1
|
Matsuzaki S, Ueda Y, Matsuzaki S, Sakaguchi H, Kakuda M, Lee M, Takemoto Y, Hayashida H, Maeda M, Kakubari R, Hisa T, Mabuchi S, Kamiura S. Relationship between Abnormal Placenta and Obstetric Outcomes: A Meta-Analysis. Biomedicines 2023; 11:1522. [PMID: 37371617 DOI: 10.3390/biomedicines11061522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/21/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
The placenta has several crucial physiological functions that help maintain a normal pregnancy. Although approximately 2-4% of pregnancies are complicated by abnormal placentas, obstetric outcomes remain understudied. This study aimed to determine the outcomes and prevalence of patients with abnormal placentas by conducting a systematic review of 48 studies published between 1974 and 2022. The cumulative prevalence of circumvallate placenta, succenturiate placenta, multilobed placenta, and placenta membranacea were 1.2%, 1.0%, 0.2%, and 0.004%, respectively. Pregnancies with a circumvallate placenta were associated with an increased rate of emergent cesarean delivery, preterm birth (PTB), and placental abruption compared to those without a circumvallate placenta. The succenturiate lobe of the placenta was associated with a higher rate of emergent cesarean delivery, whereas comparative results were observed in terms of PTB, placental abruption, and placenta previa in comparison to those without a succenturiate lobe of the placenta. A comparator study that examined the outcomes of multilobed placentas found that this data is usually unavailable. Patient-level analysis (n = 15) showed high-rates of abortion (40%), placenta accreta spectrum (40%), and a low term delivery rate (13.3%) in women with placenta membranacea. Although the current evidence is insufficient to draw a robust conclusion, abnormal placentas should be recognized as a high-risk factor for adverse outcomes during pregnancy.
Collapse
Affiliation(s)
- Shinya Matsuzaki
- Department of Gynecology, Osaka International Cancer Institute, Osaka 541-8567, Japan
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Satoko Matsuzaki
- Department of Obstetrics and Gynecology, Osaka General Medical Center, Osaka 558-8558, Japan
| | - Hitomi Sakaguchi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Mamoru Kakuda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Misooja Lee
- Department of Forensic Medicine, School of Medicine, Kindai University, Osaka 589-8511, Japan
| | - Yuki Takemoto
- Department of Gynecology, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Harue Hayashida
- Department of Gynecology, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Michihide Maeda
- Department of Gynecology, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Reisa Kakubari
- Department of Gynecology, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Tsuyoshi Hisa
- Department of Gynecology, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Seiji Mabuchi
- Department of Gynecology, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Shoji Kamiura
- Department of Gynecology, Osaka International Cancer Institute, Osaka 541-8567, Japan
| |
Collapse
|
2
|
Trombetta G, Fabbro D, Demori E, Driul L, Damante G, Xodo S. Rare spontaneous monochorionic dizygotic twins: a case report and a systematic review. BMC Pregnancy Childbirth 2022; 22:564. [PMID: 35836143 PMCID: PMC9284757 DOI: 10.1186/s12884-022-04866-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Monochorionic dizygotic twins are a rare condition, mostly related to assisted reproductive technology. This type of twinning is burdened by the same risk of pregnancy complications found in monochorionic monozygotic pregnancies. CASE PRESENTATION We report a case of spontaneous monochorionic dizygotic twins sharing situs inversus abdominalis and isolated levocardia, with only one twin affected by biliary atresia with splenic malformation syndrome. We also conducted a literature review of the 14 available documented monochorionic dizygotic twin gestations spontaneously conceived. CONCLUSIONS It is still unclear how this unusual type of twinning can occur in spontaneous conception. The evidence so far suggest the importance to timely diagnose the chorionicity, in order to adequately manage the typical complications associated with monochorionicity.
Collapse
Affiliation(s)
- Giulia Trombetta
- Department of Gynecology and Obstetrics, School of Medicine of Udine, Udine, Italy
| | - Dora Fabbro
- Istituto Di Genetica Medica, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Eliana Demori
- Istituto Di Genetica Medica, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Lorenza Driul
- Department of Gynecology and Obstetrics, School of Medicine of Udine, Udine, Italy.,Dipartimento Di Area Medica, Università Degli Studi Di Udine, Udine, Italy
| | - Giuseppe Damante
- Istituto Di Genetica Medica, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy. .,Dipartimento Di Area Medica, Università Degli Studi Di Udine, Udine, Italy.
| | - Serena Xodo
- Department of Gynecology and Obstetrics, School of Medicine of Udine, Udine, Italy. .,Department of Gynecology and Obstetrics, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero Santa Maria della Misericordia, Udine, UD, Italy.
| |
Collapse
|