Placental aging, fetal prognosis and fetomaternal doppler indices

Objective: To investigate the possible effects of the morphological changes in the placenta on fetal prognosis and on umbilical artery and uterine art ery Doppler indices in late, low-risk pregnancies. Study design: Placental changes were evaluated ultrasonographically and pathologically in 224 pregn ant women after the 25th gestational week. The placental morphology were gr aded ultrasonographically into five subgroups according to increasing sever ity of the changes. Postnatally, the neonate was examined, Apgar scores, an d adverse events if any, were noted. Placentas with infarction, decidual ne crosis, ischemic villitis, chorioangioma, placenta previa or placental abru ption and high risk pregnancies were excluded. Results: There were 21, 38, 52, 56 and 57 cases in grades I, II, III, IV, and V respectively. Apgar sco res of the babies in all placental grades were similar (P>0.05). In all cas es, Doppler indices of both uterine and umbilical artery were within normal limits. No significant association between placental morphological charact eristics and Doppler indices of either uterine or umbilical arteries could be demonstrated. There was no correlation between Apgar scores and morpholo gical characteristics of the placenta or Doppler indices. Conclusions: Morp hological changes of placental aging are common and seem to have no effect on fetus and on Doppler flow of the umbilical and uterine arteries, provide d these are not high-risk pregnancies and placental changes are not infarct ion, villitis or severe structural or localization anomaly. (C) 1999 Elsevi er Science Ireland Ltd. All rights reserved.