OBJECTIVE We evaluated placental alterations in different subtypes of fetal growth restriction (FGR) to determine any clinical associations. METHODS FGR placentas classified according to the Amsterdam criteria were correlated with clinical findings. Percentage of intact terminal villi and villous capillarization ratio were calculated in each specimen. Correlations of placental histopathology and perinatal outcomes were studied. 61 FGR cases were studied. RESULTS Early-onset-FGR was more often associated with preeclampsia and recurrence than late-onset-FGR; placentas from early-onset-FGR often had diffuse maternal (or fetal) vascular malperfusion and villitis of unknown etiology. Decreased percentage of intact terminal villi was associated with pathologic CTG. Decreased villous capillarization was associated with early-onset-FGR and birth weight below the second percentile. Avascular villi and infarction were more common when femoral length/abdominal circumference ratio was >0.26, and perinatal outcome was poor in this group. CONCLUSION In early-onset-FGR and preeclamptic FGR, altered vascularization of villi may have a key role in pathogenesis, and recurrent FGR is associated with villitis of unknown etiology. There is an association between femoral length/abdominal circumference ratio >0.26 and histopathological alterations of placenta in FGR pregnancies. There are no significant differences in the percentage of intact terminal villi between different FGR subtypes by onset or recurrency.

中文翻译：

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胎盘病理学及其与胎儿生长受限不同亚型临床症状的关联。

目的 我们评估了不同亚型胎儿生长受限 (FGR) 的胎盘改变，以确定任何临床关联。方法 根据阿姆斯特丹标准分类的 FGR 胎盘与临床结果相关。计算每个样本中完整的终末绒毛百分比和绒毛毛细血管化率。研究了胎盘组织病理学与围产期结局的相关性。研究了 61 个 FGR 病例。结果 早发性 FGR 比晚发性 FGR 更常与先兆子痫和复发相关；早发性 FGR 的胎盘常常存在弥漫性母体（或胎儿）血管灌注不良和病因不明的绒毛炎。完整终末绒毛百分比的降低与病理性 CTG 相关。绒毛毛细血管化减少与早发性 FGR 和出生体重低于第二个百分位有关。当股骨长度/腹围比>0.26时，无血管绒毛和梗塞更常见，并且该组的围产期结局较差。结论 在早发型 FGR 和先兆子痫 FGR 中，绒毛血管化的改变可能在发病机制中起关键作用，而复发性 FGR 与病因不明的绒毛炎相关。FGR 妊娠中股骨长度/腹围比 >0.26 与胎盘组织病理学改变之间存在关联。不同 FGR 亚型之间的完整终末绒毛百分比在发病或复发方面没有显着差异。