Wiederholungsrisiko der Plazentainsuffizienz aus klinischer und morphologischer Sicht

Objective: We evaluated whether recurrence of intrauterine growth restriction (IUGR) in subsequent pregnancies can be predicted by histologic findings in the placenta. Methods: A total of 15,863 singleton deliveries were reviewed. A total of 32 cases of recurrent IUGR were identified. We reviewed the clinical data and the results of histomorphologic examination of the placentas in 61 mothers with 1 pregnancy complicated by IUGR, the 32 mothers with recurrent pregnancies complicated by IUGR, and 130 mothers with uncomplicated pregnancies. Maternal age > 35 years, coincidental social factors, and structural changes of the placental villi were analyzed as possible predictive factors. Results: Maternal age > 35 years, smoking, maternal diabetes or hypertension, and hypovascularization of the placenta (13% in the mothers with one pregnancy with IUGR, 28% in the mothers with recurrent IUGR and none in the control group) were risk factors for the recurrence of IUGR. Conclusion: Hypovascularization of the placental villi is an independent risk factor for recurrent IUGR in a subsequent pregnancy.