Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Placental examination

prognosis after delivery of the growth-restricted fetus

Tachibana, Makiko; Nakayama, Masahiro; Miyoshi, Yoko

Current Opinion in Obstetrics and Gynecology: April 2016 - Volume 28 - Issue 2 - p 95–100
doi: 10.1097/GCO.0000000000000249
MATERNAL FETAL MEDICINE: Edited by James F. Smith Jr.
Buy

Purpose of review This article describes the role of placental examination in the prognostic evaluation of fetal growth restriction (FGR) infants.

Recent findings A new comprehensive placental classification system was reported. Maternal underperfusion, fetal thrombotic vasculopathy (FTV), villitis (including villitis of unknown etiology and infectious villitis), inflammation, and immature/dysmature villi are important factors affecting FGR prognosis, whereas genomic imprinting is a key factor affecting growth and diseases, as well as placental abnormality.

Summary We discuss the role of placental examination in determining FGR prognosis. Maternal underperfusion, fetal thrombotic vasculopathy, and villitis (including villitis of unknown etiology and infectious villitis) are the most important findings affecting FGR prognosis. Although limited, data have suggested an association of inflammation and immature/dysmature villi with postnatal growth in FGR infants. Placental size also contributes postnatally through fetal programming. In addition, placental imprinting can be a key of pre and postnatal growth and diseases, including imprinting disorders, as well as placental abnormalities such as placental mesenchymal dysplasia.

aDepartment of Pediatrics, Osaka University Graduate School of Medicine, Suita

bDepartment of Pathology and Laboratory Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan

Correspondence to Yoko Miyoshi, MD, PhD, Department of Pediatrics, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan. Tel: +81 6 6879 3932; fax: +81 6 6879 3939; e-mail: miyoshi@ped.med.osaka-u.ac.jp

Copyright © 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.