{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:22:19Z","timestamp":1785421339363,"version":"3.56.0"},"reference-count":32,"publisher":"Vilnius University Press","issue":"2","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AML"],"abstract":"<jats:p>Fetal growth restriction is one of the main factors contributing to neonatal mortality, stillbirth, and cardiovascular dysfunction in a fetus and newborn, where one of the common causes is placental dysfunction; it can occur as a result of placental vascular anomalies, which requires clarification and systematization of existing scientific provisions based on the assessment of morphological patterns of fetoplacental circulatory disorders.The aim of the study was to investigate and evaluate morphological markers of fetoplacental blood flow disorders in late manifestation of fetal growth restriction by pathohistological examination of placental tissue.Materials and methods:\u00a0Clinical and anamnestic features were assessed in 80 pregnant women with late manifestation of fetal growth restriction (the main group of research) and in 40 patients with a timely labour and birth of fetuses with normal fetometry parameters for the gestational age. 32 and 10 placental tissue samples were selected in the main group and in the comparison group, respectively, for pathohistological examination, and a postnatal macro-histomorphological assessment of the placenta was performed.Results:\u00a0Postnatal macromorphometric characteristics of placental tissue reflect pathological features of its formation, dominated by an abnormal shape (46\u201357.5%), eccentric umbilical cord insertion (43\u201353.8%) with main and intermediate types of vascular branching (37\u201346.2%), and a statistically lower placental weight and diameter. A combination of maternal and fetal vascular malperfusion was noted, with the following most significant markers: infarctions (13\u201340.6%), distal villous hypoplasia (24\u201375.0%), increased syncytial nodules as a manifestation of delayed villous maturation as a manifestation of premature maturation (24\u201375.0%), decidual arteriopathy (13\u201340.6%). Analysis of histopathological data indicates malperfusion of the fetal vessels, with the proportion of villitis and markers of intrauterine infection verified in one third of the samples (13\u201340.6%).Conclusions:\u00a0In cases of late-onset fetal growth restriction, placental lesions occur with the development of maternal and fetal vascular malperfusion. Pathomorphological criteria of maternal vascular malperfusion are statistically significant in the main group: infarctions, distal villous hypoplasia, decidual arteriopathy, and chorionic villous dysmaturation. Fetal vascular malperfusion is characterized by obliteration and thrombosis of the stem vessels of the anchoring and intermediate villi, avascularization, hyalinosis of the villi, and, less frequently, delayed maturation with the development of stromal-vascular karyorexis. In our study, both Type 1 and Type 2 fetal vascular malperfusion in different placentas with fetal growth restriction were found, but the segmental type was still the most common.<\/jats:p>","DOI":"10.15388\/amed.2025.32.2.21","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:49:53Z","timestamp":1766728193000},"page":"21","source":"Crossref","is-referenced-by-count":0,"title":["Pathomorphological Patterns of Placental Dysfunction in Late Manifestation of Fetal Growth Restriction"],"prefix":"10.15388","volume":"32","author":[{"given":"Oksana","family":"Zhurakivska","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/023wxgq18","id-type":"ROR","asserted-by":"publisher"}],"name":"Ivano-Frankivsk National Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuliia","family":"Yarotska","sequence":"additional","affiliation":[{"name":"Perinatal Center of Kyiv"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmytr\u043e","family":"Govsieiev","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03edafd86","id-type":"ROR","asserted-by":"publisher"}],"name":"Bogomolets National Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oksana","family":"Ostrovska","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/023wxgq18","id-type":"ROR","asserted-by":"publisher"}],"name":"Ivano-Frankivsk National Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Rymarchuk","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/023wxgq18","id-type":"ROR","asserted-by":"publisher"}],"name":"Ivano-Frankivsk National Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6097","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Baschat AA, Galan HL, Lee W, DeVore GR, Mari G, Hobbins J, Vintzileos A, Platt LD, Manning FA. The role of the fetal biophysical profile in the management of fetal growth restriction. Am J Obstet Gynecol. 2022;226(4):475-486. doi:10.1016\/j.ajog.2022.01.020","DOI":"10.1016\/j.ajog.2022.01.020"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Melamed N, Baschat A, Yinon Y, Athanasiadis A, Mecacci F, Figueras F, et al. FIGO (International Federation of Gynecology and obstetrics) initiative on fetal growth: best practice advice for screening, diagnosis, and management of fetal growth restriction. Int J Gynaecol Obstet. 2021;152(1):3-57. doi:10.1002\/ijgo.13522","DOI":"10.1002\/ijgo.13522"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Hromova AM, Berezhna VA, Liakhovska TYu, Ketova OM, Shafarchuk VM. Peculiarities of pregnancy course, childbirth and morphofunctional state of placenta in women with intrauterine fetal growth retardation. Actual Problems of Modern Medicine. 2021;21(3):11-16. doi:10.31718\/2077-1096.21.3.11","DOI":"10.31718\/2077-1096.21.3.11"},{"key":"ref3","unstructured":"Standard of medical care \"Fetal growth restriction\". 2023. https:\/\/moz.gov.ua\/uploads\/10\/50191-dn_1718_02102023_dod.pdf"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Yarotska YuO, Zahorodnia OS. Placental morphology - from theory to practice. Reprod Health Women. 2021;(9-10):67-72. doi:10.30841\/2708-8731.9-10.2021.252595","DOI":"10.30841\/2708-8731.9-10.2021.252595"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Burton GJ, Jauniaux E. Pathophysiology of placental-derived fetal growth restriction. Am J Obstet Gynecol. 2018;218(2S):S745-S761. doi:10.1016\/j.ajog.2017.11.577","DOI":"10.1016\/j.ajog.2017.11.577"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Cindrova-Davies T, Sferruzzi-Perri AN. Human placental development and function. Semin Cell Dev Biol. 2022;131:66-77. doi:10.1016\/j.semcdb.2022.03.039","DOI":"10.1016\/j.semcdb.2022.03.039"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Dubetskyi BI, Makarchuk OM, Andriiets OA, Rymarchuk MI. Risk factors for umbilical cord pathology and factors of negative perinatal consequences and morbidity of newborns. Neonat Surg Perinat Med. 2023;12(4(46)):12-20. doi:10.24061\/2413-4260.XII.4.46.2022.3","DOI":"10.24061\/2413-4260.XII.4.46.2022.3"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Tonni G, Lituania M, Grisolia G, Pinto A, Bonasoni MP, Rizzo G, et al. Placental and Umbilical Cord Anomalies Detected by Ultrasound as Clinical Risk Factors of Adverse Perinatal Outcomes. Case Series Review of Selected Conditions. Part 3: Vascular Anomalies of the Umbilical Cord and Fetoplacental Vascular Malperfusion. J Clin Ultrasound. 2025;53(4):863-879. doi:10.1002\/jcu.23904","DOI":"10.1002\/jcu.23904"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Redline RW, Ravishankar S, Bagby CM, Saab ST, Zarei S. Four major patterns of placental injury: a stepwise guide for understanding and implementing the 2016 Amsterdam consensus. Mod Pathol. 2021;34(6):1074-1092. doi:10.1038\/s41379-021-00747-4","DOI":"10.1038\/s41379-021-00747-4"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Molina LCG, Odibo L, Zientara S, et al. Validation of Delphi procedure consensus criteria for defining fetal growth restriction. Ultrasound Obstet Gynecol. 2020;56(1):61-66. doi:10.1002\/uog.20854","DOI":"10.1002\/uog.20854"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Lees CC, Stampalija T, Baschat A, da Silva Costa F, Ferrazzi E, Figueras F, et al. ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction. Ultrasound Obstet Gynecol. 2020;56(2):298-312. doi:10.1002\/uog.22134","DOI":"10.1002\/uog.22134"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Martinez J, Boada D, Figueras F, Meler E. How to define late fetal growth restriction. Minerva Obstet Gynecol. 2021;73(4):409-414. doi:10.23736\/s2724-606x.21.04775-4","DOI":"10.23736\/S2724-606X.21.04775-4"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Mylrea-Foley B, Napolitano R, Gordijn S, Wolf H, Lees CC, Stampalija T; TRUFFLE-2 Feasibility Study Authors. Do differences in diagnostic criteria for late fetal growth restriction matter? Am J Obstet Gynecol MFM. 2023;5(11):101117. doi:10.1016\/j.ajogmf.2023.101117","DOI":"10.1016\/j.ajogmf.2023.101117"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"MacDonald TM, Hui L, Robinson AJ, Dane KM, Middleton AL, Tong S, Walker SP. Cerebral-placental-uterine ratio as novel predictor of late fetal growth restriction: prospective cohort study. Ultrasound Obstet Gynecol. 2019;54(3):367-375. doi:10.1002\/uog.20150","DOI":"10.1002\/uog.20150"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Dureau ZJ, Rogers BB. Placental pathology. Diagn Histopathol. 2019;25(9):341-349. doi:10.1016\/j.mpdhp.2019.06.003","DOI":"10.1016\/j.mpdhp.2019.06.003"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Khong TY, Mooney EE, Ariel I, Balmus NC, Boyd TK, Brundler MA, et al. Sampling and Definitions of Placental Lesions: Amsterdam Placental Workshop Group Consensus Statement. Arch Pathol Lab Med. 2016;140(7):698-713. doi:10.5858\/arpa.2015-0225-CC","DOI":"10.5858\/arpa.2015-0225-CC"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Redline RW, Ravishankar S. Fetal vascular malperfusion, an update. APMIS. 2018;126(7):561-569. doi:10.1111\/apm.12849","DOI":"10.1111\/apm.12849"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Veerbeek JH, Nikkels PG, Torrance HL, Gravesteijn J, Post Uiterweer ED, Derks JB, Koenen SV, Visser GH, Van Rijn BB, Franx A. Placental pathology in early intrauterine growth restriction associated with maternal hypertension. Placenta. 2014;35(9):696-701. doi:10.1016\/j.placenta.2014.06.375","DOI":"10.1016\/j.placenta.2014.06.375"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Ueda M, Tsuchiya KJ, Yaguchi C, et al. Placental pathology predicts infantile neurodevelopment. Sci Rep. 2022;12(1):1-10. doi:10.1038\/s41598-022-06300-w","DOI":"10.1038\/s41598-022-06300-w"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Roberts D, Aisagbonhi O, Parast MM. Incorporating placental pathology into clinical care and research. Trends Mol Med. 2024;30(12):1103-1112. doi:10.1016\/j.molmed.2024.08.002","DOI":"10.1016\/j.molmed.2024.08.002"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Ryan WD, Trivedi N, Benirschke K, Lacoursiere DY, Parast MM. Placental histologic criteria for diagnosis of cord accident: sensitivity and specificity. Pediatr Dev Pathol. 2012;15(4):275-280. doi:10.2350\/11-12-1127-oa.1","DOI":"10.2350\/11-12-1127-OA.1"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Bernson-Leung ME, Boyd TK, Meserve EE, Danehy AR, Kapur K, Trenor CC, et al. Placental pathology in neonatal stroke: a retrospective case-control study. J Pediatr. 2018;195:39-47.e5. doi:10.1016\/j.jpeds.2017.11.061","DOI":"10.1016\/j.jpeds.2017.11.061"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Chisholm KM, Heerema-McKenney A. Fetal thrombotic vasculopathy: significance in liveborn children using proposed society for pediatric pathology diagnostic criteria. Am J Surg Pathol. 2014; 39:274-280. doi:10.1097\/pas.0000000000000334","DOI":"10.1097\/PAS.0000000000000334"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Ruschkowski B, Nasr A, Oltean I, Lawrence S, El Demellawy D. Examining the Relationship Between Gastroschisis and Placental Fetal Vascular Malperfusion. Pediatr Dev Pathol. 2021;24(6):531-541. doi:10.1177\/10935266211029629","DOI":"10.1177\/10935266211029629"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Carr DJ, David AL, Aitken RP, Milne JS, et al. Placental vascularity and markers of angiogenesis in relation to prenatal growth status in overnourished adolescent ewes. Placenta. 2016;46:79-86. doi:10.1016\/j.placenta.2016.08.076","DOI":"10.1016\/j.placenta.2016.08.076"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Bender HG, Werner C, Kortmann HR, Becker V. Zur Endangitis obliterans der Plazentagef\u00e4sse [Obliterative angiopathy of placental stem villi (author's transl)]. Arch Gynakol. 1976;221(2):145-159. doi:10.1007\/BF00667144","DOI":"10.1007\/BF00667144"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Catov JM, Muldoon MF, Gandley RE, et al. Maternal Vascular Lesions in the Placenta Predict Vascular Impairments a Decade After Delivery. Hypertension. 2022;79(2):424-434. doi:10.1161\/HYPERTENSIONAHA.121.18394","DOI":"10.1161\/HYPERTENSIONAHA.121.18394"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Ernst LM. Maternal vascular malperfusion of the placental bed. APMIS. 2018;126:551-560. doi:10.1111\/apm.12833","DOI":"10.1111\/apm.12833"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Zur RL, McLaughlin K, Aalto L, et al. Phenotypes of maternal vascular malperfusion placental pathology and adverse pregnancy outcomes: A retrospective cohort study. BJOG. 2024;131:1515-1523. doi:10.1111\/1471-0528.17837","DOI":"10.1111\/1471-0528.17837"},{"key":"ref30","unstructured":"Ruckh\u00e4berle KE, Ruckh\u00e4berle B. Das Chorionepithel in Resorptionszotten von Plazenten hypotropher Termgeborener. Ein Beitrag zur Morphologie bei chronischer Plazentainsuffizienz [Chorionic epithelium in the resorption-villi of placentas of hypotrophic term-born infants. Morphology in chronic placental insufficiency]. Zentralbl Gynakol. 1976;98(11):660-670."},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"Yoo C, Jang DG, Jo YS, Yoo J, Lee G. Pathologic Differences between Placentas from Intrauterine Growth Restriction Pregnancies with and without Absent or Reversed End Diastolic Velocity of Umbilical Arteries. Korean J Pathol. 2011;45(1):36-44. doi:10.4132\/KoreanJPathol.2011.45.1.36","DOI":"10.4132\/KoreanJPathol.2011.45.1.36"}],"container-title":["Acta medica Lituanica"],"original-title":[],"link":[{"URL":"https:\/\/www.journals.vu.lt\/AML\/article\/download\/43141\/41133","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journals.vu.lt\/AML\/article\/download\/43141\/41134","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journals.vu.lt\/AML\/article\/download\/43141\/41133","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T06:42:22Z","timestamp":1766731342000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journals.vu.lt\/AML\/article\/view\/43141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,26]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,7,29]]}},"URL":"https:\/\/doi.org\/10.15388\/amed.2025.32.2.21","relation":{},"ISSN":["2029-4174","1392-0138"],"issn-type":[{"value":"2029-4174","type":"electronic"},{"value":"1392-0138","type":"print"}],"subject":[],"published":{"date-parts":[[2025,12,26]]}}}