Department of Obstetrics and Gynaecology, Riga Stradins University, Dzirciema Street 16, Riga 1013, Latvia.
Arch Gynecol Obstet. 2011 Nov;284(5):1087-93. doi: 10.1007/s00404-010-1781-x. Epub 2010 Dec 14.
The purpose of the study was to find an association between the uterine and umbilical arteries blood flow patterns in growth-restricted (FGR) and normal fetuses and placental microscopic lesions.
Fifty women with prenatally suspected and post-delivery confirmed FGR of singleton fetuses were enrolled in a case-controlled follow-up study from May 2007 to December 2008. Unselected patients with appropriately growing fetuses, matched for gestational age, served as controls. Uterine and umbilical Doppler waveforms were recorded before delivery.
Compared with control group with normal Doppler, FGR women with abnormal Doppler velocimetry of uterine and umbilical arteries had more intervillous thrombi (p = 0.01 and p < 0.0001, respectively) and villous infarctions (p = 0.02 and p = 0.0003, respectively). Thickening of the basal membrane and villitis was clearly linked to the FGR (p = 0.006 and p = 0.01). Vasculitis, on the other hand, is linked to normal growth, without affecting Doppler velocities.
Abnormal Doppler may predict hemorrhagic and ischemic placental lesions in FGR pregnancies and may lead to future improvement of the management of current and subsequent pregnancies.
本研究旨在探讨生长受限（FGR）和正常胎儿的子宫和脐带动脉血流模式与胎盘微观病变之间的关系。
本病例对照随访研究纳入了 2007 年 5 月至 2008 年 12 月期间产前疑似和产后确诊的 50 例单胎 FGR 孕妇。选择胎龄匹配的正常生长胎儿孕妇作为对照组。在分娩前记录子宫和脐带动脉多普勒血流波形。
与对照组正常多普勒血流相比，FGR 孕妇子宫和脐带动脉血流异常的孕妇中，绒毛间血栓更多（p = 0.01 和 p < 0.0001，分别），绒毛梗死更多（p = 0.02 和 p = 0.0003，分别）。基底膜增厚和绒毛膜炎与 FGR 明显相关（p = 0.006 和 p = 0.01）。另一方面，血管炎与正常生长有关，不影响多普勒血流速度。
异常的多普勒血流可能预测 FGR 妊娠中的出血性和缺血性胎盘病变，并可能导致当前和后续妊娠管理的未来改善。
