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• W2021984925 abstract "ObjectiveThe aim of the Prospective Observational Trial to Optimize Pediatric Health in IUGR (PORTO) Study was to evaluate the optimal management of fetuses with EFW<10th centile. The objective of this analysis was to identify clinical and placental pathological features in fetuses with EFW<10th centile that distinguish those affected by adverse perinatal outcomes from unaffected fetuses.Study DesignThe multicenter PORTO Study recruited 1,200 pregnancies with EFW<10th and subjected them to intensive antenatal sonographic surveillance. Adverse perinatal outcome was defined as composite outcome of IVH, PVL, HIE, NEC, BPD, sepsis or death. Placentas from a single center were included to ensure uniform handling and reporting. Placental pathology was categorized into villous development abnormalities, maternal and fetal vascular pathologies and inflammatory lesions.ResultsOf the 260 placentas evaluated in this single center, 72% (n=187) of fetuses remained <10th centile until delivery. Infants with adverse outcome were delivered significantly earlier resulting in lower birthweights (p<0.0001). The earlier delivery was precipitated by the clinical severity of IUGR (p<0.0001). Placentas of infants with adverse outcome were smaller with increased placental/ birthweight ratio (p<0.001), both of which relate to earlier gestation at delivery. The occurrence of nucleated erythroblasts as a sign of intrauterine hypoxia was significantly more common in the adverse outcome group (p=0.0001). Other placental findings significantly associated with adverse outcome after multivariate analysis adjusting for gestational age at delivery were accelerated villous maturation, distal villous hypoplasia and increased syncytial knotting (Table 1).ConclusionTabled 1Clinical and placental pathological features in IUGR and adverse outcomesP-values: Fisher exact test for binary variables; Median two sample test for continuous variables.*Median and IQR are presented; # P-value<0.05 after adjusting for GA at delivery (logistic regression). Open table in a new tab ObjectiveThe aim of the Prospective Observational Trial to Optimize Pediatric Health in IUGR (PORTO) Study was to evaluate the optimal management of fetuses with EFW<10th centile. The objective of this analysis was to identify clinical and placental pathological features in fetuses with EFW<10th centile that distinguish those affected by adverse perinatal outcomes from unaffected fetuses. The aim of the Prospective Observational Trial to Optimize Pediatric Health in IUGR (PORTO) Study was to evaluate the optimal management of fetuses with EFW<10th centile. The objective of this analysis was to identify clinical and placental pathological features in fetuses with EFW<10th centile that distinguish those affected by adverse perinatal outcomes from unaffected fetuses. Study DesignThe multicenter PORTO Study recruited 1,200 pregnancies with EFW<10th and subjected them to intensive antenatal sonographic surveillance. Adverse perinatal outcome was defined as composite outcome of IVH, PVL, HIE, NEC, BPD, sepsis or death. Placentas from a single center were included to ensure uniform handling and reporting. Placental pathology was categorized into villous development abnormalities, maternal and fetal vascular pathologies and inflammatory lesions. The multicenter PORTO Study recruited 1,200 pregnancies with EFW<10th and subjected them to intensive antenatal sonographic surveillance. Adverse perinatal outcome was defined as composite outcome of IVH, PVL, HIE, NEC, BPD, sepsis or death. Placentas from a single center were included to ensure uniform handling and reporting. Placental pathology was categorized into villous development abnormalities, maternal and fetal vascular pathologies and inflammatory lesions. ResultsOf the 260 placentas evaluated in this single center, 72% (n=187) of fetuses remained <10th centile until delivery. Infants with adverse outcome were delivered significantly earlier resulting in lower birthweights (p<0.0001). The earlier delivery was precipitated by the clinical severity of IUGR (p<0.0001). Placentas of infants with adverse outcome were smaller with increased placental/ birthweight ratio (p<0.001), both of which relate to earlier gestation at delivery. The occurrence of nucleated erythroblasts as a sign of intrauterine hypoxia was significantly more common in the adverse outcome group (p=0.0001). Other placental findings significantly associated with adverse outcome after multivariate analysis adjusting for gestational age at delivery were accelerated villous maturation, distal villous hypoplasia and increased syncytial knotting (Table 1). Of the 260 placentas evaluated in this single center, 72% (n=187) of fetuses remained <10th centile until delivery. Infants with adverse outcome were delivered significantly earlier resulting in lower birthweights (p<0.0001). The earlier delivery was precipitated by the clinical severity of IUGR (p<0.0001). Placentas of infants with adverse outcome were smaller with increased placental/ birthweight ratio (p<0.001), both of which relate to earlier gestation at delivery. The occurrence of nucleated erythroblasts as a sign of intrauterine hypoxia was significantly more common in the adverse outcome group (p=0.0001). Other placental findings significantly associated with adverse outcome after multivariate analysis adjusting for gestational age at delivery were accelerated villous maturation, distal villous hypoplasia and increased syncytial knotting (Table 1). ConclusionTabled 1Clinical and placental pathological features in IUGR and adverse outcomesP-values: Fisher exact test for binary variables; Median two sample test for continuous variables.*Median and IQR are presented; # P-value<0.05 after adjusting for GA at delivery (logistic regression). Open table in a new tab P-values: Fisher exact test for binary variables; Median two sample test for continuous variables. *Median and IQR are presented; # P-value<0.05 after adjusting for GA at delivery (logistic regression)." @default.
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• W2021984925 title "100: Clinical significance of placental lesions in IUGR–results from a national prospective study" @default.
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