Difference between revisions of "Intrauterine growth restriction"

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'''Intrauterine growth restriction''', abbreviated '''IUGR''', is a common problem in obstetrics characterized by a small fetus.  ''IUGR'' often shows up on requisitions for [[placenta]]s.
'''Intrauterine growth restriction''', abbreviated '''IUGR''', is a common problem in obstetrics characterized by a small fetus.  ''IUGR'' often shows up on requisitions for [[placenta]]s.


Generally, it is subdivided into:
==Classification==
Generally, it is subdivided into:<ref name=pmid18641412>{{Cite journal  | last1 = Roberts | first1 = DJ. | last2 = Post | first2 = MD. | title = The placenta in pre-eclampsia and intrauterine growth restriction. | journal = J Clin Pathol | volume = 61 | issue = 12 | pages = 1254-60 | month = Dec | year = 2008 | doi = 10.1136/jcp.2008.055236 | PMID = 18641412 }}
</ref>
#Symmetric IUGR.
#Symmetric IUGR.
#*Not associated with placental abnormalities.
#*Head in proportion to body.
#Asymmetric IUGR.
#Asymmetric IUGR.
#*Associated with placental abnormalities.
#*Head large in proportion to body - due to decreased abdominal growth.


==IUGR not otherwise specified==
===Symmetric IUGR===
Features:<ref name=pmid18641412/>
*Not associated with placental abnormalities - other than small mass.
*Early event, i.e. early in gestation.
 
Etiology:
*Chromosomal anomalies, others.
 
===Asymmetric IUGR===
Features:<ref name=pmid18641412/>
*Often associated with placental abnormalities.
 
Etiology:
*Usu. abnormal vascular development of the placenta resulting in ischemia.
 
==Various papers on IUGR and placental pathology==
===Histopathology/frequency in IUGR===
Finding/frequency:<ref name=pmid18641412/>
*[[Chorangiosis]] ~ 39%.
*Ischemia ~ 18%.
*[[Villitis of unknown etiology]] ~ 13%.
*[[Fetal thrombotic vasculopathy]] ~ 8%.
 
===IUGR not otherwise specified===
Features:<ref name=pmid15025340>{{Cite journal  | last1 = Mardi | first1 = K. | last2 = Sharma | first2 = J. | title = Histopathological evaluation of placentas in IUGR pregnancies. | journal = Indian J Pathol Microbiol | volume = 46 | issue = 4 | pages = 551-4 | month = Oct | year = 2003 | doi =  | PMID = 15025340 }}</ref>
Features:<ref name=pmid15025340>{{Cite journal  | last1 = Mardi | first1 = K. | last2 = Sharma | first2 = J. | title = Histopathological evaluation of placentas in IUGR pregnancies. | journal = Indian J Pathol Microbiol | volume = 46 | issue = 4 | pages = 551-4 | month = Oct | year = 2003 | doi =  | PMID = 15025340 }}</ref>
*Low mass placenta.
*[[Placental growth restriction|Low mass placenta]].
*[[Perivillous fibrin deposition]].
*[[Perivillous fibrin deposition]].
*Placental infarction.
*[[Placental infarction]].
*Increased syncytial knots.
*Increased syncytial knots.
*Distal [[villous hypoplasia]].<ref>URL: [http://www.diagnostichistopathology.co.uk/article/S1756-2317(12)00039-4/abstract http://www.diagnostichistopathology.co.uk/article/S1756-2317(12)00039-4/abstract]. Accessed on: 17 October 2013.</ref>


==Idiopathic IUGR==
===Idiopathic IUGR===
Not associated with placental abnormalities.<ref name=pmid>{{Cite journal  | last1 = Tomas | first1 = SZ. | last2 = Roje | first2 = D. | last3 = Prusac | first3 = IK. | last4 = Tadin | first4 = I. | last5 = Capkun | first5 = V. | title = Morphological characteristics of placentas associated with idiopathic intrauterine growth retardation: a clinicopathologic study. | journal = Eur J Obstet Gynecol Reprod Biol | volume = 152 | issue = 1 | pages = 39-43 | month = Sep | year = 2010 | doi = 10.1016/j.ejogrb.2010.05.006 | PMID = 20627398 }}</ref>
Not associated with placental abnormalities.<ref name=pmid>{{Cite journal  | last1 = Tomas | first1 = SZ. | last2 = Roje | first2 = D. | last3 = Prusac | first3 = IK. | last4 = Tadin | first4 = I. | last5 = Capkun | first5 = V. | title = Morphological characteristics of placentas associated with idiopathic intrauterine growth retardation: a clinicopathologic study. | journal = Eur J Obstet Gynecol Reprod Biol | volume = 152 | issue = 1 | pages = 39-43 | month = Sep | year = 2010 | doi = 10.1016/j.ejogrb.2010.05.006 | PMID = 20627398 }}</ref>



Latest revision as of 19:00, 17 October 2013

Intrauterine growth restriction, abbreviated IUGR, is a common problem in obstetrics characterized by a small fetus. IUGR often shows up on requisitions for placentas.

Classification

Generally, it is subdivided into:[1]

  1. Symmetric IUGR.
    • Head in proportion to body.
  2. Asymmetric IUGR.
    • Head large in proportion to body - due to decreased abdominal growth.

Symmetric IUGR

Features:[1]

  • Not associated with placental abnormalities - other than small mass.
  • Early event, i.e. early in gestation.

Etiology:

  • Chromosomal anomalies, others.

Asymmetric IUGR

Features:[1]

  • Often associated with placental abnormalities.

Etiology:

  • Usu. abnormal vascular development of the placenta resulting in ischemia.

Various papers on IUGR and placental pathology

Histopathology/frequency in IUGR

Finding/frequency:[1]

IUGR not otherwise specified

Features:[2]

Idiopathic IUGR

Not associated with placental abnormalities.[4]

See also

References

  1. 1.0 1.1 1.2 1.3 Roberts, DJ.; Post, MD. (Dec 2008). "The placenta in pre-eclampsia and intrauterine growth restriction.". J Clin Pathol 61 (12): 1254-60. doi:10.1136/jcp.2008.055236. PMID 18641412.
  2. Mardi, K.; Sharma, J. (Oct 2003). "Histopathological evaluation of placentas in IUGR pregnancies.". Indian J Pathol Microbiol 46 (4): 551-4. PMID 15025340.
  3. URL: http://www.diagnostichistopathology.co.uk/article/S1756-2317(12)00039-4/abstract. Accessed on: 17 October 2013.
  4. Tomas, SZ.; Roje, D.; Prusac, IK.; Tadin, I.; Capkun, V. (Sep 2010). "Morphological characteristics of placentas associated with idiopathic intrauterine growth retardation: a clinicopathologic study.". Eur J Obstet Gynecol Reprod Biol 152 (1): 39-43. doi:10.1016/j.ejogrb.2010.05.006. PMID 20627398.