Placental lakes, absent umbilical artery diastolic flow and poor fetal growth in early pregnancy.

Abstract

Uteroplacental insufficiency is a common cause of intrauterine growth retardation in the third trimester of pregnancy. We report a case in which placental vascular lesions, absent end-diastolic frequencies in the umbilical artery and high maternal serum levels of alpha-fetoprotein and human chorionic gonadotropin were observed from the beginning of the second trimester in a patient with a history of recurrent first- and second-trimester miscarriages. Fetal growth started to slow down from 14 weeks of gestation and no end-diastolic phase was found in the umbilical artery until 18 weeks of gestation, when the pregnancy was terminated. In apparently healthy women with or without a history of fetal death during the first half of pregnancy, the discovery of placental vascular lesions together with a high resistance to blood flow in the umbilical circulation should prompt early antepartum surveillance.