Document Detail


Pathological assessment of intrauterine growth restriction.
MedLine Citation:
PMID:  19854107     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Intrauterine growth restriction (IUGR) is a major cause of foetal and neonatal morbidity and mortality. During post mortem, the pathologist is well placed to diagnose the presence and cause of IUGR in a stillborn baby. This article describes the approach of the pathologist in diagnosing IUGR and some of the pitfalls. We distinguish between reduced growth potential (formerly symmetrical IUGR) and nutritional IUGR (formerly asymmetrical IUGR). Aetiologically, restricted growth can be of foetal, maternal and placental origin. We discuss the importance of identifying the cause of IUGR in a clinicopathological context and the pathological findings in some of the more frequent causes of IUGR presenting at post mortem. Based on an accurate gestational age, ideally determined by the obstetrician in early pregnancy, the pathologist can derive a birth weight centile. However, the pathologist is also able to identify other indicators of IUGR, such as an elevated brain/liver weight ratio, atrophic thymus and changes in other internal organs. Placental examination plays a major role in the investigation as the majority of IUGR cases have significant placental pathology. This includes pre-eclampsia-related changes, abnormalities of the villous parenchyma and pathology of the umbilical cord. The potential benefit of a meticulous workup of IUGR foetuses is to provide an explanation of the pathological condition and to identify avoidable causes.
Authors:
Phillip Cox; Tamas Marton
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Publication Detail:
Type:  Journal Article     Date:  2009-10-23
Journal Detail:
Title:  Best practice & research. Clinical obstetrics & gynaecology     Volume:  23     ISSN:  1532-1932     ISO Abbreviation:  Best Pract Res Clin Obstet Gynaecol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101121582     Medline TA:  Best Pract Res Clin Obstet Gynaecol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  751-64     Citation Subset:  IM    
Affiliation:
Birmingham Women's Hospital NHS Foundation Trust, Metchley Park Road, Birmingham, B15 2TG, UK. Phillip.cox@bwhct.nhs.uk
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