Write your message
Volume 7, Issue 3 (May - June 2022)                   J Obstet Gynecol Cancer Res 2022, 7(3): 177-185 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Mansour Ghanaei M, Amir Afzali S, Morady A, Mansour Ghanaie R, Asghari Ghalebin S M, Rafiei E et al . Intrauterine Growth Restriction with and without Pre-Eclampsia: Pregnancy Outcome and Placental Findings. J Obstet Gynecol Cancer Res. 2022; 7 (3) :177-185
URL: http://jogcr.com/article-1-459-en.html
1- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Alzahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
2- Lahijan Milad Hospital, Lahijan, Guilan, Iran
3- Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4- Guilan University of Medical Sciences, Rasht, Iran
5- Razi Clinical Research Development Unit, Guilan University of Medical Science, Rasht, Iran
6- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Alzahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran , royakabodmehri@yahoo.com
Abstract:   (692 Views)

Background & Objective: Accordingly, this study aimed to assess pregnancy outcomes and pathological findings of the placenta caused by intrauterine growth restriction (IUGR) with or without pre-eclampsia (PE).
Materials & Methods: This cohort study was conducted on two groups: Group I was PE-induced IUGR (PE-IUGR), and group II was idiopathic IUGR (I-IUGR). Pregnancy and neonatal outcomes were evaluated in both groups. The placental assessment was also performed based on pathological findings. Data were compiled and analyzed by SPSS 21. An analytical study was conducted on the groups based on t (or non-parametric Mann-Whitney), chi-square, and Fisher’s exact tests.
Results: The findings of this study showed that maternal age, body mass index (BMI), the incidence of preterm delivery, and low birth weight were higher in the PE-IUGR group (P<0.001 in all) than in the I-IUGR group, and the difference was statistically significant. Additionally, circulatory disorders and impaired anomalies were higher in the PE-IUGR group (P>0.001) than in the I-IUGR group.
Conclusion: Placental disorders and reduced blood flow to the fetus due to placental disorders might lead to low birth weight and preterm delivery.

Full-Text [PDF 337 kb]   (303 Downloads) |   |   Full-Text (HTML)  (407 Views)  
Systematic Review: Original Research | Subject: Obstetrics and Gynecology
Received: 2021/07/28 | Accepted: 2021/08/21 | Published: 2022/01/12

1. Burton GJ, Yung HW, Cindrova-Davies T, Charnock-Jones DS. Placental endoplasmic reticulum stress and oxidative stress in the pathophysiology of unexplained intrauterine growth restriction and early onset preeclampsia. Placenta. 2009;30 Suppl A:S43-8. [DOI:10.1016/j.placenta.2008.11.003] [PMID] [PMCID]
2. Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A, Network VO. Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction. Am J Obstet Gynecol. 2000;182(1):198-206. [DOI:10.1016/S0002-9378(00)70513-8]
3. Barros FC, Barros AJ, Villar J, Matijasevich A, Domingues MR, Victora CG. How many low birthweight babies in low-and middle-income countries are preterm? Revista de Saúde Pública. 2011;45(3):607-16. [DOI:10.1590/S0034-89102011005000019] [PMID]
4. A E-BM, TS E-D, AM E-N. Environmental factors and apoptotic indices in patients with intrauterine growth retardation: a nested case-control study. Environ Toxicol Pharmacol. 2015 39(2):589-96. [DOI:10.1016/j.etap.2015.01.009] [PMID]
5. Kaufmann P, Black S, Huppertz B. Endovascular trophoblast invasion: implications for the pathogenesis of intrauterine growth retardation and preeclampsia. Biol Reprod. 2003;69(1):1-7. [DOI:10.1095/biolreprod.102.014977] [PMID]
6. Srinivas SK, Edlow AG, Neff PM, Sammel MD, Andrela CM, Elovitz MA. Rethinking IUGR in preeclampsia: dependent or independent of maternal hypertension? J Perinatol. 2009;29(10):680-4. [DOI:10.1038/jp.2009.83] [PMID] [PMCID]
7. Amaral LM, Wallace K, Owens M, LaMarca B. Pathophysiology and Current Clinical Management of Preeclampsia. Curr Hypertens Rep. 2017;19(8):61. [DOI:10.1007/s11906-017-0757-7] [PMID] [PMCID]
8. Ness RB, Sibai BM. Shared and disparate components of the pathophysiologies of fetal growth restriction and preeclampsia. Am J Obstet Gynecol. 2006;195(1):40-9. [DOI:10.1016/j.ajog.2005.07.049] [PMID]
9. Shear RM, Rinfret D, Leduc L. Should we offer expectant management in cases of severe preterm preeclampsia with fetal growth restriction? Am J Obstet Gynecol. 2005;192(4):1119-25. [DOI:10.1016/j.ajog.2004.10.621] [PMID]
10. Huppertz B. Placental origins of preeclampsia: challenging the current hypothesis. Hypertension. 2008;51(4):970-5. [DOI:10.1161/HYPERTENSIONAHA.107.107607] [PMID]
11. Cunningham FG JLk, Bloom SL, Dashe JS, Hoffman BL. Fetal-Growth Disorders. Williams Obstetrics. 25 th ed. New York: Mc Graw Hill; 2018. p. 844-62.
12. Moldenhauer JS, Stanek J, Warshak C, Khoury J, Sibai B. The frequency and severity of placental findings in women with preeclampsia are gestational age dependent. Am J Obstet Gynecol. 2003;189(4):1173-7. [DOI:10.1067/S0002-9378(03)00576-3]
13. Brosens I, Pijnenborg R, Vercruysse L, Romero R. The "Great Obstetrical Syndromes" are associated with disorders of deep placentation. Am J Obstet Gynecol. 2011;204(3):193-201. [DOI:10.1016/j.ajog.2010.08.009] [PMID] [PMCID]
14. Kovo M, Schreiber L, Bar J. Placental vascular pathology as a mechanism of disease in pregnancy complications. Thrombosis Res. 2013;131:S18-S21. [DOI:10.1016/S0049-3848(13)70013-6]
15. Mukherjee A, Chan AD, Keating S, Redline RW, Fritsch MK, Machin GA, et al. The placental distal villous hypoplasia pattern: interobserver agreement and automated fractal dimension as an objective metric. Pediatr Dev Pathol. 2016;19(1):31-6. [DOI:10.2350/15-03-1619-OA.1] [PMID]
16. Eger SHW, Sommerfelt K, Kiserud T, Markestad T. Foetal umbilical artery Doppler in small preterms:(IQ) Neurocognitive outcome at 5 years of age. Acta paediatrica. 2013;102(4):403-9. [DOI:10.1111/apa.12164] [PMID]
17. von Dadelszen P, Magee LA, Roberts JM. Subclassification of preeclampsia. Hypertens Pregnancy. 2003;22(2):143-8. [DOI:10.1081/PRG-120021060] [PMID]
18. Motawea HK, Chotani MA, Ali M, Ackerman W, Zhao G, Ahmed AA, et al. Human Placenta Expresses α2-Adrenergic Receptors and May Be Implicated in Pathogenesis of Preeclampsia and Fetal Growth Restriction. Am J Pathol. 2018;188(12):2774-85. [DOI:10.1016/j.ajpath.2018.08.011] [PMID] [PMCID]
19. Ramkumar J, Sagayaraj BM, Sharma N. Vascular Endothelial Growth Factor Study of Placenta in Preeclampsia. Cardiol Angiol. 2018:1-9. [DOI:10.9734/CA/2018/43655]
20. Askar E, Selim S, Sibai H. Histological changes of human placenta in early intrauterine growth restriction with and without preeclampsia. Journal of Medical Histology. 2019;3(1):65-76. [DOI:10.21608/jmh.2019.12648.1056]
21. Melchiorre K, Wormald B, Leslie K, Bhide A, Thilaganathan B. First-trimester uterine artery Doppler indices in term and preterm pre-eclampsia. Ultrasound Obstet Gynecol. 2008;32(2):133-7. [DOI:10.1002/uog.5400] [PMID]
22. Surico D, Bordino V, Cantaluppi V, Mary D, Gentilli S, Oldani A, et al. Preeclampsia and intrauterine growth restriction: Role of human umbilical cord mesenchymal stem cells-trophoblast cross-talk. PLoS One. 2019;14(6):e0218437. [DOI:10.1371/journal.pone.0218437] [PMID] [PMCID]
23. Awamleh Z, Gloor GB, Han VKM. Placental microRNAs in pregnancies with early onset intrauterine growth restriction and preeclampsia: potential impact on gene expression and pathophysiology. BMC Med Genomics. 2019;12(1):91. [DOI:10.1186/s12920-019-0548-x] [PMID] [PMCID]
24. Kovo M, Schreiber L, Elyashiv O, Ben-Haroush A, Abraham G, Bar J. Pregnancy outcome and placental findings in pregnancies complicated by fetal growth restriction with and without preeclampsia. Reprod Sci. 2015;22(3):316-21. [DOI:10.1177/1933719114542024] [PMID]
25. Chammas MF, Nguyen TM, Li MA, Nuwayhid BS, Castro LC. Expectant management of severe preterm preeclampsia: is intrauterine growth restriction an indication for immediate delivery? Am J Obstet Gynecol. 2000;183(4):853-8. [DOI:10.1067/mob.2000.109049] [PMID]
26. Witlin AG, Saade GR, Mattar F, Sibai BM. Predictors of neonatal outcome in women with severe preeclampsia or eclampsia between 24 and 33 weeks' gestation. Am J Obstet Gynecol. 2000;182(3):607-11. [DOI:10.1067/mob.2000.104224] [PMID]
27. Gerretsen G, Huisjes H, Elema J. Morphological changes of the spiral arteries in the placentae bed in relation to pre‐eclampsia and fetal growth retardation. BJOG: An International Journal of Obstetrics & Gynaecology. 1981;88(9):876-81. [DOI:10.1111/j.1471-0528.1981.tb02222.x] [PMID]
28. Benton SJ, McCowan LM, Heazell AE, Grynspan D, Hutcheon JA, Senger C, et al. Placental growth factor as a marker of fetal growth restriction caused by placental dysfunction. Placenta. 2016;42:1-8. [DOI:10.1016/j.placenta.2016.03.010] [PMID]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License Journal of Obstetrics, Gynecology and Cancer Research by Farname Inc is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Based on a work at http://jogcr.com/.

© 2022 CC BY-NC 4.0 | Journal of Obstetrics, Gynecology and Cancer Research (JOGCR)

Designed & Developed by : Yektaweb | Piblisher: Farname Inc.