Reduced placental villous tree elaboration in small-for-gestational-age pregnancies: Relationship with umbilical artery Doppler waveforms

Our purpose was to investigate the three-dimensional architecture of placental villi from normal and growth-restricted fetuses and relate findings to umbilical artery blood flow velocity waveforms. Placentas from term (n = 15) and preterm (n = 5) appropriately grown and term (n = 9) and preterm (n =...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 1995-02, Vol.172 (2), p.518-525
Main Authors: Jackson, Moira R., Walsh, Anne J., Morrow, Robert J., Muller, Brendan M., Lye, Stephen J., Ritchie, J.W.Knox
Format: Article
Language:English
Subjects:
Blood Flow Velocity
Chorionic Villi - anatomy & histology
Chorionic Villi - blood supply
Chorionic Villi - growth & development
Chorionic Villi - pathology
Female
Fetal Growth Retardation - pathology
Fetal Growth Retardation - physiopathology
Humans
Infant, Newborn
Infant, Premature
Infant, Small for Gestational Age
Placenta - anatomy & histology
Placenta - blood supply
Placenta - pathology
Pregnancy
Ultrasonography, Doppler
Ultrasonography, Prenatal
Umbilical Arteries - diagnostic imaging
Umbilical Arteries - physiology
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Summary:Our purpose was to investigate the three-dimensional architecture of placental villi from normal and growth-restricted fetuses and relate findings to umbilical artery blood flow velocity waveforms. Placentas from term (n = 15) and preterm (n = 5) appropriately grown and term (n = 9) and preterm (n = 7) growth-restricted fetuses (birth weight < 10th percentile) were examined to determine the number of arteries per stem villus and the three-dimensional configuration of the villous trees and their vessels. Umbilical blood flow before delivery was assessed by Doppler ultrasonography. The effects of age and growth restriction were determined by two-way analyses of variance. Growth restriction was associated with reduced large vessel wall thickness (p < or = 0.05) but no reduction in the number of these vessels per stem villus. The volumes and surface areas of intermediate and terminal villi were reduced (p < or = 0.001), especially in preterm growth-restricted cases, where a marked reduction in diastolic blood flow velocity was observed in the umbilical artery. Reduced villous development may contribute to abnormal umbilical artery blood flood flow, as assessed by Doppler ultrasonography, in some cases of intrauterine growth restriction.
ISSN:0002-9378
1097-6868
DOI:10.1016/0002-9378(95)90566-9