Área placentária em casos de morte perinatal

Abstract

The placental area (PA) mirror the endometrium covered by the placenta and the uteroplacental blood flow to the fetus. Recently, has been demonstrated that PA is an early and independent determinant of fetal growth and a marker of adverse reproductive outcome and of adult health conditions and chronic diseases (Barker’s hypothesis). There are few studies regarding PA in fetal diseases and none in perinatal deaths. Objective: To describe the PA distribution and abnormalities in perinatal deaths. Material and methods: Out from all perinatal deaths placentas examined between 2004 and 2014 at two Pathology Laboratories in Vitória City, Espírito Santo State, Brazil, we selected for the study 258 cases in which the gestational age (GA) was confirmed by ultrasound. The placental edge was outlined in a transparent plastic sheet and the PA measured by point counting planimetry, converted to z score (z/GA), classified as small (SGA, z/IG < -1,28), adequate (AGA), and large (LGA, z/IG > +1,28) for GA, and its occurrence calculated according to the socioeconomic status, the environment (fetal or neonatal) and the chronology of death. Results: The PA distribution in perinatal deaths showed a leftward deviance and large variation (z/GA -0,89 ± 1,81), a high proportion of SGA (46,5%), the expected proportion of LGA (12,8%), and not any significant variation according to socioeconomic status, environment or chronology of death. Conclusion: These results confirm that PA is a marker of adverse perinatal outcome, adducing evidence for its routine measurement and assessment in ultrasound and pathological examination.