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. 2024 Jul-Aug;52(6):680-686.
doi: 10.1002/jcu.23686. Epub 2024 Apr 8.

Fetal hemodynamics and placental histopathology in Down syndrome

Luisa Guimarães Santos  1 , Renato Augusto Moreira de Sá  1   2 , Ana Elisa Rodrigues Baião  1 , Elyzabeth Avvad Portari  3 , Alexia de Avila Frayha  1 , Saint Clair Gomes Junior  4 , Edward Araujo Júnior  5   6
Affiliations

Fetal hemodynamics and placental histopathology in Down syndrome

Luisa Guimarães Santos et al. J Clin Ultrasound. 2024 Jul-Aug.

Abstract

Objective: To evaluate the association between Doppler patterns in fetuses with Down syndrome (DS) and their placental histopathologic findings.

Methods: A retrospective cross-sectional study was performed by collecting data from medical records of singleton pregnancies between January 2014 and January 2022, whose fetuses had a confirmed diagnosis of DS either prenatally or postnatally. Placental histopathology, maternal characteristics, and prenatal ultrasound (biometric parameters and umbilical artery [UA] Doppler) were evaluated.

Results: Of 69 eligible pregnant women, 61 met the inclusion and exclusion criteria. In the sample, 15 fetuses had an estimated fetal weight < 10th percentile for gestational age (GA) and were considered small for gestational age (SGA). Thirty-eight fetuses had increased resistance on the UA Doppler. Histologic changes were detected in 100% of the placentas, the most common being delayed villous maturation, alterations associated with poor fetal vascular perfusion, and villous dysmorphism. More than 50% of the placentas showed alterations related to placental insufficiency. We did not observe a statistically significant association between UA Doppler examination and placental alterations. All placentas analyzed in the SGA subgroup showed findings compatible with placental insufficiency.

Conclusion: We found no statistically significant association between placental histopathologic findings and UA Doppler abnormalities in fetuses with DS. The placental alterations identified were delayed villous maturation, alterations associated with poor fetal vascular perfusion, and villous dysmorphism.

Keywords: Doppler; Down syndrome; biometric parameters; histopathology; placenta; umbilical artery.

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References

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