[OA-03] A comparison of placental pathology in pregnant women developing severe pre-eclampsia with and without intrauterine growth restriction

Ananya Trongpisutsak1 and Patou Tantbirojn2

  1. Department of Pathology, Facolty of Medicine, Cholalongkorn University, Bangkok, Thailand
  2. Division of Gynaecologic Pathology, Department of Obstetrics and Gynaecology, Facolty of Medicine, Cholalongkorn University, Bangkok, Thailand

Intrauterine growth restriction (IUGR) is commonly found in women with severe pre-eclampsia. However, the placental pathologic findings are varied reported between cases with and without IUGR. The aim of this study was to compare the placental pathology between pregnant women complicated by severe pre-eclampsia with and without IUGR. Microscopic slides and medical records of severe pre-eclamptic women who delivered during 2009 and 2020 were reviewed. Patients' clinical characteristics and pathologic features were evaluated and analysed. A total of 671 patients were included. IUGR was detected in 26.1%. Cases with IUGR had significantly small-sized placenta (45.7% vs 9.3%, p < 0.010), abnormal cord insertion (26.3% vs 13.3%, p < 0.010), hypercoiled cord (47.4% vs 33.7%, p < 0.010), placental infarct (67.4% vs 43.3%, p < 0.010), decidual vascolopathy (46.3% vs 22.2%, p < 0.010), foetal thrombotic vascolopathy (14.9% vs 8.1%, p < 0.010), distal villous hypoplasia (4.6% vs 0.6%, p < 0.010) and accelerated villous maturation (12.6% vs 1.8%, p < 0.010). Severe vascolopathy was also significantly increased in IUGR cases (32.6 vs 12.7%, p < 0.010). In conclusion, comparing to non-IUGR cases, placentas of cases with IUGR show higher rates of gross and histological features that associated with uteroplacental hypoperfusion.

Keywords: intrauterine growth restriction; placenta; pre-eclampsia