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

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 receiv...

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Autores principales: Sundari Amirthakatesan, Abinaya, Devi Chandramohan, Sharmila, Gurusamy, Uma maheshwari
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Iranian Society of Pathology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293607/
https://www.ncbi.nlm.nih.gov/pubmed/37383163
http://dx.doi.org/10.30699/IJP.2023.551426.2867
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author Sundari Amirthakatesan, Abinaya
Devi Chandramohan, Sharmila
Gurusamy, Uma maheshwari
author_facet Sundari Amirthakatesan, Abinaya
Devi Chandramohan, Sharmila
Gurusamy, Uma maheshwari
author_sort Sundari Amirthakatesan, Abinaya
collection PubMed
description 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.
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spelling pubmed-102936072023-06-28 The Histomorphological Spectrum of Placenta in Growth Restricted Fetuses in A Tertiary Care Centre in South India Sundari Amirthakatesan, Abinaya Devi Chandramohan, Sharmila Gurusamy, Uma maheshwari Iran J Pathol Original Article 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. Iranian Society of Pathology 2023 2023-03-22 /pmc/articles/PMC10293607/ /pubmed/37383163 http://dx.doi.org/10.30699/IJP.2023.551426.2867 Text en https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution- 4.0 International License (https://creativecommons.org/licenses/by/4.0/) which permits Share, copy and redistribution of the material in any medium or format or adapt, remix, transform, and build upon the material for any purpose, even commercially.
spellingShingle Original Article
Sundari Amirthakatesan, Abinaya
Devi Chandramohan, Sharmila
Gurusamy, Uma maheshwari
The Histomorphological Spectrum of Placenta in Growth Restricted Fetuses in A Tertiary Care Centre in South India
title The Histomorphological Spectrum of Placenta in Growth Restricted Fetuses in A Tertiary Care Centre in South India
title_full The Histomorphological Spectrum of Placenta in Growth Restricted Fetuses in A Tertiary Care Centre in South India
title_fullStr The Histomorphological Spectrum of Placenta in Growth Restricted Fetuses in A Tertiary Care Centre in South India
title_full_unstemmed The Histomorphological Spectrum of Placenta in Growth Restricted Fetuses in A Tertiary Care Centre in South India
title_short The Histomorphological Spectrum of Placenta in Growth Restricted Fetuses in A Tertiary Care Centre in South India
title_sort histomorphological spectrum of placenta in growth restricted fetuses in a tertiary care centre in south india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293607/
https://www.ncbi.nlm.nih.gov/pubmed/37383163
http://dx.doi.org/10.30699/IJP.2023.551426.2867
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