Study on the relationship between fetal growth restriction and oligohydramnios with pregnancy outcome and placental pathology

Objective To study the correlation between placental pathology and pregnancy outcome in women with fetal growth restriction and oligohydramnios. Methods A total of 177 cases of fetal growth restriction(FGR) were randomly selected from January2018 to June 2020 in Huizhou First Maternity and Child Health Hospital, and included FGR with oligohydramnios into the experimental group (n= 57). Those without oligohydramnios were included in the control group (n= 120). The two groups of pregnant women were compared with their delivery methods, amniotic fluid state, 24-hour postpartum hemorrhage, the duration from the discovery of FGR to delivery, and the neonatal birth weight,Apgar score, umbilical artery blood gas analysis, perinatal complications, whether to transfer to NICU, umbilical cord, placenta weight and pathological results, etc., were statistically analyzed by the method of correlation analysis.The rate of cesarean section in the experimental group was 84. 21%, and the rate of emergency cesarean section in the experimental group was 56%, which was signify. Results Cantly higher than that in the control group(P< 0. 05), the differences were statistically significant(P< 0. 05);The incidence of amniotic fluid turbidity and NICU admission in the experimental group was significantly higher than that in the control group, and the differences were statistically significant(P< 0. 05);in the experimental group, it was found that the duration from FGR to fetal delivery was significantly shorter than that in the control group. It was statistically significant(P< 0. 05); the experimental group had more complications such as neonatal pneumonia, neonatal respiratory distress syndrome, myocardial damage, and bronchial dysplasia than the control group, but the difference was not statistically significant(P> 0. 05);The incidence of abnormal umbilical cord in the experimental group was significantly higher than that in the control group, and the placental weight was less than that in the control group, but the difference was not statistically significant(P>0. 05). In the experimental group, there were 27 cases of over-maturation of placental villi, increased villous syncytial nodules, and poor vascular perfusion, such as decidual vasculopathy, there were 22 cases of malperfusion of fetal blood vessels, such as thrombotic angiopathy, occlusion of dry blood vessels and deposition of fibrin in blood vessels, there were 12 cases of acute Chorioamnionitis,acute choriovasculitis, acute umbilical vein inflammation, non-specific inflammation, and 2 cases of choriovasculopathy, the incidence of placental malperfusion and fetal malperfusion in the experimental group was significantly higher than that in the control group,especially the rate of over mature placental villi and thrombotic vasculopathy, the difference was statistically significant(P< 0. 05). Conclusion Poor maternal vascular perfusion, inflammation and inadequate fetal vascular perfusion are the pathohistological characteristics of FGR with oligohydramnios, which may synergize and lead to inadequate placental function, which may seriously affect the outcome of maternal-fetal pregnancy, and even endanger the long-term prognosis of the newborn.