CORRELATION OF DOPPLER AND PLACENTAL IMMUNOHISTOCHEMICAL FEATURES IN NORMAL AND INTRAUTERINE GROWTH-RETARDED FETUSES

The aim of this study was to correlate and compare Doppler and anatomi cal placental findings obtained from 48 normal and 35 intrauterine gro wth-retarded (IUGR) fetuses. The IUGR group consisted of 19 fetuses fr om pregnancies complicated by pre-eclampsia and 16 from healthy mother s. Color Doppler evaluation of umbilical, spiral and uterine arteries was performed Placental specimens from both normal and growth-retarded fetuses were obtained at the time of delivery. Placental specimens we re evaluated using histochemical and immunohistochemical techniques. A progressive decrease in the pulsatility index was observed in umbilic al, spiral and uterine arteries throughout pregnancy in the normal-gro wth fetuses. High umbilical artery pulsatility index values were obtai ned in 29 out of the 35 growth-retarded fetuses, six of them showing a bsent or reversed end-diastolic umbilical artery flow pattern. A total of 13 IUGR fetuses showed high resistance uterine artery flow velocit y waveforms. Increased pulsatility index values were obtained from the spiral arteries of 16 growth-retarded fetuses. Abnormal histological and histochemical placental patterns were observed in all the growth-r etarded fetuses with umbilical artery Doppler abnormalities. The prese nce of a peculiar dendritic cell subpopulation, strongly resembling th e Langerhans cells, expressing the HLA-DR+/CD1+ phenotype, was detecte d in all growth-retarded fetuses, whether there was maternal pathology or not. Our data show uterine and spiral artery data as being ineffec tive in the monitoring of IUGR fetuses. The placental extracellular ma trix seems to play an important role in the regulation of the umbilica l circulation. The presence of CD1+ cells as a sign of a possible immu nological mechanism in the pathogenesis of the intrauterine growth ret ardation is discussed.