OP04.03: Placental vascular malperfusion in fetuses with congenital heart diseases: distinction based on pathophysiology

Literature suggests a correlation between placental malperfusion (PM) and CHD, highlighting the importance of this relationship for early diagnosis, monitoring, and management of CHD. Therefore, our aim was to characterise placental anomalies in pregnancies complicated by CHD. From March 2021 to October 2023, 95 CHD-affected fetal placentas were analysed. A pathologist categorised placental pathology as maternal placental malperfusion (MPM), fetal placental malperfusion (FPM), and combined maternal-fetal placental malperfusion (MFPM). Placentas were categorised according to fetal pathophysiology into Right Heart Obstructive lesions (RHO), Left Heart Obstructive lesions (LHO), pathologies with Pulmonary Overflow Volume (OV), Fetal Heart failure (HF) and Transposition of Great Arteries (TGA). In our population, newborns with the highest birthweight were affected by OV (in centiles, 66.4 ± 27.4, p = 0.004), with higher BW/PW in LHO and lower in TGA (see figure 1), along with a higher prevalence of LGA placentas in the TGA group (54.3%, p = 0.07). PM was more prevalent in patients with OV (87.5%) and to a lesser extent in TGA (60%) (see figure 1). The graph illustrates the distribution of PM signs. An association between placental vascular anomalies and fetal CHD is confirmed. The higher prevalence of PM in patients with OV may be biased by the high number of comorbidities. Meanwhile, a higher BW/PW in LHOs may be justified by a reduction in combined ventricular output in more severe forms. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.