Are placental chorionic capillary nucleated red blood cell counts useful compared to umbilical cord blood tests?

Erythroblasts in the Vessels of the Placenta – An Independent Factor of Chronic Hypoxic Damage to the Fetus

The aim is a comparative histological study of the relative number of fetal erythroblasts in the vessels of the placentas from a full term pregnancy with a low and high risk of fetal hypoxic damage. Material and methods. Based on data on the course of pregnancy, the state of health of the mother and the fetus/newborn, as well as histological examination of the placenta, 388 archived placenta tissue samples were selected in 2 groups: a high risk group for chronic hypoxic damage to the fetus and a group without clinical and laboratory signs of fetal/newborn hypoxia. The relationship between the number of erythroblasts in the vessels of the placenta and chronic hypoxic damage to the fetus was analyzed. Results: The high risk of chronic hypoxic fetal damage is higher for placentas with ≥8 fetal erythroblasts in chorionic villi vessels (OR=3.175; 95% CI =1.921-5.248, p<0.001), with maternal vascular malperfusion (OR=2.798; 95% CI = 1.506-5.164, p=0.001) and combined (cross) placental lesions (OR=2.245; 95%CI=1.246-4.046, p =0.007) with damage of ≥30% of placental tissue. Conclusion: 8 or more fetal erythroblasts in the lumen of the vessels of the placenta is an additional independent factor in chronic hypoxic damage to the fetus. These results are of practical importance for identifying a group of newborns with a high risk of chronic hypoxic damage in the perinatal period and stratification of the risk group in the postnatal period in order to reduce infant morbidity and mortality.