Placental histological patterns and uterine artery Doppler velocimetry in pregnancies complicated by early or late pre‐eclampsia. (May 2016)

• Record Type: Journal Article
• Authors: Orabona, R.; Donzelli, C. M.; Falchetti, M.; Santoro, A.; Valcamonico, A.; Frusca, T.
• Is Part Of: Ultrasound in obstetrics & gynecology. Volume 47:Number 5(2016)
• Page Start: 580
• Page End: 585
• Publication Date: 2016-05
• Subjects: early pre‐eclampsia -- late pre‐eclampsia -- placental histology -- pre‐eclampsia -- uterine artery Doppler velocimetry; Ultrasonics in obstetrics -- Periodicals; Generative organs, Female -- Diseases -- Diagnosis -- Periodicals; Diagnosis, Ultrasonic -- Periodicals; Genital Diseases, Female -- ultrasonography -- Periodicals; Ultrasonography, Prenatal -- Periodicals; 618.047543
• DOI: 10.1002/uog.15799
• Languages: English
• ISSNs: 0960-7692

Abstract

Abstract : Linked Comment: Ultrasound Obstet Gynecol 2016; 47: 546–546 ABSTRACT: Objectives: To study placental patterns in pregnancies complicated by pre‐eclampsia (PE) and to verify whether the findings are related to gestational age (GA) at PE onset and second‐trimester uterine artery (UtA) Doppler. Methods: For all pre‐eclamptic women who delivered between January 2010 and December 2013, we collected retrospectively data related to placental findings and UtA Doppler velocimetry performed at PE onset. The study cohort was divided into groups according to early‐onset (EO) or late‐onset (LO) PE. Regression analysis was performed to test the ability of UtA Doppler velocimetry to predict subsequent development of placental lesions, after correcting for possible confounders. Results: Placental abnormalities occurred with a significantly lower incidence in the LO‐PE group ( n = 72) than in the EO‐PE group ( n = 105) ( P = 0.02). Irrespective of GA at PE onset, UtA pulsatility index (PI) was able to predict macroscopic infarctions ( P = 0.001), distal villous hypoplasia ( P = 0.03), decidual arteriolopathy ( P = 0.03), villous infarcts ( P < 0.001), syncytiotrophoblast 'knots' ( P = 0.02), microcalcifications ( P = 0.02), perivillous fibrin deposition ( P = 0.02) and placental hemorrhage ( P = 0.01). Conclusions: Similar placental abnormalities were present in both EO‐PE and LO‐PE groups, although with quantitative differences according to GA and UtA Doppler velocimetry at PE onset. Histological patterns were predicted by UtA‐PI, independently of GA, supporting the use of UtA Doppler velocimetry as the key criterion in PE classification. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.