Abstract
Fresh placental tissue was studied by phase contrast microscopy following 125 normal and complicated pregnancies. 76 infants were full-term, 29 premature, 11 small for gestational age, and 9 from insulin-dependent diabetics. The fetal outcome was correlated with the placental score determined by grading pathological features in the 1) syncitium (hypoplasia, hyperplasia); 2) stroma (edema and intravillous hemorrhage); and 3) vascularity of the villus (congestion, ishemia and avascularity). A total score of 0 indicated normal features for gestational age. Significant correlation was observed between placental score, fetal mortality and morbidity. The mortality was 52% (11/21) with placental scores 6 or above; whereas only 2 of 104 infants with scores below 6 died (p < .001). The table below shows results in infants below 37 weeks.
19 of the 21 infants with scores of 6 or above presented with problems of extra-uterine adaption including asphyxia, anemia, respiratory problems, in contrast to 12 of 104 with scores below 6 (p < .001). All infants with severe hyaline membrane disease (arterial PO2 <50 mm. Hg. in 100% O2) had scores above 6 and demonstrated placental vascular changes with syncitial hypoplasia. Phase microscopy of the placenta is a simple (ten minute) procedure and appears to be helpful in predicting fetal outcome.
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Fanaroff, A., Aladjem, S., France, F. et al. Identification of the high-risk infant from placental phase microscopy. Pediatr Res 5, 411 (1971). https://doi.org/10.1203/00006450-197108000-00168
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DOI: https://doi.org/10.1203/00006450-197108000-00168