The placental component in early-onset and late-onset preeclampsia in relation to fetal growth restriction

Objective To identify pathological placental differences between early-onset and late-onset preeclampsia, in relation to fetal growth restriction (FGR). Methods Placentas from patients with preeclampsia were analyzed for lesions of maternal vascular supply consistent with maternal underperfusion and lesions of fetal vascular supply consistent with fetal thrombo-occlusive disease. Findings were compared between patients who gave birth before 34?weeks (early-onset preeclampsia) and after 34?weeks (late-onset preeclampsia). Results Compared with the late-onset group (n?=?93), the early-onset group (n?=?37) had higher rates of FGR (62.2% vs 25.8%, P?<?0.001) and lesions of maternal vascular supply (95% vs 60%, P?<?0.001). Within the early-onset group, cases with FGR (n?=?23) had more lesions of fetal vascular supply (47.8% vs 7%, P?=?0.01), with similar high rates of lesions of maternal vascular supply (91% vs 100%) compared with those without FGR. Within the late-onset preeclampsia group, cases with FGR (n?=?24) had higher rates of maternal vascular supply lesions (88% vs 51%, P?=?0.003) than those without FGR, but similar rates of fetal vascular supply lesions (25% vs 16%, P?=?0.32). Conclusion The placental fetal vascular supply lesions in combination with maternal vascular lesions are more dominant in early-onset preeclampsia with FGR as compared with early-onset preeclampsia without FGR. (c) 2012 John Wiley & Sons, Ltd.