Preeclampsia and intrauterine growth restriction are two separate disease entities that, according to numerous reports, share the same pathogenesis. In both, angiogenesis disorders and generalized inflammation are the dominant symptoms. In this study, we hypothesized that both diseases demonstrate the same profile in early preeclampsia, late preeclampsia, and intrauterine growth restriction patients, with the only difference being the degree of exacerbation of lesions. One hundred sixty-seven patients were enrolled in the study and divided into four groups: early preeclampsia, late preeclampsia, and intrauterine growth restriction groups, and one control group. Concentrations of the angiogenesis and inflammatory markers soluble fms-like tyrosine kinase receptor 1, placental growth factor, high-sensitivity C-reactive protein, and interleukin-6 were determined, and the behavior of these markers and correlations among them were studied. Higher concentrations of soluble fms-like tyrosine kinase receptor 1, high-sensitivity C-reactive protein, and interleukin-6 and a lower concentration of placental growth factor were observed in the study groups compared with the control group. No differences in concentrations of the studied markers were found among the study groups but significant correlations were observed. The higher values for the angiogenesis and inflammatory markers both in preeclampsia patients and patients with intrauterine growth restriction of placental origin compared with the control group suggest the existence of the same underlying disorders in the development of these pathologies. The observed mutual correlations for disordered angiogenesis and inflammatory markers are suggestive of a mutual relationship between these processes in the development of pathologies evolving secondary to placental ischemia. The same lesion profile was observed for both preeclampsia and ‘placental’ intrauterine growth restriction patients, which could be used in developing common diagnostic criteria for pregnant patients.

Background Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are used as markers of preeclampsia. The aim of this paper was to assess the correlations between the sFlt-1/PlGF ratio values within the <38, 38–85 and >85 brackets and perinatal outcomes in pregnancies that require determination of these markers. Methods A total of 927 pregnant patients between 18 and 41 weeks’ gestation suspected of or confirmed with any form of placental insufficiency (preeclampsia, intrauterine growth restriction [IUGR], gestational hypertension, HELLP syndrome, placental abruption) were included in the study. In each of the patients, the sFlt-1/PlGF ratio was calculated. Patients were divided into three groups according to the sFlt-1/PlGF ratio brackets of <38, 38–85 and >85. Results Significantly worse perinatal outcomes were found in the sFlt-1/PlGF >85 group, primarily with lower cord blood pH, neonatal birth weight and shorter duration of gestation. Statistically significant correlations between the values of these markers and the abovementioned perinatal effects were found. Conclusion An sFlt-1/PlGF ratio value of >85 suggests that either preeclampsia or one of the other placental insufficiency forms may occur, which is associated with lower cord blood pH, newborn weight and earlier delivery. Determining the disordered angiogenesis markers and calculating the sFlt-1/PlGF ratio in pregnancies complicated by placental insufficiency may lead to better diagnosis, therapeutic decisions and better perinatal outcomes.

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Abnormally accelerated, premature placental senescence plays a crucial role in the genesis of pregnancy pathologies. Abnormal growth in the third trimester can present as small for gestational age fetuses or fetal growth restriction. One differs from the other by the presence of signs of placental insufficiency and the risk of stillbirth. The majority of stillbirths occur in normally grown fetuses and are classified as “unexplained”, which often leads to conclusions that they were unpreventable. The main characteristic of aging is a gradual decline in the function of cells, tissues, and organs. These changes result in the accumulation of senescent cells in mitotic tissues. These cells begin the aging process that disrupts tissues’ normal functions by affecting neighboring cells, degrading the extracellular matrix, and reducing tissues’ regeneration capacity. Different degrees of abnormal placentation result in the severity of fetal growth restriction and its sequelae, including fetal death. This review aims to present the current knowledge and identify future research directions to understand better placental aging in late fetal growth restriction and unexplained stillbirth. We hypothesized that the final diagnosis of placental insufficiency can be made only using markers of placental senescence.

This systematic review was conducted to gather evidence of preeclampsia occurring before the 20th week of gestation, additionally considering the role of PLGF and sFlt-1 in the development of the disease. In the three cases of preeclampsia before the 20th week of gestation presented in the authors’ material, all pregnancies ended up with IUFD, and the SFlt-1/PLGF ratios were significantly elevated in all women. Eligible publications were identified with searches in the PubMed, Embase, Scopus, and Web of Science databases. No date or language restrictions were made. All original peer-reviewed scientific reports were included. A total of 30 publications were included in the final report, including case reports and case series. No other publication types regarding this issue were identified. In the literature, 34 cases of preeclampsia with onset occurring before the 20th week of gestation were identified, for a final total of 37 cases. Live births were reported in 5 cases (10.52%), and there were 9 intrauterine fetal demises (24.32%), and 23 terminations of pregnancy (62.16%). Preeclampsia before the 20th week of gestation is rare but can occur. We collected all available evidence regarding this phenomenon, with 37 cases reported worldwide. We call for large-scale cohort or register-based studies to establish revised definitions or develop new ones regarding the currently unrecognized very early onset preeclampsia.

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Background: Growth charts are the primary tools for evaluating neonatal birth weight and length. They help and qualify the neonates as Appropriate for Gestational Age (AGA), Small for Gestational Age (SGA), or Large for Gestational Age (LGA). The most commonly used neonatal charts include Intergrowth-21st, WHO, and Fenton. The aim of the study was to compare the tools used for assessing neonatal birth weight and the incidence of SGA and LGA using the different charts. Methods: Data on 8608 births in the Clinical Department of Obstetrics and Gynecology were compared. We divided the patient population into five gestational age groups. The 10th and 90th percentiles were calculated. The percentage of cases meeting the SGA and LGA criteria was determined. Results: Statistically significant differences between growth charts were identified for each of the groups. The 10th percentile for the study population corresponded to 2970 g for females and 3060 g for males born in the 40th week of gestation. The 90th percentile values were 4030 g and 4120 g. Our analysis showed a statistically significant difference in detection of LGA or SGA between three growth charts and our data both in male (χ 2 (3) = 157.192, p < 0.001, Kramer's V = 0.444) and female newborns (χ 2 (3) = 162.660, p < 0.001, Kramer's V = 0.464). Discussion: Our results confirm that differences exist between growth charts. There is a need for harmonizing growth assessment standards. It is recommended that a growth chart should be developed for the Polish population, which would improve the diagnosis of SGA and LGA.

Objectives: Significance of the crown-rump length (CRL) measurement criteria in the assessments of gestational age and actual precision in daily clinical practice. Material and methods:We recruited 806 pregnant women with singleton pregnancy and history of regular menstrual periods.We analysed retrospectively CRL measurements obtained during routine first trimester scan performed between 11 + 0 and 13 + 6 weeks gestation. Gestational age was calculated using both the last menstrual period (LMP) and the CRL. The images of the CRL measurements were assessed by the expert. The visual analysis of the images in terms of meeting the five criteria recommended by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) was performed. Statistical analysis were used to assess how the above-mentioned criteria influenced calculation of the gestational age. results:The study showed 323 out of 806 of the CRL measurements (40.1%) were qualified by a specialist as accurate, 279 (34.6%) as inaccurate, and 204 (25.3%) as inaccurate, but not changing the duration of a pregnancy. With the application in the assessment of the five criteria of the ISOUG 217 (26.9%), the following results of qualification were obtained: accurate -fulfilled ≥ 4, inaccurate 341 (42.3%) -fulfilled ≤ 2, whereas inaccurate, but not changing the duration of a pregnancy 248 (30.8%) -3 criteria fulfilled. We found that only the neutralof the fetus demonstrated a significant corellation with the assessment of the duration of a gestation. conclusions: a) the accurate audit of the CRL measurements is recommended; b) neutral position of the fetus is the most important criterion out of 5.