Placenta of idiopathic fetal growth restriction: cytochemically detectable enzyme activities do not change at a subcellular level.

The present study was designed to localize some important enzymes, such as adenosine diphospate-degrading enzyme (ADP-degrading enzyme) (plasma membrane enzyme), cytochrome c oxidase (mitochondrial enzyme) and glucose-6-phosphatase (endoplasmic reticulum enzyme), in placentae from patients with idiopathic fetal growth restriction (FGR) associated with absent end-diastolic flow velocity in the fetal umbilical artery. We compared these enzyme activities and their localization patterns to those in placentae both from pre-eclampsia with FGR and normal pregnancy with appropriate for their gestational age infants. In idiopathic FGR placentae, the intensity and localization patterns of these three enzymes did not differ from those seen in the placentae from normal pregnancy. Decreased ADP-degrading enzyme activity and cytochrome c oxidase negative mitochondria, which were characteristic features of pre-eclamptic trophoblasts, were absent from trophoblasts of the idiopathic FGR placentae. These observations indicated that enzyme-cytochemically detectable trophoblastic cell dysfunction may be absent in idiopathic FGR, or if present, there is less functional impairment of each trophoblast in this disease than in pre-eclampsia. Though both idiopathic FGR and pre-eclampsia lead to placental insufficiency, and finally to restricted fetal growth, a different mechanism and pathophysiology may work at the cellular and subcellular levels in these two diseases.