First trimester preeclampsia screening and risk of placental lesions.

OBJECTIVES

The purpose of our study was evaluate differences in placental histopathology basing on first trimester preeclampsia screening.

STUDY

DESIGN

Observational case-control study; monocentric enrolment at first trimester ultrasound at the department of Obstetrics and Gynecology of IRCCS Policlinico San Matteo; 278 placental specimen from 234 non-preeclamptic women and 44 preeclamptic women; histopathological examination and evaluation basing on first trimester preeclampsia multiparametric screening; continuous variables were compared by Kruskal-Wallis analysis of variance, categorical variables were compared by Fisher exact test or chi-square test.

MAIN OUTCOME MEASURES: Placental lesions prevalence according to first trimester screening result.

RESULTS

preeclamptic screen-positive patients had higher frequency of adverse pregnancy outcomes and higher frequency of placental MVM lesions. Screen-positive patients who do not developed preeclampsia had poor maternal and fetal outcomes and higher prevalence of MVM, FVM and placental chronic inflammatory lesions.

CONCLUSIONS

Our results shows that the screening identifies pregnancies with placental lesions, which, irrespectively of the development of preeclampsia, correlate with impaired fetal growth and poor pregnancy outcomes. The presence of MVM, FVM and VUE in patients at high risk for preeclampsia reflects the need for close clinical follow-up during pregnancy due to the increased risk of adverse outcomes.