Correlation of Umbilical Artery Doppler with placental Histomorphology in FGR
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 12
Abstract
Abstract: Doppler velocimetry (DV) is widely used to assess the vascular formation of the placenta in fetal growth restriction (FGR)and to estimate the haemodynamic condition of the growth-restricted fetus. Umbilical artery (UA) flow is essentially placental, rather than fetal. Hence, DV provides information about the fetal side of the placenta and, alongside placental histopathology; it could possibly help to decipher aetiopathogenesis in FGR cases. Objectives: To correlate UA DV findings occurring in FGR with placental findings.Methods- A total of 100 singleton FGR pregnancies (>28weeks) were included in the study.The placental lesions and neonatal outcomes were correlated with DV findings. We had 30 cases with normal UA Doppler velocimetry, 30 cases with low end diastolic flow (Increased S/D ratio or PI) and 40 cases of absent or reversed diastolic flow.Results- FGR pregnancies with AREDV had significantly lower mean birth weight i.e 1.14kg as compared with 1.59kg and 1.98kg in FGR with increased S/D or PI and normal UA Doppler velocimetry respectively. (P < 0.001).The placentas in AREDV weighed less, and had higher number of ischemic lesions. Among the lesions featuring under perfusion of placenta, 5 lesions i.e placental infarct( P<0.003), increased syncytial knots(p < 0.001) cytotrophoblastic proliferation, calcification and per villous fibrin deposition(p < 0.001) are present which are significantly higher in the abnormal Doppler group as compared with normal UA Doppler. Conclusion- There was a significantly higher number of maternal placental malperfusion lesions and poor perinatal outcome in SGA patients with abnormal UA Doppler velocimetry. Keywords:FGR, Umbilical artery Doppler, absent or reversed diastolic umbilical artery flow, placental insufficiency in FGR, placental histomorphology.
Authors and Affiliations
Manoj Kr. Mazumdar, Gokul Chandra Das, Shireen Mumtaz Barbhuiya, Manjula choudhury
Keywords
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