The following is a summary of “Placental differences between severe fetal growth restriction and hypertensive disorders of pregnancy requiring early preterm delivery: Morphometric analysis of the villous tree supported by artificial intelligence,” published in the February 2024 issue of Obstetrics and Gynecology by Jacobs et al.
Fetal growth restriction and hypertensive disorders of pregnancy, individually or combined, are significant obstetrical syndromes with overlapping placental pathologies. Despite similarities, distinct differences in placental villous structures may reveal unique developmental pathways.
This retrospective cohort study aimed to assess differences in placental villi and vessels among severe, early-onset fetal growth restriction, hypertensive disorders of pregnancy, and their combination necessitating early preterm delivery. The study group hypothesized divergent placental morphogenesis trajectories after defective placentation, with specific effects on villi in hypertensive disorders and both villous and vascular structures in severe fetal growth restriction.
Paraffin-embedded placental tissues from four groups were analyzed using immunohistochemistry and artificial intelligence-driven morphometric analyses. Quantitative assessments of villi and vessels were performed, and linear regression models were applied for statistical analyses.
Hypertensive disorders were associated with decreased stem villi, smaller stem villous area, and fewer stem villous vessels, while severe growth restriction primarily affected terminal villi, showing reductions in number, area, vessels, and vascular area. The combination of both conditions did not exacerbate these effects.
Distinct placental abnormalities characterize hypertensive disorders and severe fetal growth restriction, suggesting different pathophysiological pathways. These findings may inform preventive or therapeutic strategies by elucidating mechanisms underlying divergent placental development following defective placentation.
Source: sciencedirect.com/science/article/abs/pii/S0002937824003703
