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. | ||
#* | #*Head in proportion to body. | ||
#Asymmetric IUGR. | #Asymmetric IUGR. | ||
#* | #*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]
- Symmetric IUGR.
- Head in proportion to body.
- 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]
- Chorangiosis ~ 39%.
- Ischemia ~ 18%.
- Villitis of unknown etiology ~ 13%.
- Fetal thrombotic vasculopathy ~ 8%.
IUGR not otherwise specified
Features:[2]
- Low mass placenta.
- Perivillous fibrin deposition.
- Placental infarction.
- Increased syncytial knots.
- Distal villous hypoplasia.[3]
Idiopathic IUGR
Not associated with placental abnormalities.[4]
See also
References
- ↑ 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.
- ↑ Mardi, K.; Sharma, J. (Oct 2003). "Histopathological evaluation of placentas in IUGR pregnancies.". Indian J Pathol Microbiol 46 (4): 551-4. PMID 15025340.
- ↑ URL: http://www.diagnostichistopathology.co.uk/article/S1756-2317(12)00039-4/abstract. Accessed on: 17 October 2013.
- ↑ 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.