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Siargkas A, Tsakiridis I, Michos G, Liberis A, Stavros S, Kyriakakis M, Domali E, Mamopoulos A, Dagklis T. Impact of Placental Grading on Pregnancy Outcomes: A Retrospective Cohort Study. Healthcare (Basel) 2025; 13:601. [PMID: 40150451 PMCID: PMC11942256 DOI: 10.3390/healthcare13060601] [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: 01/29/2025] [Revised: 03/03/2025] [Accepted: 03/07/2025] [Indexed: 03/29/2025] Open
Abstract
BACKGROUND Placental grading remains underutilized in clinical practice despite its potential prognostic value. This study aimed to elucidate the relationship between premature placental calcification (PPC) and relevant perinatal outcomes in a large cohort. METHODS We conducted a retrospective cohort study involving 3088 singleton pregnancies that underwent routine third-trimester ultrasound examinations (30+0 to 35+6 gestational weeks) at the Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, between January 2018 and December 2023. Placental calcification was graded using the Grannum system, categorizing placentas into Grades 0-1 (control), Grade 2, and Grade 3. Primary outcomes assessed were small for gestational age neonates (SGA) and preeclampsia. Secondary outcomes included gestational hypertension, fetal growth restriction (FGR), stillbirth, gestational age at birth, and birthweight centile. Multiple logistic regression was employed to adjust for confounders, i.e., maternal age, BMI, smoking, conception via assisted reproductive technology, and uterine artery pulsatility index. RESULTS In total, 544 pregnancies (17.6%) had Grade 2 placentas, and 41 pregnancies (1.3%) had Grade 3 placentas. Compared to the control group, Grade 2 placentas were associated with increased odds of SGA (adjusted odds ratio [aOR] 1.80; 95% confidence intervals [CI]: 1.43-2.25) and FGR (aOR 1.81; 95% CI: 1.35-2.42). Grade 3 placentas showed even higher odds of SGA (aOR 3.09; 95% CI: 1.55-6.17) and FGR (aOR 3.26; 95% CI: 1.53-6.95). No significant associations were found between placental grading and preeclampsia or stillbirth. Additionally, PPC was linked to lower birthweight percentiles and earlier gestational age at birth. CONCLUSIONS Premature placental calcification (before 36+0 weeks), particularly Grade 3, is significantly associated with adverse perinatal outcomes such as SGA and FGR. Incorporating placental grading into routine prenatal care may enhance risk stratification and guide clinical decision making beyond traditional assessment methods.
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Affiliation(s)
- Antonios Siargkas
- Third Department of Obstetrics and Gynecology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.S.); (T.D.)
| | - Ioannis Tsakiridis
- Third Department of Obstetrics and Gynecology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.S.); (T.D.)
| | - Georgios Michos
- Third Department of Obstetrics and Gynecology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.S.); (T.D.)
| | - Anastasios Liberis
- Third Department of Obstetrics and Gynecology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.S.); (T.D.)
| | - Sofoklis Stavros
- Third Department of Obstetrics and Gynecology, University Hospital “ATTIKON”, Medical School of the National, Kapodistrian University of Athens, 11527 Athens, Greece
| | - Menelaos Kyriakakis
- Third Department of Obstetrics and Gynecology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.S.); (T.D.)
| | - Ekaterini Domali
- First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Apostolos Mamopoulos
- Third Department of Obstetrics and Gynecology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.S.); (T.D.)
| | - Themistoklis Dagklis
- Third Department of Obstetrics and Gynecology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.S.); (T.D.)
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Ortega MA, Pekarek T, De Leon-Oliva D, Boaru DL, Fraile-Martinez O, García-Montero C, Bujan J, Pekarek L, Barrena-Blázquez S, Gragera R, Rodríguez-Benitez P, Hernández-Fernández M, López-González L, Díaz-Pedrero R, Asúnsolo Á, Álvarez-Mon M, García-Honduvilla N, Saez MA, De León-Luis JA, Bravo C. Placental Tissue Calcification and Its Molecular Pathways in Female Patients with Late-Onset Preeclampsia. Biomolecules 2024; 14:1237. [PMID: 39456171 PMCID: PMC11506500 DOI: 10.3390/biom14101237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 08/20/2024] [Accepted: 09/27/2024] [Indexed: 10/28/2024] Open
Abstract
Preeclampsia (PE) is a complex multisystem disease characterized by hypertension of sudden onset (>20 weeks' gestation) coupled with the presence of at least one additional complication, such as proteinuria, maternal organ dysfunction, or uteroplacental dysfunction. Hypertensive states during pregnancy carry life-threatening risks for both mother and baby. The pathogenesis of PE develops due to a dysfunctional placenta with aberrant architecture that releases factors contributing to endothelial dysfunction, an antiangiogenic state, increased oxidative stress, and maternal inflammatory responses. Previous studies have shown a correlation between grade 3 placental calcifications and an elevated risk of developing PE at term. However, little is known about the molecular pathways leading to placental calcification. In this work, we studied the gene and protein expression of c-Jun N-terminal kinase (JNK), Runt-related transcription factor 2 (RUNX2), osteocalcin (OSC), osteopontin (OSP), pigment epithelium-derived factor (PEDF), MSX-2/HOX8, SOX-9, WNT-1, and β-catenin in placental tissue from women with late-onset PE (LO-PE). In addition, we employed von Kossa staining to detect mineral deposits in placental tissues. Our results show a significant increase of all these components in placentas from women with LO-PE. Therefore, our study suggests that LO-PE may be associated with the activation of molecular pathways of placental calcification. These results could be the starting point for future research to describe the molecular mechanisms that promote placental calcification in PE and the development of therapeutic strategies directed against it.
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Affiliation(s)
- Miguel A. Ortega
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
| | - Tatiana Pekarek
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
| | - Diego De Leon-Oliva
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
| | - Diego Liviu Boaru
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
| | - Oscar Fraile-Martinez
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
| | - Cielo García-Montero
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
| | - Julia Bujan
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
| | - Leonel Pekarek
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
| | - Silvestra Barrena-Blázquez
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
- Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain
| | - Raquel Gragera
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
| | - Patrocinio Rodríguez-Benitez
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (P.R.-B.); (J.A.D.L.-L.); (C.B.)
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
- Health Research Institute Gregorio Marañón, 28009 Madrid, Spain
- Department of Nephrology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
| | - Mauricio Hernández-Fernández
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
| | - Laura López-González
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
| | - Raul Díaz-Pedrero
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
| | - Ángel Asúnsolo
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
- Immune System Diseases-Rheumatology and Internal Medicine Service, University Hospital Prince of Asturias, Networking Research Center on for Liver and Digestive Diseases (CIBEREHD), 28806 Alcala de Henares, Spain
| | - Natalio García-Honduvilla
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
| | - Miguel A. Saez
- Department of Medicine and Medical Specialities, (CIBEREHD), Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (T.P.); (D.D.L.-O.); (D.L.B.); (O.F.-M.); (C.G.-M.); (J.B.); (L.P.); (R.G.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (S.B.-B.); (L.L.-G.); (R.D.-P.); (Á.A.)
- Pathological Anatomy Service, University Hospital Gómez-Ulla, 28806 Alcala de Henares, Spain
| | - Juan A. De León-Luis
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (P.R.-B.); (J.A.D.L.-L.); (C.B.)
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
- Health Research Institute Gregorio Marañón, 28009 Madrid, Spain
| | - Coral Bravo
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (P.R.-B.); (J.A.D.L.-L.); (C.B.)
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
- Health Research Institute Gregorio Marañón, 28009 Madrid, Spain
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Staicu A, Albu C, Nemeti G, Bondor CI, Boitor-Borza D, Preda AP, Florian A, Goidescu IG, Sachelaru D, Bora N, Constantin R, Surcel M, Stamatian F, Rotar IC, Cruciat G, Muresan D. Ultrasound Placental Remodeling Patterns and Pathology Characteristics in Patients with History of Mild SARS-CoV-2 Infection during Pregnancy. Diagnostics (Basel) 2023; 13:diagnostics13061200. [PMID: 36980508 PMCID: PMC10047494 DOI: 10.3390/diagnostics13061200] [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: 02/13/2023] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Introduction: This research aims to describe a progressive pattern of ultrasound placental remodeling in patients with a history of SARS-CoV-2 infection during pregnancy. Materials and Methods: This was a longitudinal, cohort study which enrolled 23 pregnant women with a history of former mild SARS-CoV-2 infection during the current pregnancy. Four obstetricians analyzed placental ultrasound images from different gestational ages following COVID infection and identified the presence and degree of remodeling. We assessed the inter-rater agreement and the interclass correlation coefficients. Pathology workup included placental biometry, macroscopic and microscopic examination. Results: Serial ultrasound evaluation of the placental morphology revealed a progressive pattern of placental remodeling starting from 30-32 weeks of gestation towards term, occurring approximately 8-10 weeks after the SARS-CoV-2 infection. Placental changes-the "starry sky" appearance and the "white line" along the basal plate-were identified in all cases. Most placentas presented normal subchorionic perivillous fibrin depositions and focal stem villi perivillous fibrin deposits. Focal calcifications were described in only 13% of the cases. Conclusions: We identified two ultrasound signs of placental remodeling as potential markers of placental viral shedding following mild SARS-CoV-2. The most likely pathology correspondence for the imaging aspect is perivillous and, respectively, massive subchorionic fibrin deposits identified in most cases.
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Affiliation(s)
- Adelina Staicu
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Camelia Albu
- Department of Pathology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
- IMOGEN Centre of Advanced Research Studies, Emergency County Hospital, 400000 Cluj-Napoca, Romania
| | - Georgiana Nemeti
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Cosmina Ioana Bondor
- Department of Medical Informatics and Biostatistics, Iuliu Haţieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Dan Boitor-Borza
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Andreia Paraschiva Preda
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Andreea Florian
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Iulian Gabriel Goidescu
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Diana Sachelaru
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Nelida Bora
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Roxana Constantin
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Mihai Surcel
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Florin Stamatian
- IMOGEN Centre of Advanced Research Studies, Emergency County Hospital, 400000 Cluj-Napoca, Romania
| | - Ioana Cristina Rotar
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Gheorghe Cruciat
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Daniel Muresan
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Obstetrics and Gynecology I Clinic, Emergency County Hospital, 400006 Cluj-Napoca, Romania
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Farias SFST, Barbosa HTS, Pinheiro BQ, Xavier Júnior FAF, Morais GBD, Evangelista JSAM, Silva LDMD. Macro and microscopic characteristics of the placenta and its relationship with the weight and the Apgar score of canine neonates. Theriogenology 2023; 202:21-27. [PMID: 36889048 DOI: 10.1016/j.theriogenology.2023.02.018] [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: 11/17/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023]
Abstract
The placenta is the main organ of pregnancy and is directly related to the proper development of the fetus. The correlation among some placental measurements and their respective neonates is widely studied in the human species. However, the studies regarding bitches are still limited. Therefore, the aim of this work was to evaluate if there is a relationship between placental weight and volume and the weight of neonates at birth in the canine species, as well as its influence on their viability. In this work, 7 bitches, 18 neonates and their placentas were evaluated. The weight of the placentas was measured using an analytical balance and the volume was calculated by measuring the volume of water displaced after placing it in a container of water. The neonates were weighed and classified according to the Apgar score after birth. Samples from each placenta were fixed in formalin and embedded in paraffin, then placed on slides and stained in hematoxylin and eosin. From these samples, the microvascular density (MVD) was calculated, as well as the presence or absence of necrosis, calcification and haemorrhage, classified in scores from 0 to 2. Data were analyzed using Kendall's test. The mean weight of the placentas was 29.11 ± 11.06 g and the volume was 21.33 ± 10.65 cm³. The mean weight of the neonates was 282.94 ± 123.28 g and the Apgar score was 8.83 ± 2.06. The mean MVD of the placentas was 0.04 ± 0.01. A positive correlation was observed between birth weight and placental weight and volume. Placental weight also positively correlated with placental volume. Also, no significant correlation was found between MVD and alterations with placental weight and volume and with the weight and Apgar score of neonates. Among the microscopic changes, only necrosis showed a moderate correlation with placental weight and volume. It can be concluded that the placenta has an influence on the weight of neonates, which is essential for its development in intra and extrauterine life. However, more studies are required in the described species, to better elucidate these questions.
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Affiliation(s)
- Sarah Fernanda Salgado Tavares Farias
- Laboratory of Carnivore Reproduction, School of Veterinary Medicine, State University of Ceará (Universidade Estadual do Ceará, UECE), 1700, Doutor Silas Munguba Avenue, CEP, 60714-903, Fortaleza, CE, Brazil
| | - Hélida Tainan Silva Barbosa
- Laboratory of Carnivore Reproduction, School of Veterinary Medicine, State University of Ceará (Universidade Estadual do Ceará, UECE), 1700, Doutor Silas Munguba Avenue, CEP, 60714-903, Fortaleza, CE, Brazil
| | - Breno Queiroz Pinheiro
- Laboratory of Carnivore Reproduction, School of Veterinary Medicine, State University of Ceará (Universidade Estadual do Ceará, UECE), 1700, Doutor Silas Munguba Avenue, CEP, 60714-903, Fortaleza, CE, Brazil
| | - Francisco Antônio Félix Xavier Júnior
- Laboratory of Comparative Experimental Histology and Morphology, State University of Ceará - 1700, Doutor Silas Munguba Avenue, CEP, 60714-903, Fortaleza, CE, Brazil
| | - Glaycianne Bezerra de Morais
- Laboratory of Comparative Experimental Histology and Morphology, State University of Ceará - 1700, Doutor Silas Munguba Avenue, CEP, 60714-903, Fortaleza, CE, Brazil
| | - Janaína Serra Azul Monteiro Evangelista
- Laboratory of Comparative Experimental Histology and Morphology, State University of Ceará - 1700, Doutor Silas Munguba Avenue, CEP, 60714-903, Fortaleza, CE, Brazil
| | - Lúcia Daniel Machado da Silva
- Laboratory of Carnivore Reproduction, School of Veterinary Medicine, State University of Ceará (Universidade Estadual do Ceará, UECE), 1700, Doutor Silas Munguba Avenue, CEP, 60714-903, Fortaleza, CE, Brazil.
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EROL KOÇ EM, YAMAN S, TAŞÇI Y, ÖMÜR N, YILMAZ FM, KARAKAYA J, BEDİR FINDIK R. Fetuin A level in advanced placental calcification at term pregnancies. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1075563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Rduch T, Tsolaki E, El Baz Y, Leschka S, Born D, Kinkel J, Anthis AHC, Fischer T, Jochum W, Hornung R, Gogos A, Herrmann IK. The Role of Inorganics in Preeclampsia Assessed by Multiscale Multimodal Characterization of Placentae. Front Med (Lausanne) 2022; 9:857529. [PMID: 35433726 PMCID: PMC9009444 DOI: 10.3389/fmed.2022.857529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/07/2022] [Indexed: 12/03/2022] Open
Abstract
Preeclampsia is one of the most dangerous diseases in pregnancy. Because of the hypertensive nature of preeclampsia, placental calcifications are believed to be a predictor for its occurrence, analogous to their role in cardiovascular diseases. However, the prevalence and the relevance of calcifications for the clinical outcome with respect to preeclampsia remains controversial. In addition, the role of other inorganic components present in the placental tissue in the development of preeclampsia has rarely been investigated. In this work, we therefore characterized inorganic constituents in placental tissue in groups of both normotensive and preeclamptic patients (N = 20 each) using a multi-scale and multi-modal approach. Examinations included elemental analysis (metallomics), sonography, computed tomography (CT), histology, scanning electron microscopy, X-ray fluorescence and energy dispersive X-ray spectroscopy. Our data show that tissue contents of several heavy metals (Al, Cd, Ni, Co, Mn, Pb, and As) were elevated whereas the Rb content was decreased in preeclamptic compared to normotensive placentae. However, the median mineral content (Ca, P, Mg, Na, K) was remarkably comparable between the two groups and CT showed lower calcified volumes and fewer crystalline deposits in preeclamptic placentae. Electron microscopy investigations revealed four distinct types of calcifications, all predominantly composed of calcium, phosphorus and oxygen with variable contents of magnesium in tissues of both maternal and fetal origin in both preeclamptic and normotensive placentae. In conclusion our study suggests that heavy metals, combined with other factors, can be associated with the development of preeclampsia, however, with no obvious correlation between calcifications and preeclampsia.
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Affiliation(s)
- Thomas Rduch
- Laboratory for Particles Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology (Empa), St. Gallen, Switzerland.,Department of Gynaecology and Obstetrics, Kantonsspital St.Gallen, St. Gallen, Switzerland
| | - Elena Tsolaki
- Laboratory for Particles Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology (Empa), St. Gallen, Switzerland.,Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, Institute of Process Engineering, ETH Zürich, Zurich, Switzerland
| | - Yassir El Baz
- Department of Radiology, Kantonsspital St.Gallen, St. Gallen, Switzerland
| | - Sebastian Leschka
- Department of Radiology, Kantonsspital St.Gallen, St. Gallen, Switzerland
| | - Diana Born
- Institute of Pathology, Kantonsspital St.Gallen, St. Gallen, Switzerland
| | - Janis Kinkel
- Department of Gynaecology and Obstetrics, Kantonsspital St.Gallen, St. Gallen, Switzerland
| | - Alexandre H C Anthis
- Laboratory for Particles Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology (Empa), St. Gallen, Switzerland.,Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, Institute of Process Engineering, ETH Zürich, Zurich, Switzerland
| | - Tina Fischer
- Department of Gynaecology and Obstetrics, Kantonsspital St.Gallen, St. Gallen, Switzerland
| | - Wolfram Jochum
- Institute of Pathology, Kantonsspital St.Gallen, St. Gallen, Switzerland
| | - René Hornung
- Department of Gynaecology and Obstetrics, Kantonsspital St.Gallen, St. Gallen, Switzerland
| | - Alexander Gogos
- Laboratory for Particles Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology (Empa), St. Gallen, Switzerland.,Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, Institute of Process Engineering, ETH Zürich, Zurich, Switzerland
| | - Inge K Herrmann
- Laboratory for Particles Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology (Empa), St. Gallen, Switzerland.,Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, Institute of Process Engineering, ETH Zürich, Zurich, Switzerland
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A New Approach in Detectability of Microcalcifications in the Placenta during Pregnancy Using Textural Features and K-Nearest Neighbors Algorithm. J Imaging 2022; 8:jimaging8030081. [PMID: 35324636 PMCID: PMC8953054 DOI: 10.3390/jimaging8030081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Ultrasonography is the main method used during pregnancy to assess the fetal growth, amniotic fluid, umbilical cord and placenta. The placenta’s structure suffers dynamic modifications throughout the whole pregnancy and many of these changes, in which placental microcalcifications are by far the most prominent, are related to the process of aging and maturation and have no effect on fetal wellbeing. However, when placental microcalcifications are noticed earlier during pregnancy, they could suggest a major placental dysfunction with serious consequences for the fetus and mother. For better detectability of microcalcifications, we propose a new approach based on improving the clarity of details and the analysis of the placental structure using first and second order statistics, and fractal dimension. (2) Methods: The methodology is based on four stages: (i) cropping the region of interest and preprocessing steps; (ii) feature extraction, first order—standard deviation (SD), skewness (SK) and kurtosis (KR)—and second order—contrast (C), homogeneity (H), correlation (CR), energy (E) and entropy (EN)—are computed from a gray level co-occurrence matrix (GLCM) and fractal dimension (FD); (iii) statistical analysis (t-test); (iv) classification with the K-Nearest Neighbors algorithm (K-NN algorithm) and performance comparison with results from the support vector machine algorithm (SVM algorithm). (3) Results: Experimental results obtained from real clinical data show an improvement in the detectability and visibility of placental microcalcifications.
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GENÇ S, ÖZKAN Y, KÜKRER S, ŞİRİNOĞLU H, MİHMANLI V. Preterm placental calcification: maternal calcium, magnesium, 25(OH)D levels and adverse obstetric outcomes in low-risk pregnant women. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1065286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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9
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Mohamed ML, Elbeily MM, Shalaby MM, Khattab YH, Taha OT. Umbilical cord diameter in the prediction of foetal growth restriction: a cross sectional study. J OBSTET GYNAECOL 2022; 42:1117-1121. [PMID: 34994292 DOI: 10.1080/01443615.2021.2010185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This was a cross sectional study with a prospective design conducted from October 2018 to October 2019. We recruited patients at risk for FGR and normal pregnant women. Each patient had ultrasound examination for the umbilical cord diameter in the 28th, 32nd, 36th, and the 40th week, Foetal growth restriction developed in 10/76 (13.2%) patients in the at risk group. The umbilical cord diameter was significantly lower in the at risk group (1.8 ± 0.2 versus 2.0 ± 0.2 in the control group with a p value of <.001). The umbilical cord diameter was highly predictive for the occurrence of FGR at each antenatal care visit as well as at delivery. We concluded that the umbilical cord diameter was a significant predictor of foetal growth restriction when applied through the antenatal care visits. It is a simple and easy method causing no distress for the patients.IMPACT STATEMENTWhat is already known on this subject? Conflicting results exist regarding the predictive role of the umbilical cord in foetal growth restriction.What do the results of this study add? Foetal umbilical cord diameter was correlated significantly to foetal weight and had a significant predictive role in the prediction of FGR. The cut off values for the umbilical cord diameter in women with FGR were not evaluated before.What are the implications of these findings for clinical practice and/or further research? Comparing the ultrasound findings with histopathologic examination of the umbilical cord and the placentas would be recommended.
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Affiliation(s)
- Mariam L Mohamed
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Magda M Elbeily
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Maisara M Shalaby
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Yara H Khattab
- Department of Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Omima T Taha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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10
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Dash S, Das B, Panda SR, Rajguru M, Jena P, Mishra A, Rath SK. Perinatal Outcomes in Premature Placental Calcification and the Association of a Color Doppler Study: Report from a Tertiary Care Hospital in Eastern India. Clin Pract 2021; 11:841-849. [PMID: 34842626 PMCID: PMC8628690 DOI: 10.3390/clinpract11040099] [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: 09/02/2021] [Revised: 10/25/2021] [Accepted: 11/04/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Placental calcification, identified before the 36th week of gestational age, is known as premature placental calcification (PPC). PPC could be a clue for the poor fetal outcome. However, its association with adverse perinatal outcomes is yet to be confirmed. Objective: The primary objective was to determine and compare the perinatal outcomes in pregnancies with and without documented premature placental calcification. Methodology: The present study was a prospective cohort study performed from October 2017 to September 2019. We consecutively enrolled 494 antenatal women who presented to our antenatal OPD after taking consent to participate in our study. Transabdominal sonographies were conducted between 28-36 weeks of gestation to document placental maturity. We compared maternal and fetal outcomes between those who were identified with grade III placental calcification (n = 140) and those without grade III placental calcification (n = 354). Results: The incidence of preeclampsia, at least one abnormal Doppler index, obstetrics cholestasis, placental abruption, and FGR (fetal growth restriction) pregnancies were significantly higher in the group premature placental calcification. We also found a significantly increased incidence of Low APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) scores, NICU (Neonatal Intensive Care Unit) Admission, Abnormal CTG (cardiotocography), meconium-stained liquor, and low birth weight babies in those with grade III placental calcification. Conclusion: Clinicians should be aware of documenting placental grading while performing ultrasonography during 28 to 36 weeks. Ultrasonographically, the absence of PPC can define a subcategory of low-risk pregnant populations which probably need no referral to specialized centers and can be managed in these settings.
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Affiliation(s)
- Sudarshan Dash
- Department of Obstetrics and Gynaecology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar 751024, India; (S.D.); (B.D.); (M.R.); (P.J.); (S.K.R.)
| | - Banya Das
- Department of Obstetrics and Gynaecology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar 751024, India; (S.D.); (B.D.); (M.R.); (P.J.); (S.K.R.)
| | - Soumya Ranjan Panda
- Department of Obstetrics and Gynaecology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar 751024, India; (S.D.); (B.D.); (M.R.); (P.J.); (S.K.R.)
- Correspondence: ; Tel.: +91-94603-79740
| | - Monalisa Rajguru
- Department of Obstetrics and Gynaecology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar 751024, India; (S.D.); (B.D.); (M.R.); (P.J.); (S.K.R.)
- IMO-JB, ESIC Hospital, Bhubaneswar 751022, India
| | - Pramila Jena
- Department of Obstetrics and Gynaecology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar 751024, India; (S.D.); (B.D.); (M.R.); (P.J.); (S.K.R.)
| | - Abheepsa Mishra
- The Feinstein Institute for Medical Research, Manhasset, NY 11030, USA;
| | - Sudhanshu Kumar Rath
- Department of Obstetrics and Gynaecology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar 751024, India; (S.D.); (B.D.); (M.R.); (P.J.); (S.K.R.)
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11
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Schiffer V, van Haren A, De Cubber L, Bons J, Coumans A, van Kuijk SM, Spaanderman M, Al-Nasiry S. Ultrasound evaluation of the placenta in healthy and placental syndrome pregnancies: A systematic review. Eur J Obstet Gynecol Reprod Biol 2021; 262:45-56. [PMID: 33984727 DOI: 10.1016/j.ejogrb.2021.04.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION An antepartum screening method to determine normal and abnormal placental function is desirable in the prevention of maternal and fetal pregnancy complications. Placental appearance can easily be obtained and evaluated using 2D ultrasonography, but surprisingly little is known about the change in placental appearance during gestation. Aim of this systematic review was to describe the antepartum placental appearance in placenta syndrome (PS) pregnancies, and to compare this to the appearance in healthy pregnancies. METHODS A systematic review investigating placental thickness, -lakes and/or -calcifications by ultrasound examination in both uncomplicated (reference group) and PS pregnancies in relation to gestational age was performed. English literature was searched using PubMed (NCBI), EMBASE (Ovid) and the Cochrane Library, from database inception until September 2020. Data on placental thickness was presented as a continuous variable or as the proportion of abnormal placental thickness. Data on placental lakes and -calcifications was presented as prevalence (%). There was no restriction applied on the definition of placental lakes or -calcifications. Due to heterogeneity, pooling of the results was not performed. RESULTS A total of 28 studies were included describing 1719 PS cases; consisting of 370 (21 %) cases with preeclampsia or pregnancy induced hypertension, 1341 (78 %) cases with fetal growth restriction (FGR) or small for gestational age (SGA), and 8 (1%) cases with combined clinical expressions. In addition, the reference group comprised 3315 pregnant women. Placental thickness showed an increase between the first and second trimester, which was higher in PS- compared to uncomplicated pregnancies. Placental lakes were frequently observed in FGR and SGA pregnancies, especially in the second trimester. Grade 3 calcifications were most prominent in the PS pregnancies, specifically in the late second and third trimester. Moreover, in the reference group, no grade 3 calcifications were reported before 35 weeks of gestation. CONCLUSION Placental appearance in PS-pregnancies shows higher placental thickness and greater presence of placental lakes and -calcifications compared to uncomplicated pregnancies. Standardized definitions of (ab-)normal placental appearance and longitudinal research in both healthy and complicated pregnancies are needed to improve personalized obstetric care.
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Affiliation(s)
- Veronique Schiffer
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre (MUMC+), the Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University, the Netherlands.
| | - Ashlee van Haren
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre (MUMC+), the Netherlands
| | - Lisa De Cubber
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre (MUMC+), the Netherlands
| | - Judith Bons
- Central Diagnostic Laboratory, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Audrey Coumans
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre (MUMC+), the Netherlands
| | - Sander Mj van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC+), the Netherlands
| | - Marc Spaanderman
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre (MUMC+), the Netherlands
| | - Salwan Al-Nasiry
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre (MUMC+), the Netherlands
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Tesi M, Miragliotta V, Scala L, Aronica E, Lazzarini G, Fanelli D, Rota A, Abramo F. Gross and histological findings in the canine placenta and amnion at term: What's normal, abnormal or pathological? Reprod Domest Anim 2021; 56:691-702. [PMID: 33529420 DOI: 10.1111/rda.13905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 11/28/2022]
Abstract
The canine placenta is an underexamined organ. Placental abnormalities can affect foetus development and may be responsible for a low weight of the infant at birth; however, knowledge on their clinical significance in the canine species is limited. We aimed to describe macroscopic and microscopic findings in the canine placenta and amnion at term in clinically uncomplicated pregnancies and to evaluate their relationship with birth weight of healthy puppies. During natural delivery or C-section, the birth weight of 82 puppies was recorded, 72 placentas and 66 amnions were recovered. The foetal and maternal surfaces of the placental girdle, marginal haematoma and amnion were evaluated. Each gross finding was recorded, morphometrically assessed and sampled for histological diagnosis. Furthermore, specimens of placenta and amnion were collected from representative areas and microscopic deviations from normal structure were evaluated in haematoxylin and eosin sections. Gross examination revealed 'abnormalities' in the 75.4% of the collected placentas. Necrosis was the gross change most commonly observed in the placental girdle (72.5%). Congestion (17.4%) and clotted blood/fibrinoid material (2.9%) were also observed. No gross changes of either the marginal haematoma or the amnion were recorded. Histologically, placental girdle showed necrosis (62.3%), mineralization (52.2%), congestion (36.2%) and neutrophilic infiltration (27.5%). Marginal haematoma exhibited mineralization (11.6%) and neutrophils (29%), while necrotic foci were rarely observed (4.3%). In the amnion, the most frequent alteration observed was hypertrophy of the epithelium (35.9%) followed by oedema (31.2%), mineralized foci (28.1%), fibrosis (23.4%), congestion (15.6%) and more rarely neutrophils (12.5%). Puppies' birth weight was not statistically affected by either gross or histological abnormalities. Our study revealed that macroscopic and microscopic 'abnormalities' of the placenta and amnion may be common in uncomplicated pregnancies at term; however, no implications on puppies' birth weight were observed. Deviations from 'normal' morphology of canine foetal adnexa warrant further investigation to assess their clinical implications if present.
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Affiliation(s)
- Matteo Tesi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | | | - Lorenza Scala
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Elisa Aronica
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Giulia Lazzarini
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Diana Fanelli
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Alessandra Rota
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Francesca Abramo
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
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Lederer W, Schaffenrath H, Alomar-Dominguez C, Thaler J, Fantin R, Dostal L, Putz G, Humpel C. Cerebrospinal beta-amyloid peptides(1-40) and (1-42) in severe preeclampsia and HELLP syndrome - a pilot study. Sci Rep 2020; 10:5783. [PMID: 32238862 PMCID: PMC7113242 DOI: 10.1038/s41598-020-62805-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/16/2020] [Indexed: 12/11/2022] Open
Abstract
During pregnancy, substantial alterations in cerebral plasticity, vascular remodeling and neuronal growth occur in the maternal brain. We investigated whether concentrations of selected neurodiagnostic biomarkers in the cerebrospinal fluid of women with preeclampsia/HELLP syndrome differ from those in healthy controls using enzyme-linked immunosorbent assay technique. We found that tau protein concentrations (p = 0.016) and phospho-tau/tau ratio (p < 0.001) in cerebrospinal fluid were significantly lower in 39 preeclamptic women compared to 44 healthy controls during third trimester of pregnancy. Beta-amyloid(1-40)/(1-42) ratio was significantly higher in HELLP syndrome than in severe preeclampsia (8.49 + 2.73 vs. 4.71 + 1.65; p = 0.007). We conclude that beta-amyloid(1-40)/(1-42) ratio in cerebrospinal fluid can discriminate severe preeclampsia and HELLP syndrome. High beta-amyloid peptide and low tau protein concentrations are associated with impaired development of the materno-feto-placental unit and correlate with placental dysfunction.
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Affiliation(s)
- Wolfgang Lederer
- Medical University of Innsbruck, Department of Anesthesiology and Critical Care Medicine, Innsbruck, 6020, Austria.
| | - Helene Schaffenrath
- Medical University of Innsbruck, Department of Gynecology and Obstetrics, Innsbruck, 6020, Austria
| | - Cristina Alomar-Dominguez
- Medical University of Innsbruck, Department of Anesthesiology and Critical Care Medicine, Innsbruck, 6020, Austria
| | - Julia Thaler
- Medical University of Innsbruck, Department of Anesthesiology and Critical Care Medicine, Innsbruck, 6020, Austria
| | - Raffaella Fantin
- Medical University of Innsbruck, Department of Anesthesiology and Critical Care Medicine, Innsbruck, 6020, Austria
| | - Lucie Dostal
- Medical University of Innsbruck, Department of Medical Statistics, Informatics and Health Economics, Innsbruck, 6020, Austria
| | - Guenther Putz
- Medical University of Innsbruck, Department of Anesthesiology and Critical Care Medicine, Innsbruck, 6020, Austria
| | - Christian Humpel
- Medical University of Innsbruck Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck, 6020, Austria
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Pathological Mineralization: The Potential of Mineralomics. MATERIALS 2019; 12:ma12193126. [PMID: 31557841 PMCID: PMC6804219 DOI: 10.3390/ma12193126] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/11/2019] [Accepted: 09/19/2019] [Indexed: 12/11/2022]
Abstract
Pathological mineralization has been reported countless times in the literature and is a well-known phenomenon in the medical field for its connections to a wide range of diseases, including cancer, cardiovascular, and neurodegenerative diseases. The minerals involved in calcification, however, have not been directly studied as extensively as the organic components of each of the pathologies. These have been studied in isolation and, for most of them, physicochemical properties are hitherto not fully known. In a parallel development, materials science methods such as electron microscopy, spectroscopy, thermal analysis, and others have been used in biology mainly for the study of hard tissues and biomaterials and have only recently been incorporated in the study of other biological systems. This review connects a range of soft tissue diseases, including breast cancer, age-related macular degeneration, aortic valve stenosis, kidney stone diseases, and Fahr’s syndrome, all of which have been associated with mineralization processes. Furthermore, it describes how physicochemical material characterization methods have been used to provide new information on such pathologies. Here, we focus on diseases that are associated with calcium-composed minerals to discuss how understanding the properties of these minerals can provide new insights on their origins, considering that different conditions and biological features are required for each type of mineral to be formed. We show that mineralomics, or the study of the properties and roles of minerals, can provide information which will help to improve prevention methods against pathological mineral build-up, which in the cases of most of the diseases mentioned in this review, will ultimately lead to new prevention or treatment methods for the diseases. Importantly, this review aims to highlight that chemical composition alone cannot fully support conclusions drawn on the nature of these minerals.
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Heazell AEP, Hayes DJL, Whitworth M, Takwoingi Y, Bayliss SE, Davenport C. Biochemical tests of placental function versus ultrasound assessment of fetal size for stillbirth and small-for-gestational-age infants. Cochrane Database Syst Rev 2019; 5:CD012245. [PMID: 31087568 PMCID: PMC6515632 DOI: 10.1002/14651858.cd012245.pub2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Stillbirth affects 2.6 million pregnancies worldwide each year. Whilst the majority of cases occur in low- and middle-income countries, stillbirth remains an important clinical issue for high-income countries (HICs) - with both the UK and the USA reporting rates above the mean for HICs. In HICs, the most frequently reported association with stillbirth is placental dysfunction. Placental dysfunction may be evident clinically as fetal growth restriction (FGR) and small-for-dates infants. It can be caused by placental abruption or hypertensive disorders of pregnancy and many other disorders and factorsPlacental abnormalities are noted in 11% to 65% of stillbirths. Identification of FGA is difficult in utero. Small-for-gestational age (SGA), as assessed after birth, is the most commonly used surrogate measure for this outcome. The degree of SGA is associated with the likelihood of FGR; 30% of infants with a birthweight < 10th centile are thought to be FGR, while 70% of infants with a birthweight < 3rd centile are thought to be FGR. Critically, SGA is the most significant antenatal risk factor for a stillborn infant. Correct identification of SGA infants is associated with a reduction in the perinatal mortality rate. However, currently used tests, such as measurement of symphysis-fundal height, have a low reported sensitivity and specificity for the identification of SGA infants. OBJECTIVES The primary objective was to assess and compare the diagnostic accuracy of ultrasound assessment of fetal growth by estimated fetal weight (EFW) and placental biomarkers alone and in any combination used after 24 weeks of pregnancy in the identification of placental dysfunction as evidenced by either stillbirth, or birth of a SGA infant. Secondary objectives were to investigate the effect of clinical and methodological factors on test performance. SEARCH METHODS We developed full search strategies with no language or date restrictions. The following sources were searched: MEDLINE, MEDLINE In Process and Embase via Ovid, Cochrane (Wiley) CENTRAL, Science Citation Index (Web of Science), CINAHL (EBSCO) with search strategies adapted for each database as required; ISRCTN Registry, UK Clinical Trials Gateway, WHO International Clinical Trials Portal and ClinicalTrials.gov for ongoing studies; specialist abstract and conference proceeding resources (British Library's ZETOC and Web of Science Conference Proceedings Citation Index). Search last conducted in Ocober 2016. SELECTION CRITERIA We included studies of pregnant women of any age with a gestation of at least 24 weeks if relevant outcomes of pregnancy (live birth/stillbirth; SGA infant) were assessed. Studies were included irrespective of whether pregnant women were deemed to be low or high risk for complications or were of mixed populations (low and high risk). Pregnancies complicated by fetal abnormalities and multi-fetal pregnancies were excluded as they have a higher risk of stillbirth from non-placental causes. With regard to biochemical tests, we included assays performed using any technique and at any threshold used to determine test positivity. DATA COLLECTION AND ANALYSIS We extracted the numbers of true positive, false positive, false negative, and true negative test results from each study. We assessed risk of bias and applicability using the QUADAS-2 tool. Meta-analyses were performed using the hierarchical summary ROC model to estimate and compare test accuracy. MAIN RESULTS We included 91 studies that evaluated seven tests - blood tests for human placental lactogen (hPL), oestriol, placental growth factor (PlGF) and uric acid, ultrasound EFW and placental grading and urinary oestriol - in a total of 175,426 pregnant women, in which 15,471 pregnancies ended in the birth of a small baby and 740 pregnancies which ended in stillbirth. The quality of included studies was variable with most domains at low risk of bias although 59% of studies were deemed to be of unclear risk of bias for the reference standard domain. Fifty-three per cent of studies were of high concern for applicability due to inclusion of only high- or low-risk women.Using all available data for SGA (86 studies; 159,490 pregnancies involving 15,471 SGA infants), there was evidence of a difference in accuracy (P < 0.0001) between the seven tests for detecting pregnancies that are SGA at birth. Ultrasound EFW was the most accurate test for detecting SGA at birth with a diagnostic odds ratio (DOR) of 21.3 (95% CI 13.1 to 34.6); hPL was the most accurate biochemical test with a DOR of 4.78 (95% CI 3.21 to 7.13). In a hypothetical cohort of 1000 pregnant women, at the median specificity of 0.88 and median prevalence of 19%, EFW, hPL, oestriol, urinary oestriol, uric acid, PlGF and placental grading will miss 50 (95% CI 32 to 68), 116 (97 to 133), 124 (108 to 137), 127 (95 to 152), 139 (118 to 154), 144 (118 to 161), and 144 (122 to 161) SGA infants, respectively. For the detection of pregnancies ending in stillbirth (21 studies; 100,687 pregnancies involving 740 stillbirths), in an indirect comparison of the four biochemical tests, PlGF was the most accurate test with a DOR of 49.2 (95% CI 12.7 to 191). In a hypothetical cohort of 1000 pregnant women, at the median specificity of 0.78 and median prevalence of 1.7%, PlGF, hPL, urinary oestriol and uric acid will miss 2 (95% CI 0 to 4), 4 (2 to 8), 6 (6 to 7) and 8 (3 to 13) stillbirths, respectively. No studies assessed the accuracy of ultrasound EFW for detection of pregnancy ending in stillbirth. AUTHORS' CONCLUSIONS Biochemical markers of placental dysfunction used alone have insufficient accuracy to identify pregnancies ending in SGA or stillbirth. Studies combining U and placental biomarkers are needed to determine whether this approach improves diagnostic accuracy over the use of ultrasound estimation of fetal size or biochemical markers of placental dysfunction used alone. Many of the studies included in this review were carried out between 1974 and 2016. Studies of placental substances were mostly carried out before 1991 and after 2013; earlier studies may not reflect developments in test technology.
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Affiliation(s)
- Alexander EP Heazell
- University of ManchesterMaternal and Fetal Health Research Centre5th floor (Research), St Mary's Hospital, Oxford RoadManchesterUKM13 9WL
| | - Dexter JL Hayes
- University of ManchesterMaternal and Fetal Health Research Centre5th floor (Research), St Mary's Hospital, Oxford RoadManchesterUKM13 9WL
| | - Melissa Whitworth
- University of ManchesterMaternal and Fetal Health Research Centre5th floor (Research), St Mary's Hospital, Oxford RoadManchesterUKM13 9WL
| | - Yemisi Takwoingi
- University of BirminghamInstitute of Applied Health ResearchEdgbastonBirminghamUKB15 2TT
| | - Susan E Bayliss
- University of BirminghamInstitute of Applied Health ResearchEdgbastonBirminghamUKB15 2TT
| | - Clare Davenport
- University of BirminghamInstitute of Applied Health ResearchEdgbastonBirminghamUKB15 2TT
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Wallingford MC, Benson C, Chavkin NW, Chin MT, Frasch MG. Placental Vascular Calcification and Cardiovascular Health: It Is Time to Determine How Much of Maternal and Offspring Health Is Written in Stone. Front Physiol 2018; 9:1044. [PMID: 30131710 PMCID: PMC6090024 DOI: 10.3389/fphys.2018.01044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/13/2018] [Indexed: 12/15/2022] Open
Abstract
Vascular calcification is the deposition of calcium phosphate minerals in vascular tissue. Vascular calcification occurs by both active and passive processes. Extent and tissue-specific patterns of vascular calcification are predictors of cardiovascular morbidity and mortality. The placenta is a highly vascularized organ with specialized vasculature that mediates communication between two circulatory systems. At delivery the placenta often contains calcified tissue and calcification can be considered a marker of viral infection, but the mechanisms, histoanatomical specificity, and pathophysiological significance of placental calcification are poorly understood. In this review, we outline the current understanding of vascular calcification mechanisms, biomedical consequences, and therapeutic interventions in the context of histoanatomical types. We summarize available placental calcification data and clinical grading systems for placental calcification. We report on studies that have examined the association between placental calcification and acute adverse maternal and fetal outcomes. We then review the intersection between placental dysfunction and long-term cardiovascular health, including subsequent occurrence of maternal vascular calcification. Possible maternal phenotypes and trigger mechanisms that may predispose for calcification and cardiovascular disease are discussed. We go on to highlight the potential diagnostic value of placental calcification. Finally, we suggest avenues of research to evaluate placental calcification as a research model for investigating the relationship between placental dysfunction and cardiovascular health, as well as a biomarker for placental dysfunction, adverse clinical outcomes, and increased risk of subsequent maternal and offspring cardiovascular events.
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Affiliation(s)
- Mary C Wallingford
- Mother Infant Research Institute, Tufts Medical Center, Boston, MA, United States.,Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, United States
| | - Ciara Benson
- Department of Bioengineering, University of Washington, Seattle, WA, United States
| | - Nicholas W Chavkin
- Yale Cardiovascular Research Center, Yale University School of Medicine, New Haven, CT, United States.,School of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, United States
| | - Michael T Chin
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, United States
| | - Martin G Frasch
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States
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Chen KH, Seow KM, Chen LR. Progression of gestational hypertension to pre-eclampsia: A cohort study of 20,103 pregnancies. Pregnancy Hypertens 2017; 10:230-237. [PMID: 29153686 DOI: 10.1016/j.preghy.2017.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/20/2017] [Accepted: 10/06/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate previously un-identified risk factors for the progression of gestational hypertension (GH) to pre-eclampsia (PE) by considering Grade III preterm placental calcification (PPC) and excessive weight gain (≧10kgw) at 28weeks gestation. METHODS At a tertiary teaching hospital, obstetric ultrasonography was performed at 28weeks gestation to establish a diagnosis of grade III PPC. Weight gain during pregnancy was recorded at the same time. Pregnancies complicated with chronic hypertension, major fetal congenital anomalies, termination before 24weeks gestation, and abortion before 20 weeks gestation were excluded. RESULTS In the current cohort study, 20,103 pregnancies were enrolled and categorized as normal blood pressure (NBP; n=18,223) and GH-PE (n=1880) groups. According to severity of the diseases, the GH-PE group was further divided into GH (n=1088), PE (n=792), and severe PE (n=209) groups. There were significant differences between the NBP and GH-PE groups in known factors, including maternal age, BMI, parity, multi-fetal pregnancy, and co-morbidities (all p<0.001), all of which increased the risk for GH-PE. Regarding the progression of GH to PE and severe PE, there was a much greater frequency of excessive weight gain (51.2% and 49.0% vs. 9.3%) or PPC (63.2% and 61.6% vs. 12.1%) in the severe PE and PE groups than the GH group. Logistic regression analysis revealed that PPC was a significant and independent risk factor for progression of GH to PE (OR, 13.71; 95% CI, 10.25-18.33) and severe PE (OR, 12.42; 95% CI, 8.89-17.35), as well as excessive weight gain during pregnancy (OR, 8.92; 95% CI, 6.67-11.92 and OR, 10.25; 95% CI, 7.30-12.40). CONCLUSION Being a pathologic implication, the presence of PPC or excessive weight gain during pregnancy may precede progression of GH, and can serve as a warning or marker that requires closer surveillance for maternal and fetal well-being. Based on the findings of PPC and excessive weight gain, at-risk pregnant woman should be counseled to facilitate early intervention or referral. In addition, avoiding excessive weight gain during pregnancy may reduce the risk of GH progression to PE.
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Affiliation(s)
- Kuo-Hu Chen
- Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan.
| | - Kok-Min Seow
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan
| | - Li-Ru Chen
- Department of Physical Medicine and Rehabilitation, Mackay Memorial Hospital, Taipei, Taiwan; Department of Mechanical Engineering, National Chiao-Tung University, Hsinchu, Taiwan
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18
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Zeng J, Marcus A, Buhtoiarova T, Mittal K. Distribution and potential significance of intravillous and intrafibrinous particulate microcalcification. Placenta 2017; 50:94-98. [PMID: 28161068 DOI: 10.1016/j.placenta.2017.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/27/2016] [Accepted: 01/05/2017] [Indexed: 01/22/2023]
Abstract
Radiologic studies indicate that placental calcifications seen at 28-32 weeks' gestation are associated with adverse fetal outcome. One type of placental calcification is typically located at the basement membrane of chorionic villi. It has a fine particulate appearance and can only be seen microscopically. We have designated these calcifications as Intravillous and Intrafibrinous Particulate MicroCalcification (IPMC). In this study we examined the distribution and potential significance of IPMC. Placentas from 14 groups of fetal and maternal outcomes are examined histologically for IPMC. These groups were preterm birth, post term birth, intrauterine fetal demise, fetuses with non-reassuring heart rates, intrauterine growth restriction, fetal anomalies, mothers with gestational hypertension, gestational diabetes, placental abruption, pre-eclampsia and placentas of normal spontaneous vaginal births and placentas with chorioamnionitis, chronic villitis and infarcts. We observed fine dust-like particulates deposited in continuous and discrete patches. The particulates were predominantly located in the basement membranes of fibrotic chorionic villi and in perivillous fibrin. Compared to placentas without adverse outcomes, a higher incidence of IPMC was seen in intrauterine fetal demise cases and in cases with infarcts which suggests that hypoxia played a role in the etiology of IPMC.
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Affiliation(s)
- Jennifer Zeng
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, 10016 New York, NY, USA.
| | - Alan Marcus
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, 10016 New York, NY, USA
| | - Tatiana Buhtoiarova
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, 10016 New York, NY, USA
| | - Khushbakhat Mittal
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, 10016 New York, NY, USA
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19
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Velarde MC, Menon R. Positive and negative effects of cellular senescence during female reproductive aging and pregnancy. J Endocrinol 2016; 230:R59-76. [PMID: 27325241 DOI: 10.1530/joe-16-0018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 06/17/2016] [Indexed: 12/21/2022]
Abstract
Cellular senescence is a phenomenon occurring when cells are no longer able to divide even after treatment with growth stimuli. Because senescent cells are typically associated with aging and age-related diseases, cellular senescence is hypothesized to contribute to the age-related decline in reproductive function. However, some data suggest that senescent cells may also be important for normal physiological functions during pregnancy. Herein, we review the positive and negative effects of cellular senescence on female reproductive aging and pregnancy. We discuss how senescent cells accelerate female reproductive aging by promoting the decline in the number of ovarian follicles and increasing complications during pregnancy. We also describe how cellular senescence plays an important role in placental and fetal development as a beneficial process, ensuring proper homeostasis during pregnancy.
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Affiliation(s)
- Michael C Velarde
- Institute of BiologyUniversity of the Philippines Diliman, Quezon City, Philippines Buck Institute for Research on AgingNovato, California, USA
| | - Ramkumar Menon
- Department of Obstetrics and GynecologyUniversity of Texas Medical Branch at Galveston, Galveston, Texas, USA Department of Clinical Medicine and Obstetrics and GynecologyAarhus University, Aarhus, Denmark
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20
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Polettini J, Dutta E, Behnia F, Saade G, Torloni M, Menon R. Aging of intrauterine tissues in spontaneous preterm birth and preterm premature rupture of the membranes: A systematic review of the literature. Placenta 2015; 36:969-73. [DOI: 10.1016/j.placenta.2015.05.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 04/13/2015] [Accepted: 05/01/2015] [Indexed: 10/23/2022]
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21
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Chen KH, Seow KM, Chen LR. The role of preterm placental calcification on assessing risks of stillbirth. Placenta 2015; 36:1039-1044. [PMID: 26194801 DOI: 10.1016/j.placenta.2015.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/26/2015] [Accepted: 06/30/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Stillbirth is an important issue in antenatal care and much remains unknown. This cohort study aims to explore the previously un-identified risk factor of third-trimester stillbirth to determine if Grade III preterm placental calcification (PPC) is associated with stillbirth. METHODS At a tertiary teaching hospital, obstetric ultrasonography was performed at 28 weeks' gestation to establish a diagnosis of PPC. Pregnancies with multifetal gestations, major fetal congenital anomalies, termination, cord accidents, apparent intrauterine infection, and antepartum complications were excluded. RESULTS 15,122 eligible pregnancies were categorized as stillbirth (n = 99) and livebirth (n = 15,023) groups. Between these two groups, there were no significant differences in maternal age, BMI, and parity, but significant differences in smoking and in PPC (35.4% vs 6.3%, p < 0.001) were observed. The peak occurrence of stillbirths was at 30 and 37 weeks' gestation, with a bimodal distribution of 11 and 17 stillbirths, respectively. For pregnancies with or without PPC, the incidences of stillbirths per-1000-births were 35.9 and 4.5, respectively. Using Kaplan-Meier survival analysis, at 40 weeks' gestation the cumulative stillbirth risk for pregnancies with PPC was higher compared to those without PPC. Logistic regression revealed that after adjusting for the effects of smoking and demographic factors, the risk of stillbirth (adjusted OR:7.62; 95% CI:5.00-11.62) was much higher when PPC was present. DISCUSSION Grade III PPC is associated with a higher incidence of stillbirth, and identified an independent risk factor. Being a pathologic implication, it may precede this negative outcome and can serve as a warning sign or marker when noted on ultrasonography.
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Affiliation(s)
- Kuo-Hu Chen
- Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan.
| | - Kok-Min Seow
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan
| | - Li-Ru Chen
- Department of Mechanical Engineering, National Chiao-Tung University, Hsinchu, Taiwan
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22
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Theophilou G, Sahashrabudhe N, Martindale EA, Heazell AEP. Correlation between abnormal placental appearance at routine 2nd trimester ultrasound scan and histological examination of the placenta after birth. J OBSTET GYNAECOL 2012; 32:760-3. [DOI: 10.3109/01443615.2012.702149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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23
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Orczyk-Pawiłowicz M, Hirnle L, Kątnik-Prastowska I. HIGH EXPRESSION OF α1,2- AND α1,6-LINKED FUCOSES ON AMNIOTIC AGP AS A BIOMARKER OF FETAL POSTMATURITY RISK. J Immunoassay Immunochem 2011; 32:103-13. [DOI: 10.1080/15321819.2010.543220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Chen KH, Chen LR, Lee YH. Exploring the relationship between preterm placental calcification and adverse maternal and fetal outcome. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 37:328-334. [PMID: 20586039 DOI: 10.1002/uog.7733] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/14/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To explore the relationship between preterm placental calcification and adverse pregnancy outcome, including maternal and fetal outcomes. METHODS In this prospective cohort study, monthly ultrasonography was performed starting at 28 weeks' gestation to establish the diagnosis of Grade III placental calcification. Women were classified into three groups: Group 1, the early preterm group, with placental calcification found prior to 32 weeks (n = 63); Group 2, the late preterm group, with placental calcification found between 32 and 36 weeks (n = 192); and Group 3, the control group, without placental calcification noted between 28 and 36 weeks (n = 521). Women who smoked cigarettes or drank alcohol during pregnancy, or who had hypertension, diabetes, significant antenatal anemia or placenta previa were all excluded. Logistic regression analysis was used to estimate the risks of adverse pregnancy outcome in Groups 1 and 2 by calculating odds ratios (OR) with 95% CIs, adjusted by maternal age, body mass index, economic status, marital status, type of delivery and parity. RESULTS Risks for adverse maternal outcome including postpartum hemorrhage (OR, 3.43; 95% CI, 1.251-9.388), placental abruption (OR, 6.52; 95% CI, 1.356-31.382) and maternal transfer to the intensive care unit (OR, 9.76; 95% CI, 1.826-52.195) and for adverse fetal outcomes including preterm birth (OR, 4.20; 95% CI, 1.775-9.940), low birth weight (OR, 4.58; 95% CI, 2.201-9.522), low Apgar score (OR, 6.53; 95% CI, 2.116-20.142) and neonatal death (OR, 9.04; 95% CI, 1.722-47.411) were much higher in Group 1 than in Group 3. In contrast, there were no significant differences in adverse pregnancy outcome between Groups 2 and 3. CONCLUSIONS Early preterm placental calcification is associated with a higher incidence of adverse pregnancy outcome, and may serve as an indicator of adverse maternal and fetal outcomes when noted on ultrasonography. Conversely, women with late preterm placental calcification are not at greater risk for adverse pregnancy outcome.
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Affiliation(s)
- K H Chen
- Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan.
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25
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Moran M, Ryan J, Higgins M, Brennan PC, McAuliffe FM. Poor agreement between operators on grading of the placenta. J OBSTET GYNAECOL 2011; 31:24-8. [PMID: 21280988 DOI: 10.3109/01443615.2010.522266] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- M Moran
- UCD School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland.
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26
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Sonographic Maturation of the Placenta at 30 to 34 Weeks Is Not Associated With Second Trimester Markers of Placental Insufficiency in Low-risk Pregnancies. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2010; 32:1134-1139. [DOI: 10.1016/s1701-2163(16)34736-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Nandi A, Wang X, Accili D, Wolgemuth DJ. The effect of insulin signaling on female reproductive function independent of adiposity and hyperglycemia. Endocrinology 2010; 151:1863-71. [PMID: 20176725 PMCID: PMC2851187 DOI: 10.1210/en.2009-0788] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Physiological states of insulin resistance such as obesity and diabetes have been linked to abnormalities in female reproductive function. However, it is difficult to distinguish the direct effects of impaired insulin signaling from those of adiposity or hyperglycemia because these conditions often coexist in human syndromes and animal models of insulin resistance. In this study, we used lean, normoglycemic mouse lines with differing degrees of hyperinsulinemia and insulin receptor (Insr) expression to dissect the effects of altered insulin signaling on female reproduction. All three mouse lines [Ttr-Insr(-/-), Insr(+/-), and Insr(+/+) (wild type)] are able to maintain fertility. However, the insulin-resistant and hyperinsulinemic mice demonstrate altered duration of estrous cycles as well as aberrant distribution and morphology of ovarian follicles. These effects appear to be independent of hyperandrogenism in the mice. Pregnancy studies indicate decreased success in early progression of gestation. In successful pregnancies, decreased embryo weights and increased placental calcification also implicate altered insulin signaling in later gestational effects. Thus, abnormal insulin signaling, independent of adipose tissue mass, adipokine expression levels, and hyperglycemia, can affect parameters of the female hypothalamic-pituitary-gonadal axis and pregnancy outcomes.
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Affiliation(s)
- Anindita Nandi
- Columbia University Medical Center, Russ Berrie Medical Pavilion, Room 608, 1150 St. Nicholas Avenue, New York, New York 10032, USA
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28
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Acosta-Maldonado B, Sánchez-Ramírez B, Reza-López S, Levario-Carrillo M. Effects of exposure to pesticides during pregnancy on placental maturity and weight of newborns: A cross-sectional pilot study in women from the Chihuahua State, Mexico. Hum Exp Toxicol 2009; 28:451-9. [DOI: 10.1177/0960327109107045] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
It is known that pesticides cross the placental barrier and can cause alterations in the development of placental structures resulting in adverse effects in reproduction. The objectives of this study were to investigate the effects of pesticide exposure during pregnancy on placental maturity and to evaluate the relationship between placental maturity, gestational age and birth weight. We collected the placentas from singleton pregnancies from women exposed (n = 9) and non-exposed (n = 45 full-term and n = 31 preterm) to pesticides as evaluated geographically, by questionnaire and by acetylcholinesterase levels. Placental morphometry from the central and peripheral regions was examined by microscopy and staining with hematoxylin and eosin. The placental maturity index (PMI) was estimated by dividing the number of epithelial plates in terminal villi to their thickness in 1 mm2 of the placental parenchyma. Gestational age, birth weight and the following characteristics of the mother were also recorded: pre-pregnancy body mass index, weight gain during pregnancy and hemoglobin concentrations. Birth weight and the gestational age were correlated with PMI (r = .54 and r = .44, respectively; p < .01). Pesticide exposure was associated with a higher PMI (beta = 7.38, p = .01) after adjusting by variables related to placental maturity. In conclusion, the results suggest a relationship between prenatal exposure to pesticides and placental maturity and may potentially affect the nutrient transport from the mother to the fetus.
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Affiliation(s)
- Brenda Acosta-Maldonado
- Medical Research Unit in Clinical Epidemiology of the Mexican Social Security Institute, Chihuahua, Mexico
| | - Blanca Sánchez-Ramírez
- Graduate Program in Biotechnology, Faculty of Chemical Sciences, Autonomous University of Chihuahua, Apdo. Postal 1542-C, Chihuahua, Mexico
| | - Sandra Reza-López
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Margarita Levario-Carrillo
- Medical Research Unit in Clinical Epidemiology of the Mexican Social Security Institute, Chihuahua, Mexico,
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Chan OTM, Mannino FL, Benirschke K. A retrospective analysis of placentas from twin pregnancies derived from assisted reproductive technology. Twin Res Hum Genet 2007; 10:385-93. [PMID: 17564529 DOI: 10.1375/twin.10.2.385] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There are conflicting studies associating twin pregnancies derived from assisted reproductive technology (ART) with preterm birth, low birthweight, and other negative outcomes. This work investigates whether ART is linked with any placental pathology, given that placentation significantly influences fetal development. A 5-year, retrospective cohort study was conducted on placentas from twin pregnancies. The placental information from 417 patients was divided into two groups: placentas derived from ART and placentas derived from spontaneous pregnancies (non-ART). Available clinical information and pathologic findings from both groups then were compared. There was no statistical difference in the prevalence of placental pathology between the non-ART and ART cohorts (i.e., cord insertion, single umbilical artery, cord knot, retroplacental hemorrhage, infarction, vasculopathy, vascular anastomoses, chorangiosis, villitis, deciduitis, chorioamnionitis, meconium staining). However, 8% of ART multiple pregnancies were monochorionic. While monochorionicity is a known risk factor for adverse obstetric and neonatal outcomes, the rate of monochorionic placentation did not increase as a result of ART. Nevertheless, it is interesting to note that this small percentage of monochorionic placentation occurred in the ART cohort despite the implantation of individual embryos. Overall, the data suggests that ART does not have a role in the pathologic placentation of twin pregnancies.
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Affiliation(s)
- Owen T M Chan
- Department of Pathology, University of California, San Diego Medical Center, San Diego, CA 92103-8321, USA
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30
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Current awareness in prenatal diagnosis. Prenat Diagn 2005; 25:529-34. [PMID: 16032805 DOI: 10.1002/pd.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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