PLACENTAL BED LESIONS AND INFANT BIRTH-WEIGHT IN HYPERTENSIVE PREGNANT-WOMEN

Sixty pregnant women with systemic arterial hypertension, whose pregna ncies were interrupted by cesarean section at the Maternity Ward of Ho spital de Clinicas de Porto Alegre between May 1989 and October 1990, were examined. Specimens of the placental bed were collected by biopsy and the presence of acute atheromatosis and/or fibrinoid necrosis was investigated. The patients were divided into two groups according to the presence or absence of vascular lesions. The biopsy findings of th e placental bed were compared with adequate weight at birth related to gestational age, and to the following clinical parameters of the moth er: arterial blood pressure, serum creatinine, serum uric acid and pro teinuria. Twenty-seven (45%) patients presented vascular lesions in th e placental bed compatible with acute atheromatosis and/or fibrinoid n ecrosis. The presence of vascular changes in the placental bed correla ted significantly to diminished weight of the newborn, in terms of the mean weight and in terms of small-for-gestational-age infants, non-ne phrotic proteinuria (greater than or equal to 300 mg/24 h) and increas ed levels of uric acid (greater than or equal to 5.5 mg/dl).