placenta in Growth Restricted Fetuses in A Tertiary Care Centre in South India

Document Type : Original Research

Authors

Abinaya Sundari Amirthakatesan 1
Sharmila Devi Chandramohan 2
Uma Maheshwari Gurusamy 3

1 Department of Pathology, PSG IMSR, Coimbatore, India

2 Department of Professor, Pathology, Annapoorana medical college, Salem, India

3 Professor, Pathology, PSG IMSR, Coimbatore, India

https://doi.org/10.30699/ijp.2023.551426.2867
Abstract
Background & Objective: Fetal growth restriction (FGR) is one of the leading causes of perinatal morbidity and mortality. Our study aimed to analyze the gross and histopathological changes in the placentas of growth-restricted fetuses.
Methods: Placentas of fifty growth-restricted fetuses received in the Department of Pathology for 3 years were studied. Clinical data including ultra-sonographic findings were obtained. The received placentas were photographed and the details were documented in a prepared template. The relevant tissues were processed, analyzed, and correlated with the clinical findings.
Results: The study demonstrates distinctive gross and histological abnormalities in the placentas of growth-restricted fetuses. More than two-thirds of the placentas had shorter gestational age (preterm), seen as commonly associated with maternal co-morbidities such as oligohydramnios and pregnancy induced hypertension (PIH). The predominant gross lesions observed were the umbilical cord abnormalities, infarcts, and intervillous thrombus. Maternal vascular malperfusion (MVM) and fetal vascular malperfusion (FVM) were the two common histologic findings. Characteristic placental lesions with a significant risk of recurrence identified were distal villous immaturity (DVI), villitis of unknown etiology (VUE), and massive perivillous fibrin deposition (MPVFD). The unusual placental causes included  villous capillary lesions and histological chorioamnionitis.
Conclusion: Although a diverse etiology can cause FGR, the severity depends on the cumulative effects of multiple placental lesions. Hence, a meticulous placental examination is crucial for the effective management of growth-restricted fetuses in the current and subsequent pregnancies.

Keywords

Foetal Growth Restriction (FGR)
Placental examination
Foetal Vascular Malpersion (FVM)
Maternal Vascular Malperfusion ( MVM)
Distal Villous Immaturity ( DVI)

Subjects

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Iranian Journal of Pathology
Volume 18, Issue 1
Winter 2023
Pages 12-23

  • Receive Date 05 April 2022
  • Revise Date 21 June 2022
  • Accept Date 24 January 2023

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