Uterine doppler velocimetry predicts normotensive preeclampsia in pregnancies with fetal growth retrdation : evidencs from placental pathology and perinatal outcome

The hypothesis is that the typical presclamptic ischemic-haemerragic lesions of the placenta can be predicted by uterine Doppler veiocimatry in normotensive pregnancies with growth retarded fetuses. Study design: Detailed macroscopic and microscopic placental pathology was studied in 80 pregnancies with fetal growth retardation (FGR) and in 20 normal pregnancies. In 25 patients FGR was associated with pregnancy induced hypertension (PIH). Pregnancies with FGR were classified into four groups according to the presence of PIH and of abnormal Doppler velocimetry of the ascending uterine artery (Uter-DV) measured within 5 days from delivery, The frequency and the severity of lachemic-heamorragic lesions, fetal growth pattern, DV of the umbilical arteries and perinatal outcome were compared in these four groups and in the control group. Results: The frequency of infarctions and extensive histological ischemic damage of placental tissue was not significantly different between cases with FGR, PIH and abnormal Uter-DV (group 1) (100%) and cases with FGR and abnormal Uter-OV without PIH (group 2) (88%) (p<O.2). The frequency of these same lesions was significantly lower in cases with FGR but with normal Uter-DV (p<O,OOO7) and in cases with FGR, hypertension but normal Uter-DV (p<O.O(X)). Identical results were obse~ed for large infarctions, abruptio and the most severe ischemic damages.Umbilical S/D ratio (5.8 _+2.9 vs. 6.1 _+2.6), the prevalence of esymmatdcel growth (42 vs. 56%), gestational age (33 +4 vs. 31 +_3) and weight at birth (1297 t-644 vs. 1264 -+525) were not significantly different between group 1 and 2. These perinatal parameters were significantly better in pregnancies with FGR, with or without hypertension, but normal Uter-DV, than in groups 1 and 2. Conclusions: The frequency, severity and extension of typical presciamptic ischemic-haemorragio lesions of the placenta is not significantly different in hypertensive and normotensive patients with FGR and abnormal Doppler velocimetry of the ascending uterine arteries.