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Uterine (UtA), umbilical (UA) and fetal middle cerebral (MCA) artery pulsatility indices (PI) were assessed. The cerebroplacental ratio (CPR) was calculated by dividing MCA\u2010PI by UA\u2010PI. Doppler parameters were considered abnormal when UtA\u2010PI or UA\u2010PI was >\u200995th<\/jats:sup> centile or MCA\u2010PI or CPR was <\u20095th<\/jats:sup> centile. Placental lesions were categorized as vascular (maternal or fetal side), immunoinflammatory or other, according to the 2014 Amsterdam Placental Workshop Group Consensus Statement. Comparison between the study groups was performed using univariate and multiple regression analysis, and logistic regression was used to determine the relationship between abnormal Doppler parameters and placental lesions.<\/jats:p><\/jats:sec>Results<\/jats:title>Maternal\u2010side vascular lesions were significantly more common in PE pregnancies with SGA than in the other groups (PE\u2009+\u2009SGA, 73% vs<\/jats:italic> PE, 46% vs<\/jats:italic> SGA, 38% vs<\/jats:italic> controls, 31%; P<\/jats:italic>\u2009=\u20090.01) and included mainly two types of lesion: developmental (PE\u2009+\u2009SGA, 13% vs<\/jats:italic> PE, 5% vs<\/jats:italic> SGA, 3% vs<\/jats:italic> controls, 1.5%; P<\/jats:italic>\u2009<\u20090.001) and malperfusion (PE\u2009+\u2009SGA, 70% vs<\/jats:italic> PE, 39% vs<\/jats:italic> SGA, 32% vs<\/jats:italic> controls, 25%; P<\/jats:italic>\u2009=\u20090.001). In contrast, the incidence of fetal\u2010side developmental lesions was significantly higher in normotensive SGA pregnancies than in controls and PE pregnancies (PE\u2009+\u2009SGA, 0% vs<\/jats:italic> PE, 3% vs<\/jats:italic> SGA, 8% vs<\/jats:italic> controls, 2%; P<\/jats:italic>\u2009=\u20090.001). All cases displayed a lower prevalence of infectious lesions than did controls, with the highest prevalence of immune lesions observed in pregnancies with both PE and SGA (PE\u2009+\u2009SGA, 18% vs<\/jats:italic> PE, 8% vs<\/jats:italic> SGA, 10% vs<\/jats:italic> controls, 9%; P<\/jats:italic>\u2009=\u20090.001). All fetoplacental Doppler parameters evaluated were associated with maternal\u2010side vascular lesions, mainly malperfusion (mean UtA\u2010PI: odds ratio (OR), 2.45 (95% CI, 1.51\u20133.97); UA\u2010PI: OR, 2.05 (95% CI, 1.02\u20134.47); MCA\u2010PI: OR, 2.75 (95% CI, 1.40\u20135.42); CPR: OR, 1.75 (95% CI, 1.04\u20132.95)). This association was evident mainly in the normotensive SGA group, being\nnon\u2010significant in controls or PE pregnancies without SGA. No significant associations were observed between fetoplacental Doppler parameters and other placental lesions in any of the study groups.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>PE and SGA are associated with different patterns of placental histopathological lesions in accordance with the clinical manifestation of the placental disorder (maternal vs<\/jats:italic> fetal). Fetoplacental Doppler findings show an association with placental malperfusion lesions on the maternal side, supporting the use of abnormal Doppler as a surrogate for placental insufficiency. Copyright \u00a9 2019 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20350","type":"journal-article","created":{"date-parts":[[2019,5,22]],"date-time":"2019-05-22T09:35:26Z","timestamp":1558517726000},"page":"609-616","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Distinctive patterns of placental lesions in pre\u2010eclampsia vs<\/i> small\u2010for\u2010gestational age and their association with fetoplacental Doppler"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6795-0367","authenticated-orcid":false,"given":"C.","family":"Paules","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Center, BCNatal\u00a0\u2013\u00a0Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u, Institut Cl\u00ednic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS University of Barcelona, and Centre for 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