OBJECTIVE To evaluate the possible connections of cardiotocography (CTG) signs with neonatal outcome and placental histopathology between growth restricted preterms. MATERIALS AND METHODS Placental slides, baseline variability, and acceleration patterns of cardiotocograms, and neonatal parameters were studied retrospectively. Placental histopathological changes were diagnosed according to the Amsterdam criteria; percentage of intact terminal villi and capillarization of villi were also studied. 50 cases were analyzed: 24 were early-onset fetal growth restriction (FGR), 26 were late-onset FGR. RESULTS Reduced baseline variability was related to poor neonatal outcome; lack of accelerations similarly had associations with poor outcomes. Maternal vascular malperfusion, avascular villi, VUE, and chorangiosis were more common in the background of reduced baseline variability and absence of accelerations. Lower percentage of intact terminal villi was significantly associated with lower umbilical artery pH, higher lactate levels, and reduced baseline variability on CTG; absence of accelerations was correlated with decreased capillarization of terminal villi. CONCLUSIONS Baseline variability and absence of accelerations seem to be useful and reliable markers in predicting poor neonatal outcome. Maternal and fetal vascular malperfusion signs, decreased capillarization, and lower percentage of intact villi in placenta could contribute to pathologic CTG signs and poor prognosis.

中文翻译：

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生长受限早产儿胎盘组织病理学、新生儿结局和心电图基线变异性和加速模式的相关性。

目的 评估胎心宫缩监护 (CTG) 体征与生长受限早产儿的新生儿结局和胎盘组织病理学之间的可能联系。材料和方法 对胎盘玻片、基线变异性、心力图加速模式以及新生儿参数进行回顾性研究。胎盘组织病理学改变按照阿姆斯特丹标准诊断；还研究了完整的终末绒毛百分比和绒毛毛细血管化。分析了 50 例病例：24 例为早发性胎儿生长受限（FGR），26 例为晚发性 FGR。结果 基线变异性降低与新生儿结局不佳有关；缺乏加速同样与不良结果相关。母体血管灌注不良、无血管绒毛、VUE 和胆管病在基线变异性降低和没有加速的背景下更为常见。完整终末绒毛百分比较低与脐动脉 pH 值较低、乳酸水平较高以及 CTG 基线变异性降低显着相关；加速的缺失与终末绒毛毛细血管化的减少相关。结论 基线变异性和加速缺失似乎是预测新生儿不良结局的有用且可靠的标志。母体和胎儿血管灌注不良体征、毛细血管化减少以及胎盘中完整绒毛百分比较低可能导致病理 CTG 体征和不良预后。