The association of Doppler abnormalities with placental pathology in SGA fetuses

Objectives Distinguishing constitutional SGA from FGR may be challenging, and placental pathology may shed some light on this matter. Data on the correlation between Doppler abnormalities and placental pathology are scarce. We aimed to correlate Doppler abnormalities with placental pathology in SGA fetuses. Methods A retrospective cohort study, of all SGA live infants with placental pathology reports and Doppler investigations between 2001–2015 at \u003e24 weeks gestation, born at a single centre. Investigations included the umbilical artery (UA-PI), middle cerebral artery (MCA-PI) and cerebroplacental ratio (CPR). We stratified the prevalence of each pathology lesion according to the Doppler indices. Results Results: A total of 204 SGA fetuses were included in the analysis, of them 160 had normal Doppler indices, 11 had UA-PI \u003e95th%, 16 had AREDF, 33 had MCA-PI 95% percentile was 5.5, (95% CI 1.4–21.7) for ≥2 MVM lesions, and 8.6 (95% CI 2.1–34.3 for ≥3 MVM lesions, and similar picture was found for absent or reversed EDF (Table). Conclusions Abnormal UA Doppler (but not MCA Doppler) is strongly associated with MVM pathology. Neither UA nor MCA Doppler is associated with other placental pathologies that are related to FGR. A considerable proportion of SGA infants with abnormal placental pathology have normal Doppler indices, indicating that the current antenatal tools used to distinguish constitutional SGA from FGR have limited sensitivity.