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Journal articles on the topic 'Gestation pathologie'
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Hansen, Anne R., Margaret H. Collins, David Genest, Debra Heller, Susan Schwarz, Petra Banagon, Elizabeth N. Allred, and Alan Leviton. "Very Low Birthweight Infant's Placenta and Its Relation to Pregnancy and Fetal Characteristics." Pediatric and Developmental Pathology 3, no. 5 (September 2000): 419–30. http://dx.doi.org/10.1007/s100240010043.
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Our objective was to relate pathology of the very low birthweight (VLBW) infant's placenta to pregnancy and fetal characteristics. We correlated the pathologic features of 1146 placentas from infants with birth weights of 500–1500 g who were born between 1/1/91 and 12/ 31/93 to the number of gestations per pregnancy, initiator of preterm delivery, gestational age, birth weight Z score, and duration of rupture of membrane (ROM). Placental correlates of acute inflammation and villous edema were associated with preterm labor (PTL), pre-labor premature rupture of membranes (PROM), lower gestational age, and higher birth weight Z score. In PTL pregnancies delivered within 1 h of membrane rupture, 61% of placentas already had membrane inflammation. Placental correlates of pregnancy-induced hypertension (PIH) were seen more commonly with PIH pregnancies, older gestational age, and lower birth weight Z score. We found a more prominent histopathologic signature for singleton than for multiple gestation placentas. The placental pathologic findings associated with the clinical diagnoses of infection, PIH, and low–birth weight Z scores in our VLBW/preterm population are similar to those in the literature regarding term pregnancies. The presence of multiple histologic findings consistent with inflammation in placentas of PTL pregnancies with duration of ROM lasting < 1 h suggests that some cases of PTL are precipitated by a more long-standing infection than that previously suspected. Morphologic placental features appear to be correlates of the phenomena leading to premature delivery. Examination of the VLBW infant's placenta provides insight into the etiology and management of VLBW/preterm deliveries.
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Gawron, Lori M., Cassing Hammond, and Linda M. Ernst. "Perinatal Pathologic Examination of Nonintact, Second-Trimester Fetal Demise Specimens: The Value of Standardization." Archives of Pathology & Laboratory Medicine 137, no. 8 (August 1, 2013): 1083–87. http://dx.doi.org/10.5858/arpa.2012-0010-oa.
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Context.—Management of second-trimester intrauterine fetal demise via dilation and evacuation results in nonintact specimens for pathologic examination. Surgical pathology examination is often mandated; however, evidence on expected findings and specimen evaluation guidelines are lacking. Objectives.—To assess pathologic findings of nonintact, second-trimester fetal demise specimens, through comparison of anatomic abnormalities identified on standardized perinatal examination to individualized general pathology examinations. Design.—Single institution, retrospective chart review of 14- to 24-week gestational size fetal demise cases was conducted from May 2006 to October 2010. Suspected abnormalities, chromosomal and pathologic diagnoses were collected. A general surgical pathology examination occurred between May 2006 and October 2008, while a perinatal pathologist examined specimens between October 2008 and October 2010. Statistical analysis consisted of t tests and χ2 tests by Stata/SE 12.1. Results.—One hundred eighteen specimens were included and mean gestational size was 16.0 weeks (standard deviation, 1.6 weeks). Perinatal pathologic evaluation diagnosed significantly more abnormalities than did general pathologic examination (77.3% [34 of 44] versus 9.5% [7 of 75], P < .001). Forty-eight abnormalities were identified: 77.0% (n = 37) were placental and 23.0% (n = 11) were fetal. Chromosomal analysis was done on 73.7% (n = 87 of 118) with 12.6% (n = 11 of 87) showing abnormalities. Among aneuploid specimens, the perinatal pathologist confirmed abnormalities in 66.7% (n = 4 of 6) of cases while general pathologists confirmed abnormalities in 0% (n = 0 of 5) (P = .02). Conclusions.—Systematic surgical pathology examination of nonintact, second-trimester fetal demise specimens yields increased information on fetal or placental abnormalities, which may be clinically useful. Institutions with high-risk obstetrical practices and dilation and evacuation providers should consider integrating a standardized perinatal checklist into educational and practice guidelines.
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Aguinaga, Mónica, Yolotzin Valdespino, Daniela Medina, Salvador Espino y Sosa, Rosalba Sevilla, Osvaldo Miranda, Sandra Acevedo, et al. "Causal analysis of fetal death in high-risk pregnancies." Journal of Perinatal Medicine 49, no. 6 (March 19, 2021): 740–47. http://dx.doi.org/10.1515/jpm-2020-0352.
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Abstract Objectives To determine the causes of fetal death among the stillbirths using two classification systems from 22 weeks of gestation in a period of three years in high-risk pregnancies. This is a retrospective observational study. Methods The National Institute of Perinatal Health in Mexico City is a Level 3 care referral center attending high-risk pregnancies from throughout the country. The population consisted of patients with fetal death during a three-year period. Between January 2016 and December 2018, all stillbirths were examined in the Pathology Department by a pathologist and a medical geneticist. Stillbirth was defined as a fetal death occurring after 22 weeks of gestation. Results Main outcome measures: Causal analysis of fetal death using the International Statistical Classification of Disease and Related Health Problems-Perinatal Mortality (ICD-PM) and initial causes of fetal death (INCODE) classification systems. A total of 297 stillborn neonates were studied. The distribution of gestational age in antepartum stillbirths (55.2%) showed a bimodal curve, 36% occurred between 24 and 27 weeks and 32% between 32 and 36 weeks. In comparison, the majority (86%) of intrapartum deaths (44.8%) were less than 28 weeks of gestation. Of the 273 women enrolled, 93 (34%) consented to a complete fetal autopsy. The INCODE system showed a present cause in 42%, a possible cause in 54% and a probable cause in 93% of patients. Conclusions The principal causes of antepartum death were fetal abnormalities and pathologic placental conditions and the principal causes of intrapartum death were complications of pregnancy which caused a premature labor and infections.
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Franklin, Andrew, Sushmita Yallapragada, Robert Birkett, William Grobman, Linda M. Ernst, and Karen Mestan. "The impact of placental pathology discordance in multiple gestation pregnancies on bronchopulmonary dysplasia-associated pulmonary hypertension." Pulmonary Circulation 10, no. 1 (January 2020): 204589402091067. http://dx.doi.org/10.1177/2045894020910674.
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Bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) may either be concordant or discordant between multiple gestation births. Abnormal placental development, particularly maternal vascular malperfusion, may account for discordance in BPD-PH through fetal programming mechanisms. Maternal vascular malperfusion is a placental histologic lesion associated with intrauterine growth restriction and BPD-PH. We conducted a retrospective longitudinal cohort study of infants born <29 weeks gestation with available placental histology at Prentice Women's Hospital in Chicago from 2005–2012. The primary outcome was discordant BPD-PH associated with placental maternal vascular malperfusion. We secondarily assessed whether the risk of BPD-PH and placental lesions was different among infants of multiple (compared to singleton) gestations. The cohort consisted of 135 multiple gestation infants and 355 singletons. In a separate cohort of 39 singletons and 35 multiples, associations between 12 cytokines and angiogenic growth factors in cord blood plasma for biomarker discordance, maternal vascular malperfusion, and bronchopulmonary dysplasia were explored. Among multiples, discordant maternal vascular malperfusion was not associated with BPD-PH (OR = 1.9 (0.52, 6.9); p = 0.33) in infants exposed to placental maternal vascular malperfusion. However, singleton infants were more likely to develop BPD-PH (compared to multiples) after adjusting for mode of delivery, chorioamnionitis, chronic hypertension, placental abruption, small-for-gestational age birth weight, and gestational age (aOR = 2.7 (1.2, 5.8); p = 0.038). Singletons were more likely to be small-for-gestational age (11% vs 4%, p = 0.025) and have placental lesions compared to their multiple-gestation counterparts (96% vs 81%, p < 0.001), principally severe maternal vascular malperfusion (17% vs 4%, p < 0.001) and chronic inflammation (32% vs 11%, p < 0.001). Increased risk of BPD-PH in singleton pregnancies <29 weeks gestation compared to multiples may be related to increased frequency of these histologic lesions. Placental pathology in singleton and multiple gestation pregnancies may serve as an early biomarker to predict BPD-PH.
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Pinar, Halit, Merielle Stephens, Don B. Singer, Theonia K. Boyd, Solveig M. V. Pflueger, David L. Gang, Drucilla J. Roberts, and C. James Sung. "Triplet Placentas: Reference Values for Weights." Pediatric and Developmental Pathology 5, no. 5 (September 2002): 495–98. http://dx.doi.org/10.1007/s10024-002-0014-0.
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The occurrence of twins, triplets, and other multiple births increased significantly between 1970 and 2000 in the United States and other industrialized countries. The number of triplet placentas submitted for examination as pathologic specimens has also markedly increased, but no reference values are published for triplet weights. We examined 196 normal triplet placentas. Specimens with associated conditions known to affect the weights of the placentas were excluded. The gestational ages ranged between 20 and 38 weeks. Mean weights for different gestational ages are summarized as follows: 253 g for 20 weeks, 319 g for 22 weeks, 406 g for 24 weeks, 509 g for 26 weeks, 621 g for 28 weeks, 738 g for 30 weeks, 855 g for 32 weeks, 965 g for 34 weeks, 1065 g for 36 weeks, and 1147 g for 38 weeks. Weight gain of triplet placentas appears to parallel that of twin placentas. The mean values of placental weights for triplets at each gestational age are less than triple those of singleton weights for the same duration of gestation. The placental weights in multiple gestations do not increase proportionately with the number of fetuses.
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Dugnat, M. "Troubles des conduites alimentaires (TCA) en période périnatale : chez la mère, chez le nourrisson, dans l’interaction." European Psychiatry 29, S3 (November 2014): 611. http://dx.doi.org/10.1016/j.eurpsy.2014.09.227.
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La World Association for Infant Mental Heath (Association Internationale pour la Santé Mentale du Bébé) contribue au développement et à la transmission des connaissances, et à la promotion d’actions cliniques et thérapeutiques en faveur du bébé et de ses parents. Le groupe WAIMH-Francophone, fondé en 1994 par Serge Lebovici et Bernard Golse, insiste sur les aspects psychopathologiques, stimule un réseau francophone de différentes équipes impliquées en psychiatrie périnatale, aide à faire le point sur les travaux en cours et promouvoir un certain nombre de recherches. Plusieurs membres se sont récemment engagés sur les TCA et l’interaction. Les TCA maternels (recherche à la maternité de Port-Royal (APHP) dans le cadre d’un réseau de prise en charge) : Pendant la gestation, la femme change corporellement comme psychiquement. Sous l’effet d’une attention particulière à l‘alimentation des « réactivations » sont possibles lorsqu’elles ont un passé ou un présent de TCA. Une trentaine ont été rencontrées lors des entretiens semi-structurés anténataux puis revues au cours d’un repas avec leur enfant à trois mois, et comparées à d’autres mères sans antécédents. Des résultats préliminaires seront présentés. Les TCA du nourrisson : Après la naissance, l’alimentation est une des préoccupations premières de la mère, les recherches épidémiologiques récentes montrent en clinique pédiatrique ordinaire qu’un quart à un tiers des bébés sont sujets à des difficultés d’alimentation restrictive qui peuvent se transformer en trouble du comportement alimentaire (2 %). Une réflexion sur étiologie et facteurs de chronicisation des TCA précoces contribuant à l’amélioration des modalités de prise en charge pédiatrique, psychologique et rééducative conduira à la présentation d’une consultation conjointe pédiatre/psychologue depuis 4 ans au CHU Toulouse. Les troubles interactionnels : Chez les mères borderlines ou à pathologie des liens, les réponses orales incohérentes lors des pleurs, les réveils intempestifs à motifs alimentaires etc. font de l’alimentation un enjeu crucial de la négligence et de l’interaction pathologique.
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Hyde, Georgia, Andrew Fry, Ashok Raghavan, and Elspeth Whitby. "Biometric analysis of the foetal meconium pattern using T1 weighted 2D gradient echo MRI." BJR|Open 2, no. 1 (November 2020): 20200032. http://dx.doi.org/10.1259/bjro.20200032.
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Objectives: Foetal MRI is used to assess abnormalities after ultrasonography. Bowel anomalies are a significant cause of neonatal morbidity, however there are little data concerning its normal appearance on antenatal MRI. This study aims to investigate the pattern of meconium accumulation throughout gestation using its hyperintense appearance on T1 weighted scans and add to the current published data. Methods: This was a retrospective cohort study in a tertiary referral clinical MRI centre. Foetal body MRI scans of varying gestational ages were obtained dating between October 2011 and March 2018. The bowel was visualised on T1 weighted images. The length of the meconium and the width of the meconium at the rectum, sigmoid colon, splenic flexure and hepatic flexure was measured. Presence or absence of meconium in the small bowel was noted. Inter- and intrarater reliability was assessed. Results: 181 foetal body scans were reviewed. 52 were excluded and 129 analysed. Visualisation of the meconium in the large bowel became increasingly proximal with later gestations, and small bowel visualisation was greater at earlier gestations. There was statistically significant strong (r = 0.6–0.8) or very strong (r = 0.8–1.0) positive correlation of length and width with increasing gestation. Interrater reliability was moderate to excellent (r = 0.4–1.0). Conclusion: This study provides new information regarding the pattern of meconium accumulation throughout gestation. With care, the results can be used in clinical practice to aid diagnosis of bowel pathology. Advances in knowledge: The findings of this study provide further information concerning the normal accumulation of foetal meconium on MR imaging, an area where current research is limited.
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Brenner, Benjamin. "Inherited Thrombophilia and Pregnancy Loss." Thrombosis and Haemostasis 82, no. 08 (1999): 634–40. http://dx.doi.org/10.1055/s-0037-1615890.
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IntroductionA successful pregnancy is dependent on the development of adequate placental circulation. Abnormalities of placental vasculature may result in a number of gestational pathologies, including first and second trimester miscarriages, intrauterine growth retardation (IUGR), intrauterine fetal death (IUFD), placental abruption, and preeclampsia.1 Approximately 5% of women experience two or more consecutive abortions. Habitual abortions, defined as three or more spontaneous recurrent pregnancy losses, may affect as many as 1% to 2% of women of reproductive age. The discovery of an association between recurrent pregnancy loss, and antiphospholipid antibodies, specifically lupus anticoagulant, and anticardiolipin antibodies increased interest in a possible acquired thrombotic autoimmune cause.The inherited thrombophilias are a group of genetic disorders of blood coagulation resulting in an increased risk of thrombosis. Today, a full understanding of the inherited thrombophilias is becoming increasingly important in the management of high-risk gestations. Several reports over the last three years have suggested that not only are these disorders associated with an increased risk of thromboembolic disease during pregnancy and puerperium, but they are also associated with an increased incidence of vascular pathologies, resulting in poor gestational outcome.2 This review will cover recent data concerning thrombophilia and vascular placental pathology, potential pathophysiologic mechanisms for this association, and available therapeutic modalities for prevention of placental vascular thrombosis in order to maximize successful gestational outcome.
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Malinowski, W. "Very Early and Simple Determination of Chorionic and Amniotic Type in Twin Gestations by High-Frequency Transvaginal Ultrasonography." Acta geneticae medicae et gemellologiae: twin research 46, no. 3 (July 1997): 167–73. http://dx.doi.org/10.1017/s0001566000000581.
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AbstractObjective. The aim was to determine the chorionic and amniotic types in multifetal pregnancies with transvaginal ultrasonography at very early stage of gestation.Study design. Twenty-one spontaneous multifetal pregnancies were scanned transvaginally before 8 weeks' gestation (four of them from 4th week). The chorionic and amniotic type was determined ultrasonographically. All twin gestations had postpartum pathologic evaluation of the placenta and histologic determination of the chorionic and amniotic type.Results. Ultrasonographic evaluation of the 21 pregnancies demonstrated 20 twin and 1 triplet gestation. Four of the twin pregnancies were monochorionic-diamniotic. Triplet was monochorionic-triamniotic (spontaneously aborted in 8th week of gestation). In all 20 twin pregnancies, transvaginal ultrasonography correctly predicted the chorionic and amniotic type before 8 weeks of gestation.Conclusion. Transvaginal ultrasonography allows a reliable, simple and rapid determination; the dichorionic twin pregnancy in 4 weeks, monochorionic in 5 weeks, and differentiation of mono-or diamniotic in 7 weeks of gestation.
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Suplotova, Lyudmila Aleksandrovna, S. A. Smetanina, and N. A. Novakovskaya. "Rasprostranennost' metabolicheskogo sindroma i ego komponentov u zhenshchin v razlichnykh etnicheskikh gruppakh." Obesity and metabolism 8, no. 2 (June 15, 2011): 48–51. http://dx.doi.org/10.14341/2071-8713-4952.
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The aim of this work was to evaluate the prevalence of obesity, pathologic weight gain and metabolic syndrome among pregnant women (n=521) in Tyumen Region of Russia. We found that high prevalence of obesity, pathologic gestational weight gain and disturbances of glucose metabolism were increased in non-native than native residents of the studied region. Metabolic syndrome in gestational period is seen very rarely and includes up to three of its components. Women of reproductive age with obesity form the risk group for the development of the metabolic infringement during gestation period. It is necessary to provide specific activities to decrease a body weight among women before pregnancy in order to prevent metabolic disturbances and reproductive losses.
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Ashwal, Eran, Liran Hiersch, Howard Berger, Amir Aviram, Arthur Zaltz, John Kingdom, Jon Barrett, and Nir Melamed. "Pathologic Basis for the Definition of Discordant Growth in Dichorionic Twins." Fetal Diagnosis and Therapy 48, no. 4 (2021): 279–87. http://dx.doi.org/10.1159/000514328.
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<b><i>Objective:</i></b> The aim of the current study was to identify the optimal cutoff that should define discordance in dichorionic twin gestations through correlation with abnormal placental pathology as a specific measure of fetal growth restriction of the smaller twin. <b><i>Methods:</i></b> We performed a retrospective cohort study of all women with dichorionic twin pregnancies who gave birth in a single center between 2002 and 2015. We investigated the association between the level of growth discordance and maternal vascular malperfusion (MVM) pathology in the placenta of the smaller twin, with and without adjustment for whether the smaller twin is small for gestational age (SGA). <b><i>Results:</i></b> A total of 1,198 women with dichorionic twin gestation met the study criteria. The rate of MVM pathology in the placenta of the smaller twin increased with the level of discordance and was most obvious for discordance ≥25% (rate of MVM 12.0% compared with 2.8% in cases with discordance <10%, adjusted relative risk [aRR] 3.71, 95% confidence interval [CI] 1.97–6.99). When the analysis was adjusted for SGA of the smaller twin, discordance was independently associated with MVM pathology only when growth discordance was ≥25% (aRR 2.18, 95%-CI 1.01–4.93), while SGA was strongly associated with MVM pathology irrespective of the level of discordance. <b><i>Conclusion:</i></b> Our findings suggest that discordant growth in dichorionic twins should raise the concern of fetal growth restriction of the smaller twin, irrespective of whether the smaller twin is SGA, only when the discordance s ≥25%. The association of lower levels of discordance with abnormal placental pathology is mainly driven by the confounding effect of SGA of the smaller twin.
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Konje, Justin C., Stephen C. Bell, James J. Morton, Richard De Chazal, and David J. Taylor. "Human Fetal Kidney Morphometry during Gestation and the Relationship between Weight, Kidney Morphometry and Plasma Active Renin Concentration at Birth." Clinical Science 91, no. 2 (August 1, 1996): 169–75. http://dx.doi.org/10.1042/cs0910169.
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1. This study was designed to examine the changes in kidney morphometry during gestation in fetuses that were either appropriate or small for gestational age and the relationship between umbilical vein plasma active renin and kidney morphometry. 2. Serial ultrasound measurements of various morphometric and renal indices were performed in a cohort of 87 singleton fetuses from 22 to 38 weeks gestation. Blood was collected from the umbilical vein at delivery and active renin was measured from the plasma based on angiotensinogen I generated during incubation with plasma and ox renin substrate. 3. Growth in the longitudinal plane of fetal kidneys was similar in the small- and appropriate-for-gestational age groups; however, growth in the anterio-posterior, transverse and circumference planes of the kidneys was significantly slower in the small-for-gestational-age group after 26 weeks gestation. Differences in growth rate in the two groups were most marked between 26 and 34 weeks and persisted until delivery when the anterior-posterior diameter was significantly larger (P < 0.00001) in the appropriate-for-gestational-age group (26.1 ± 2.5 mm compared with 19.8 ± 2.6 mm). The mean umbilical vein active plasma renin concentration at delivery was significantly higher (P < 0.05) in the small-for-gestational-age group (274.4 ± 32.9 μ-units/ml plasma) than in the appropriate-for-gestational-age group (164.9 ± 28.3 μ-units/ml plasma). In addition, there were statistically significant inverse correlations between renin concentration and birthweight (r = − 0.55, P < 0.001) and between renin concentration and kidney anterior-posterior diameter (r = −0.67, P < 0.001). 4. Fetal renal growth was slower in small than in appropriate-for-gestational-age fetuses. The period of 26–34 weeks gestation was that during which maximum fetal renal growth occurred. Umbilical vein plasma renin levels were higher in small-for-gestational-age fetuses. The findings of slow fetal renal growth rate and associated high renin concentrations seen in small-for-gestational-age fetuses could be implicated in an irreversible reno-vascular pathology leading to adult hypertension. We suggest that 26 to 34 weeks could be the ‘critical period’ during which the insult that leads to in-utero programming for the development of adult hypertension occurs.
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Nikolayenkov, Igor P., Tatyana U. Kuzminykh, Marina A. Tarasova, and Darya S. Seryogina. "Features of the course of pregnancy in women with polycystic ovary syndrome." Journal of obstetrics and women's diseases 69, no. 5 (December 23, 2020): 105–12. http://dx.doi.org/10.17816/jowd695105-112.
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Polycystic ovary syndrome is one of the most common pathologies in the practice of an obstetrician-gynecologist. Overcoming infertility characteristic of this syndrome is an important problem of endocrinology, gynecology, and reproductive medicine. Innovative therapeutic and surgical methods of treatment can correct hormonal and metabolic disorders, induce ovulation and achieve a long-awaited pregnancy. Early gestation periods in patients with polycystic ovary syndrome often occur with miscarriage, and the risks of developing gestational diabetes mellitus, cervical insufficiency, gestational arterial hypertension, preeclampsia, and placental insufficiency increase. We have analyzed modern ideas about the effect of various pathogenetic links of polycystic ovary syndrome on the course of pregnancy.
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Verma, Priyanka, Monika Gupta, and Shraddha Verma. "Correlation of placental thickness with gestational age in antenatal women." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 8 (July 26, 2019): 3061. http://dx.doi.org/10.18203/2320-1770.ijrcog20193512.
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Background: Accurate estimation of gestational age and fetal wellbeing is mandatory to ensure safe pregnancy and healthy delivery. With recent development in USG, basic scan, Doppler imaging and interventional radiology helped greatly in accurate estimation of gestational age and delivering timely care. The objectives of this study was to determine the USG placental thickness at the level of insertion of cord in antenatal women from gestational age 11 to 40 weeks. To correlate placental thickness with gestational age. To calculate composite gestational age from USG parameters; CRL, BPD, HC, AC, FL. To compare the relationship of menstrual gestational age with placental thickness and composite gestational age separatelyMethods: It is a comparative study of 2 years duration. Total 322 patients were included. Gestational age was determined from LMP. Patient’s routine obstetric USG was done and composite gestational age was calculated from fetal parameters like BPD, HC, AC and FL (CRL in 11 to 14 weeks). At the same time placental thickness was determined at the level of insertion of umbilical cord. The plane of USG image was adjusted so that the thickness measured from cord insertion is perpendicular to the margin of uterine wall.Results: The following parameters were noted: correlation of period of gestation (weeks) with composite gestational age (weeks) correlation of period of gestation (weeks) with gestational age calculated by placental thickness (weeks).Conclusions: Placental thickness can give an estimation of gestational age. The linear correlation and statistical compatibility of placental thickness makes it an alternate parameter for gestational age. Knowledge of correct gestational age helps in delivering proper antenatal care, assessing fetal wellbeing, identifying pathology at the earliest and timely decision of termination and providing safe motherhood.
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Casanueva, Esther, María Eugenia Flores-Quijano, María Emila Roselló-Soberón, Luz María De-Regil, and Reyna Sámano. "Gestational Weight Gain as Predicted by Pregestational Body Mass Index and Gestational Age in Mexican Women." Food and Nutrition Bulletin 29, no. 4 (December 2008): 334–39. http://dx.doi.org/10.1177/156482650802900410.
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Objective To develop a reference pattern to evaluate gestational weight according to pregestational body mass index (BMI) and gestational age, using current longitudinal information from healthy pregnant women. Subjects and methods We followed 438 women with singleton pregnancies between weeks 16 and 36 of pregnancy. Women were excluded if they developed pathologic conditions during gestation, delivered malformed or dead fetuses, or delivered babies with a birthweight of less than 2500 or more than 4200 g or with a gestational age of less than 37 or more than 41 weeks. Weight, biochemical indicators, and clinical indicators were recorded every 4 weeks throughout the pregnancy. Data were analyzed by sequential regressions. Results Four equations for maternal predicted weight across categories of pregestational BMI (underweight, normal, overweight, and obese) and gestational ages were developed and synthesized in a table of reference values. Conclusions Optimal weight and weight gain during pregnancy can be estimated with our equations, which are corrected for pregestational BMI and gestational age.
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Edris, Fawaz E. "Trichorionic Quadruplet Delivered Beyond 36 Weeks of Gestation: A Case Report and Literature Review." Case Reports in Obstetrics and Gynecology 2011 (2011): 1–4. http://dx.doi.org/10.1155/2011/181034.
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Following one year of secondary fertility, a couple conceived with a quadruplet after transfer of three embryos through IVF-ICSI. At 36 weeks and 2 days of gestation, the mother developed gestational induced hypertension and delivered the next day by caesarean section. Pathology confirmed the zygosity to be trichorionic quadramniotic and all four babies were discharged home with their mother on postoperative day 3. Herein, we describe a successfully managed high-risk pregnancy case. A review of the literature was conducted and to our knowledge no other cases with similar criteria ever reached such advanced gestational age.
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Lee, So-Young, Hyang-Sin Lee, Minchan Gil, Chong Jai Kim, Yong-Hee Lee, Kyu-Rae Kim, and Chan-Sik Park. "Differential Expression Patterns of a Disintegrin and Metalloproteinase With Thrombospondin Motifs (ADAMTS) -1, -4, -5, and -14 in Human Placenta and Gestational Trophoblastic Diseases." Archives of Pathology & Laboratory Medicine 138, no. 5 (May 1, 2014): 643–50. http://dx.doi.org/10.5858/arpa.2012-0227-oa.
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Context.—The ability of intermediate trophoblasts to invade maternal tissue during placentation depends on how well they can degrade the extracellular matrix. Invasion into the extracellular matrix requires many complex proteases. A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) is a novel family of secreted metalloproteinases. The ADAMTS-1, -4, -5, and -14 subtypes are known to be expressed in human placenta, but little is understood about their expression patterns. Objective.—To examine the expression patterns of ADAMTS-1, -4, -5, and -14 in specific human placenta cell types during gestation and in gestational trophoblastic diseases. Design.—Placental tissues were obtained from 25 pregnant women and 21 cases of gestational trophoblastic diseases (10 early complete moles, 3 placental site trophoblastic tumors, 4 invasive moles, and 4 choriocarcinomas). The expression of the 4 ADAMTS was analyzed by immunohistochemistry. Results.—ADAMTS-1, -4, -5, and -14 were differentially expressed by the human placenta throughout gestation in a time-specific and cell type–specific manner, as well as in gestational trophoblastic diseases. ADAMTS-1 showed gradually strong staining intensity in gestational trophoblastic diseases according to the invasive potential but showed consistent strong intensity throughout normal placenta. ADAMTS-4 and ADAMTS-5 exhibited higher and restricted expression in first-trimester intermediate trophoblasts. They also exhibited comparably strong expression in gestational trophoblastic diseases. However, ADAMTS-14 expression remained unchanged throughout gestation. Conclusions.—The restricted expression pattern of ADAMTS-4 and ADAMTS-5 and their increased expression in gestational trophoblastic diseases suggest that these 2 ADAMTS subtypes are associated with a biological phenotype of trophoblasts involved in human placentation and the development of gestational trophoblastic diseases.
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Grosu, Sergio, Johannes Rübenthaler, Thomas Knösel, Matthias Trottmann, Julian Marcon, and Dirk-Andre Clevert. "Splenogonadal fusion evaluation using Contrast Enhanced Ultrasound and Elastography. A case report." Medical Ultrasonography 21, no. 3 (August 31, 2019): 356. http://dx.doi.org/10.11152/mu-1897.
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We present the case of splenogonadal fusion in a 53-year-old male patient assessed by ultrasound and MRI, confirmed by pathologic examination. In addition to B-mode and colour-coded Doppler ultrasound, shear wave elastography and CEUS were performed and are presented in detail. Splenogonadal fusion is a rare congenital anomaly presumably caused by an abnormal attachment of splenic tissue to the gonad during gestation. Diagnosis is challenging for clinicians and in unclear cases splenogonadal fusion might cause unnecessary orchiectomies with benign pathologic results. Ultrasound is the first-line imaging modality in the diagnosis of testicular pathologies. This case report summarizes all available modern ultrasound imagingtechnologies and highlights the possibilities for the diagnosis of splenogonadal fusion.
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Pinar, Halit, Sarah H. Burke, Carol W. Huang, Don B. Singer, and C. James Sung. "Reference Values for Transverse Cerebellar Diameter Throughout Gestation." Pediatric and Developmental Pathology 5, no. 5 (September 2002): 489–94. http://dx.doi.org/10.1007/s10024-001-0262-4.
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The transverse cerebellar diameter (TCD) is well established in the ultrasound literature as a reliable parameter for estimating the duration of gestation. In cases of growth restriction the cerebellum is usually spared, making TCD a reliable indicator of gestational age even when other parameters fall off the appropriate growth curve. The purpose of this study is to establish normal values for the transverse diameter of the cerebellum in pathology specimens, and to determine if these values correlate with those obtained by ultrasound. We examined 96 specimens ranging from 14 to 42 weeks gestational age and found that our values correlate well with those published in the ultrasound literature. Mean TCD with 2 standard deviations for each gestational week were determined as reference values.
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Abbo, Olivier, Luke Harper, Jean-Luc Michel, Dushka Ramful, Audrey Breden, and Frederique Sauvat. "Necrotizing Enterocolitis in Full Term Neonates: Is There Always an Underlying Cause?" Journal of Neonatal Surgery 2, no. 3 (June 28, 2013): 29. http://dx.doi.org/10.47338/jns.v2.41.
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Objective: To review our experience with full-term neonates with necrotizing enterocolitis (NEC) and to compare its characteristics to those published in the literature.Design: Retrospective review of all neonates born after 35 weeks of gestation managed in Reunion Island for NEC from 2000 to 2012.Results: Among the 217 diagnosed NEC, 27 patients (12.4%) were full term neonates, who were born at a mean gestational age of 36.8 ±1.7 weeks. The mean onset of the disease was 12.1±11.2 days after birth. Twenty patients had underlying causes (15 organic pathologies of the child, 3 isolated maternal disease, and 2 infections); 7 had idiopathic NEC. Surgery was required in 12 patients (37.5%) at 23.2±20 days after birth. NEC affected most of the time the colon (n=6) and the rectum (n=3). Overall survival rate was 88.8% (24/27). Two patients required partial non-enteral nutrition for1.3 and 2.1 years.Conclusions: NEC in full term neonates is a rare pathology. The onset of the disease in our experience was slightly later than described in the literature, but remains earlier than in the premature population. In some cases, no obvious cause can be found, suggesting a different pathogenesis. Further investigations are required in order to better understand this pathology. The goal will be to find measures to reduce global mortality.
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Brenner, Benjamin. "Thrombophilia in Pregnancy and its Role in Abortion." Women's Health 1, no. 1 (July 2005): 35–38. http://dx.doi.org/10.1517/17455057.1.1.035.
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Inherited and acquired thrombophilia are the main cause of thrombosis in pregnant women. A growing number of reports over the last few years have suggested that these disorders are also associated with an increased incidence of vascular pathologies resulting in poor gestational outcome. This article discusses recent data concerning thrombophilia and vascular placental pathology, and discusses available therapeutic modalities to prevent placental vascular thrombosis and maximize successful gestational outcome.
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Hebert, Jessica F., Jess A. Millar, Rahul Raghavan, Amie Romney, Jason E. Podrabsky, Monique Y. Rennie, Allison M. Felker, et al. "Male fetal sex affects uteroplacental angiogenesis in growth restriction mouse model†." Biology of Reproduction 104, no. 4 (January 18, 2021): 924–34. http://dx.doi.org/10.1093/biolre/ioab006.
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Abstract Abnormally increased angiotensin II activity related to maternal angiotensinogen (AGT) genetic variants, or aberrant receptor activation, is associated with small-for-gestational-age babies and abnormal uterine spiral artery remodeling in humans. Our group studies a murine AGT gene titration transgenic (TG; 3-copies of the AGT gene) model, which has a 20% increase in AGT expression mimicking a common human AGT genetic variant (A[−6]G) associated with intrauterine growth restriction (IUGR) and spiral artery pathology. We hypothesized that aberrant maternal AGT expression impacts pregnancy-induced uterine spiral artery angiogenesis in this mouse model leading to IUGR. We controlled for fetal sex and fetal genotype (e.g., only 2-copy wild-type [WT] progeny from WT and TG dams were included). Uteroplacental samples from WT and TG dams from early (days 6.5 and 8.5), mid (d12.5), and late (d16.5) gestation were studied to assess uterine natural killer (uNK) cell phenotypes, decidual metrial triangle angiogenic factors, placental growth and capillary density, placental transcriptomics, and placental nutrient transport. Spiral artery architecture was evaluated at day 16.5 by contrast-perfused three-dimensional microcomputed tomography (3D microCT). Our results suggest that uteroplacental angiogenesis is significantly reduced in TG dams at day 16.5. Males from TG dams are associated with significantly reduced uteroplacental angiogenesis from early to late gestation compared with their female littermates and WT controls. Angiogenesis was not different between fetal sexes from WT dams. We conclude that male fetal sex compounds the pathologic impact of maternal genotype in this mouse model of growth restriction.
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Alexiev, Borislav A., Xiaoqing Lin, Chen-Chih Sun, and David S. Brenner. "Meckel-Gruber Syndrome: Pathologic Manifestations, Minimal Diagnostic Criteria, and Differential Diagnosis." Archives of Pathology & Laboratory Medicine 130, no. 8 (August 1, 2006): 1236–38. http://dx.doi.org/10.5858/2006-130-1236-ms.
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Abstract This article provides an overview of the major pathologic manifestations of Meckel-Gruber syndrome, current knowledge about its pathogenesis, minimal diagnostic criteria, and differential diagnosis. Typical sonographic findings (occipital encephalocele, postaxial polydactyly, and cystic enlargement of the kidneys) allow for diagnosis of most cases before the 14th week of gestation, but the pathologist may encounter clinically unsuspected or atypical cases that require morphologic confirmation. In these cases, a meticulous autopsy is necessary to establish the diagnosis of Meckel-Gruber syndrome.
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Ritter, Jana M., Roosecelis B. Martines, and Sherif R. Zaki. "Zika Virus: Pathology From the Pandemic." Archives of Pathology & Laboratory Medicine 141, no. 1 (October 5, 2016): 49–59. http://dx.doi.org/10.5858/arpa.2016-0397-sa.
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Context.—As the number of Zika virus (ZIKV) infections continues to grow, so, too, does the spectrum of recognized clinical disease, in both adult and congenital infections. Defining the tissue pathology associated with the various disease manifestations provides insight into pathogenesis and diagnosis, and potentially future prevention and treatment, of ZIKV infections. Objective.—To summarize the syndromes and pathology associated with ZIKV infection, the implications of pathologic findings in the pathogenesis of ZIKV disease, and the use of pathology specimens for diagnosis of ZIKV infection. Data Sources.—The major sources of information for this review were published articles obtained from PubMed and pathologic findings from cases submitted to the Infectious Diseases Pathology Branch at the Centers for Disease Control and Prevention. Conclusions.—Pathologic findings associated with ZIKV infection are characteristic but not specific. In congenital Zika syndrome, tissue pathology is due to direct viral infection of neural structures, whereas in Guillain-Barré syndrome, pathology is likely due to a postviral, aberrant host-directed immune response. Both fetal and placental pathology specimens are useful for ZIKV diagnosis by molecular and immunohistochemical assays; however, the implications of ZIKV detection in placentas from second- and third-trimester normal live births are unclear, as the potential postnatal effects of late gestational exposure remain to be seen.
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Stanojevic, Milan, and Lana Leko. "Early Neonatal Morbidity after Term Delivery: How should We respond?" Donald School Journal of Ultrasound in Obstetrics and Gynecology 10, no. 2 (2016): 180–84. http://dx.doi.org/10.5005/jp-journals-10009-1465.
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ABSTRACT Aim The aim of this retrospective study was to investigate the influence of gestational age and mode of delivery at term on early neonatal morbidity and mortality in a tertiary maternity center in a 10-year period. Materials and methods The data were derived from the medical records between January 1, 2005, and December 31, 2014, from the University Hospital “Sveti Duh,” Zagreb, Croatia. There were 30,363 live born term infants included in the study. The data from the medical records have been used to analyze their mode of delivery, morbidity, and mortality. Results Term newborn infants delivered by cesarean section (CS) had increased prevalence of lower Apgar scores, resuscitation, neonatal convulsions, and neonatal encephalopathy, respiratory pathology (except for amniotic fluid aspiration), and mechanical ventilation. Early and late neonatal deaths were more prevalent in term infants delivered by CS. The prevalence of birth trauma (except for facial nerve palsy) and hyperbilirubinemia was significantly increased in vaginally born neonates. The prevalence of perinatal infections was equal in both groups of infants. Morbidity and mortality of term newborn infants presented as prevalence per 1,000 live born, regardless of the mode of a delivery week by week from 37 through 41 weeks of gestation, were also investigated. The highest prevalence for most of the observed parameters were at 37 to 41 weeks of gestation, while the lowest prevalence was observed at a gestational age between 39 and 40 weeks. This was not the case for the 1st and the 5th minute 4 to 7 Apgar scores, birth injuries, respiratory pathology, and late neonatal deaths. Conclusion Early-term delivery was connected with more morbidity and mortality in the early neonatal period. It seems that the best gestational age to be born is at 39 to 40 weeks of gestation. Mode of delivery at term counts as well, showing that vaginal delivery at term had the lowest risk of morbidity and mortality. How to cite this article Stanojevic M, Leko L. Early Neonatal Morbidity after Term Delivery: How should We respond? Donald School J Ultrasound Obstet Gynecol 2016;10(2):180-184.
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Fox, Terry, and Enid Gilbert-Barness. "PATHOLOGIC QUIZ CASE: MISSED ABORTION AT 6 WEEKS GESTATION." Fetal and Pediatric Pathology 22, no. 6 (January 2003): 495–96. http://dx.doi.org/10.1080/716100559.
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Fox, Terry, and Enid Gilbert-Barness. "PATHOLOGIC QUIZ CASE: MISSED ABORTION AT 6 WEEKS GESTATION." Pediatric Pathology & Molecular Medicine 22, no. 6 (January 2003): 495–96. http://dx.doi.org/10.1080/pdp.22.6.495.496.
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Spiridonova, N. V., O. B. Kalinkina, F. N. Gilmiyariova, and O. I. Meleshkina. "Association of missed miscarriage and fetal chromosomal disorders." Kazan medical journal 94, no. 5 (October 15, 2013): 748–51. http://dx.doi.org/10.17816/kmj1935.
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Aim. To study the frequency of chromosomal disorders as a cause of missed miscarriage. Methods. 328 women aged 30,34±0,34 years with missed miscarriage at 3 to 22 weeks of gestation were examined. the missed miscarriage was diagnosed by ultrasonography and human chorionic gonadotropin blood level. Endometrectomy with further scrape cytogenic examination were preformed. The preparations for cytogenic examination were obtained by unified direct express-method, karyotyping was performed after the routine and differentiated staining. Results. Fetal karyotype was defined in 88 women. In 54 (61.4%) women, chorionic villi and placenta of miscarried fetuses had chromosome pathologies, in 34 (63%) women - at 1 st trimester, in 20 (37%) - at 2 nd trimester. High frequency of pathological karyotypes identification was observed in 29 (65,9%) women with first pregnancy, compared to 26 (59.1%) women with second and subsequent pregnancies. The following pathologies were found: autosomal trisomy - in 32 (59.3%) women, triploidy - in 8 (14.8%) women, X-chromosome monosomy - in 6 (11.1%) women, polyploidy - in 6 (11.1%), tetraploidy - in 2 (3.7%) women. It was the first missed miscarriage in 268 women (81.7% of cases), with 23 genetic anomalies found in 23 (52.3%) of such cases. In women with repeated missed miscarriage, fetal genetic disorders were revealed in 34 (77.1%) of cases. Female karyotype was found by 7,4% more frequent compared to male karyotype: 29 (53.7%) versus 25 (46.3%) cases. Fetuses with polysomy (double and triple trisomy) and triplody were eliminated at 5-6 weeks of gestation, fetuses with 22 chromosome trisomy at 6-7 weeks of gestation, with 18 chromosome trisomy - at 7-8 weeks of gestation, with X monosomy - at 8-9 weeks of gestation, with 16 chromosome trisomy - at 10-11 weeks of gestation. No relations of fetal karyotype mutations to maternal body mass index were revealed. Conclusion. High frequency of trisomy, as well as in the case of X-chromosome monosomy, points at high incidence and high percentage of autoelimination of the fetuses having this pathology. The presence of pathological karyotype is the reason for earlier pregnancy termination.
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Reynolds, Victoria, Suzanne Meldrum, Karen Simmer, Shyan Vijayasekaran, and Noel French. "Voice problems in school-aged children following very preterm birth." Archives of Disease in Childhood 101, no. 6 (February 23, 2016): 556–60. http://dx.doi.org/10.1136/archdischild-2015-309441.
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Background and objectiveVery preterm children may be at risk of voice abnormalities (dysphonia). Risk factors previously identified in extremely preterm children include female gender, multiple intubations, complicated intubation and very low birth weight. This study sought to identify the prevalence of dysphonia in very preterm children, at school age.MethodsChildren born between 23 and 32 weeks’ gestation were included in this prospective observational study. Participants were randomly selected from a sample stratified by gestational age and number of intubations, and were aged between 5 and 12 years at the time of assessment. Clinical voice assessments were conducted by a speech pathologist, and a diagnosis of dysphonia was made based on the presence and severity of disturbance to the voice. Retrospective chart review identified medical and demographic characteristics.Results178 participants were assessed. The prevalence of dysphonia in this cohort was 61%. 31% presenting with significant dysphonia, that is, voice disturbance of greater than mild in severity. Female gender (p=0.009), gestational age (p=0.031) and duration of intubation (p=0.021) were significantly associated with dysphonia although some preterm children with dysphonia were never intubated.ConclusionsSignificant voice abnormalities were observed in children born at up to 32 weeks’ gestation, with intubation a major contributing factor.Trial registration numberACTRN12613001015730.
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Dikke, G. B., O. A. Pustotina, and V. V. Ostromensky. "Prophylaxis of placental insufficiency and other complications of gestation in women with diseases associated with endothelial dysfunction." Medical alphabet 3, no. 25 (November 19, 2019): 37–42. http://dx.doi.org/10.33667/2078-5631-2019-3-25(400)-37-42.
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The pathogenesis of placental insufficiency and other complications of gestation is associated with vascular endothelial dysfunction. Glycocalyx covering the endothelium plays a fundamental role in coagulation and fibrinolysis. The presence of low molecular weight glycosaminoglycans in glycocalyx has a protective effect. The proven clinical efficacy of sulodexide to correct vascular endothelial dysfunction, prevent placental insufficiency and other pregnancy complications makes it a promising tool for use in obstetric practice among patients with chronic diseases (arterial hypertension, diabetes, obesity, etc.), autoimmune pathology, thrombophilia and related pregnancy complications (gestational diabetes, hypertension in pregnant women, pre-eclampsia, recurrent miscarriage, fetal growth retardation).
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Mitrovic, Milena, Sinisa Stojic, Dragan Tesic, Djordje Popovic, Olivera Rankov, Dragana Tomic-Naglic, Jovanka Novakovic-Paro, et al. "The impact of diabetes mellitus on the course and outcome of pregnancy during a 5-year follow-up." Vojnosanitetski pregled 71, no. 10 (2014): 907–14. http://dx.doi.org/10.2298/vsp1410907m.
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Background/Aim. Women with diabetes, especially diabetes type 1, have worse pregnancy outcomes, as well as increased incidence of spontaneous abortions, pre-eclampsia, fetal macrosomia, preterm delivery, congenital anomalies and perinatal mortality. The aim of this study was to analyze the course and outcome of pregnancy in the patients with diabetes in relation to the group of healthy women regarding preterm delivery, perinatal morbidity and mortality. Also, the aim was to compare pregnancy outcomes in the patients with pre-existing diabetes type 1 and the patients with gestational and diabetes type 2. Methods. This retrospective study included 156 diabetic women treated at the Clinic of Endocrinology, Diabetes and Metabolic Diseases and Gynecology and Obstetrics Clinic of the Clinical Center of Vojvodina from 2006 to 2010. There were 94 patients with gestational diabetes, 48 with type 1 diabetes, and 14 patients with type 2 diabetes. The control group included 106 healthy women hospitalized at the Gynecology and Obstetrics Clinic. Results. The women with type 1 diabetes presented with a statistically significantly higher incidence of cesarean section than those without diabetes, or with type 2 or gestational diabetes (p < 0.0001); the women with type 1 diabetes delivered at an earlier week of gestation (WG) in regard to women without diabetes, or with type 2 or gestational diabetes (p = 0.0017 and p = 0.02, respectively). The incidence of perinatal morbidity: hypoglycemia (p < 0.001), pathological jaundice (p = 0.0021), and other neonatal pathologies at birth (p = 0.0031), was statistically significantly higher and Apgar scores after 1 minute (p = 0.0142) and after 5 minutes (p = 0.0003) were statistically significantly lower in the patients with diabetes compared to the healthy women. The women with type 2 and gestational diabetes were statistically significantly older than those with type 1 diabetes (p = 0.001). A higher incidence of fetal macrosomia in the women with gestational and type 2 diabetes compared to those with type 1 diabetes was at the borderline of statistical significance (p = 0.07), whereas the incidence of hypoglycemia of newborn was statistically significantly higher in the patients with type 1 diabetes (p < 0.0001). Glycosylated hemoglobin (HbA1c) levels were statistically significantly higher in the diabetic women giving birth during and before the week of gestation 36 (p = 0.0087), but there were no differences in HbA1c levels in regard to fetal macrosomia (p = 0.45) and congenital abnormalities (p = 0.32). Conclusion. The results of our study show a higher incidence of perinatal fetal morbidity (hypoglycemia, jaundice, respiratory distress syndrome) in the patients with type 1, type 2 and gestation diabetes than in the healthy controls. Also, we found a higher incidence of cesarean section in the patients with type 1 diabetes than in those with type 2, gestation diabetes and healthy controls. Although delivery in the patients with type 1, type 2 and gestational diabetes was completed approximately one to two weeks earlier compared to the healthy controls there was no statistically significant difference in the incidence of preterm delivery (? 36th week of gestation) between the women with diabetes and healthy controls. Preterm delivery associated with poorer glycaemic control reflected through higher values of HbA1c in third trimester. Risks from adverse pregnancy outcomes may be reduced to minimum by adequate preconception counseling of diabetic patients and early diagnosis of diabetes in pregnancy, in order to achieve glycemic control during organogenesis and within pregnancy and through the teamwork of endocrinologists, gynecologists and pediatricians.
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Malango, A. E. "Pathological Study of Stillbirths Placentas at Muhimbili National Hospital, Tanzania." American Journal of Clinical Pathology 154, Supplement_1 (October 2020): S22—S23. http://dx.doi.org/10.1093/ajcp/aqaa161.041.
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Abstract Introduction/Objective Stillbirth is defined as fetal death that occurs at gestational age of ≥28 weeks. In our setting clinical assessment is the only method used to determine cause of stillbirths, with no reported proportion of unknown clinical diagnosis. Studies showed that unknown cause of stillbirths can be reduced by examination of placenta. Causal identification aids in the mourning process and identifying recurrence risks. The study aimed to describe pathological changes in the placentas of stillbirths which have risk to cause fetal death Methods A descriptive cross-sectional study done for the period of 6 months, it involved examination of 80 placentas of stillbirths born at gestational age of ≥ 28 weeks, placentas were fixed in 10% neutral buffered formalin for 8–12 hours. Grossing and interpretation of placenta pathology was according to Amsterdam Placental Workshop Group Consensus Statement. Results Out of 80 stillbirths, 32(40%) had unknown clinical diagnosis. Majority of stillbirth placentas 71(91%) found with either one or combined pathologies with the risk to cause stillbirth. Maternal vascular malperfusion was the commonest pathology and was significantly associated with preterm stillbirths. Maternal floor infarction, a placenta pathology with risk to cause fetal death and high risk of recurrence was among the pathologies found, was seen in 4(5%) of stillbirth placentas. Conclusion Findings in this study clearly indicated the importance of pathological examination of placenta in determining cause of stillbirth. Placenta examination in stillbirths can identify more pathology related to stillbirths than clinical assessment alone.
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SHEVELEVA, D. I., A. V. ROMANOVSKAYA, and N. F. KHVOROSTUKHINA. "Features of virus infection COVID-19 during the pregnancy." Practical medicine 18, no. 6 (2020): 20–23. http://dx.doi.org/10.32000/2072-1757-2020-6-20-23.
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The purpose of the research was to study the features of the clinical course of COVID-19 viral infection in pregnant women, depending on the gestational stage. Material and methods. Included the study of 67 pregnant women with COVID-19 at different periods of gestation. The age of women ranged from 16 to 41 years. All pregnant women were hospitalized to the infectious diseases departments of Saratov hospitals. During the period of hospitalization, the examination of women was carried out according to the methodological recommendations of the Ministry of Health of Russia for coronavirus infection in pregnant women. During virological examination of mucus from the pharynx and nose, using the reverse transcription polymerase chain reaction method, the RNA of the COVID-19 virus was found in all pregnant women. Results. COVID-19 most frequently infects primipara in the I (61,6%) and III (70,6%) trimester of gestation and multipara in the II (62,5%) trimester of gestation with burdened obstetrics-gynecological anamnesis (58,3%) and accompanying pathologies (41,5%). In pregnant women with COVID-19, mild and intermediate forms of the disease prevailed (31,3% and 47,8% respectiely). The frequency of coronavirus infection in the I (38,8%) and II (35,8%) trimesters of gestation increases the frequency of that in the III (25,3%) trimester. Among women with COVID-19, the following symptoms were observed: decrease in smell and taste in 66 (98,5%) cases, sore throat in 59 (85%) cases, increased body temperature in 61 (90,9%) cases. Lesions of lower respiratory tract was observed in all stages of gestation, pneumonias were less frequent in the I trimester. In all cases the COVID-19 course had a favorable outcome, with no lethality.
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Useinova, R. Kh, A. N. Sulima, A. N. Rybalka, D. A. Beglitse, Z. S. Rumyantseva, P. N. Baskakov, M. A. Dizha, and E. M. Dolya. "Modern view on the etiopathogenesis of heart rhythm disorders and methods of their correction in pregnant women." Obstetrics, Gynecology and Reproduction 15, no. 4 (September 9, 2021): 419–29. http://dx.doi.org/10.17749/2313-7347/ob.gyn.rep.2021.201.
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Introduction. Issues of etiopathogenesis for various cardiovascular disorders in the structure of extragenital diseases during pregnancy pose an urgent problem and represent a global topic for further scientific research. Due to the high frequency of heart rhythm disorders in pregnant women, it is necessary to improve their management.Aim: to analyze data from the current literature on the etiopathogenesis of arrhythmias during gestation and effective methods of their correction.Materials and Methods. Literature sources of electronic databases PubMed/MEDLINE, Medscape, Google Scholar, Embase, Ovid Healthstar, Cochrane, eLibrary, CyberLeninka and scientific articles in peer-reviewed open access journals published across the last 25 years, including basic research on this pathology have been analyzed. The search in databases used keywords and their combinations in Russian and English: "arrhythmias", "arrhythmias in pregnancy", "pathogenesis of gestational arrhythmias".Results. There have been analyzed major aspects of the etiology and pathogenesis of gestational arrhythmias as well as potential causes for developing first-time rhythm disorders in pregnant women and features of the gestational period as a predictor of emerging arrhythmias in patients with pre-existing pathology of the cardiovascular system are determined. The article describes the most common rhythm disorders and acceptable ways to correct them, taking into account the latest recommendations and research in this area.Conclusion. The authors concluded that the etiopathogenesis of rhythm disorders during pregnancy and their treatment methods require further examination.
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Quijano, Fabio E., María Mónica Rey, Mariana Echeverry, and Roland Axt-Fliedner. "Body Stalk Anomaly in a 9-Week Pregnancy." Case Reports in Obstetrics and Gynecology 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/357285.
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Body stalk anomaly is a rare and severe malformation syndrome in which the exact pathophysiology and trigger factors are still unknown. This is a case of a 30-year-old patient who underwent ultrasound at 9 weeks of gestation. It revealed an abnormal location of the inferior body of the embryo in the coelomic space. The findings suggested a short umbilical cord syndrome. In order to confirm the diagnosis, the patient was scheduled for a second ultrasonography at 11 weeks of gestation. The obtained images, confirmed the location of the inferior body in the coelomic space with no visible bladder, absence of the right leg, severe abdominal wall defect, consistent with an omphalocele, and a short 5 mm umbilical cord. These last ultrasonographic findings were consistent with body stalk anomaly. Because of severe malformation incompatible with life, the patient was offered termination of pregnancy. Pathologic examination confirmed the suspected pathology of body stalk anomaly.
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Crobe, A., M. Desogus, A. Sanna, M. Fraschini, C. Gerosa, D. Fanni, V. Fanos, P. Van Eyken, and G. Faa. "Decreasing podocyte number during human kidney intrauterine development." American Journal of Physiology-Renal Physiology 307, no. 9 (November 1, 2014): F1033—F1040. http://dx.doi.org/10.1152/ajprenal.00165.2014.
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Nephron number at birth has relevant clinical importance with implications for long-term renal health. In recent years, the podocyte depletion hypothesis has emerged as an important concept in kidney pathology. This study was aimed at verifying whether human podocyte number changes significantly during intrauterine life. To this end, 62 subjects with gestational ages ranging from 20 to 41 wk were examined. Kidney sections were stained with hematoxylin and eosin and digitally scanned at ×400 magnification. Subjects were subdivided into fetuses (gestational age ≤24 wk, n = 5), preterms (gestational age ≥25 and ≤36 wk, n = 39), and full-term newborns (gestational age ≥37 wk, n = 18). The average podocyte number of 1,908 ± 645, 1,394 ± 498, and 1,126 ± 256 was, respectively, observed in fetuses, preterms, and full-term newborns. A significant main effect ( P = 0.0051) of gestational age on podocyte number was observed with a significantly lower number in full-term newborns than in fetuses ( P < 0.01). Intragroup variability was also observed. We speculate that variations in podocyte number could be correlated with factors such as drugs and maternal diet occurring during intrauterine life. In conclusion, this study shows, for the first time, a decreasing trend in podocyte number during gestation.
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Munim, Wasan, Niran Kamel, Alaa Raheem Kareem, Mustafa Rasool Hussein Aal-Saleh, Mohammed Luay Subhi, and Sarah Abdulkareem Ali Al-Dujaili. "Sex of the Fetus can be Associated with Placental Pathologies in Premature Deliveries." Diyala Journal of Medicine 19, no. 2 (December 15, 2020): 52–58. http://dx.doi.org/10.26505/djm.19025370514.
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Background: There are many pregnancy complications that are significantly associated with the gender of the fetus; one of them is preterm labour, which is an important obstetric problem that may lead to many perinatal morbidity and mortality. Objective: To find out whether there is a relation between the findings of placental pathology of premature deliveries and gender difference. Patients and Methods: Fifty deliveries before a 32 week gestational age. Obstetrical, and placental histological findings have been compared among all males (n=25), and females (n=25) premature neonates. Results: The male premature fetus had distribution rate in maternal age, gestation age at the time of delivery, placental weight, and feto-placental weight-ratio in females, but a higher birth-weight centile ([55.09±11.3] versus [43.09±8.2]). Histopathology of the placenta found no significant association of fetal-sex with acute inflammatory lesions (p=0.09), intra-placental vascular pathological findings, or utero-placental vascular pathology. However, the chronic inflammatory lesion showed a higher pathological score in male fetuses than in the females (p=0.01). Conclusion: Premature deliveries with less than thirty-two weeks, the male fetal-sex had higher placental pathological lesions, suggesting maternal immunological responses towards the invading trophoblasts. The immunological background of these pathological lesions needs further studies. Keywords: Male fetal sex, placental pathology, premature delivery
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Armand, Ray, David S. Brenner, and Chen-Chih J. Sun. "Pathologic Quiz Case: Fetal Death at 32 Weeks of Gestation." Archives of Pathology & Laboratory Medicine 127, no. 7 (July 1, 2003): e317-e318. http://dx.doi.org/10.5858/2003-127-e317-pqcfda.
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Szabo, Denis. "Vie urbaine et criminalité." III. Aspects de la vie urbaine 9, no. 1-2 (April 12, 2005): 67–81. http://dx.doi.org/10.7202/055393ar.
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Les transformations quantitatives et qualitatives de la société, depuis la révolution industrielle, ainsi que les changements technologiques subséquents ont affecté profondément la santé mentale et sociale des populations. La délinquance et la criminalité constituent un aspect de ces conflits, de ces tensions et de ces déséquilibres profonds apportés par le nouveau genre de vie et désignés par le terme «milieu technique». Le changement rapide dans les relations humaines, provoquant la rupture de liens considérés comme naturels dans les sociétés rurales caractérisées par des siècles de stabilité relative, est devenu le barème d'un progrès. Ses bénéfices se comptabilisent par degrés de bien-être et son prix, par degrés de pathologie mentale et sociale. Il n'y a donc rien d'étonnant que les premiers sociologues aient accordé une attention particulière à l'étude des relations entre urbanisation et criminalité, leurs œuvres se situant au tournant du siècle. Durkheim et Tarde, pour ne citer que les Français, ont consacré des études importantes à ce phénomène; le concept d'« anomie », élaboré à propos des suicides dans les sociétés industrielles, est devenu une notion-clef dans la criminologie sociologique de la deuxième moitié du XXe siècle, grâce en particulier à des mises au point de Mer ton [15], de Cloward et d'Ohlin [7]. La sociologie a toujours privilégié l'étude des conflits, elle se soucie uniquement de ce qui va mal. Crimes et villes allient conjointement sur une toile de fond: industrialisation; changement technologique rapide; déplacement de populations par migrations massives interrégionales, internationales et intercontinentales; symptômes de la crise accompagnant la gestation d'un monde nouveau. Quelle est la situation au Québec, société où coexistent à bien des égards des caractéristiques typiques de la société pré-industrielle, aux côtés de formes nouvelles qui s'apparentent à la société « technétronique » de demain, comme l'appelle Brzezinski [3] ? Les données sont éparses, les analyses inexistantes, le chantier en friches. Néanmoins, nous esquisserons avec des moyens de fortune quelques données du problème en indiquant ce qui rapproche et ce qui distingue le modèle québécois de celui d'autres sociétés occidentales. Nous envisagerons le problème sous deux angles complémentaires : les relations entre l'urbanisation et la criminalité en termes statistiques à partir de bases régionales; quelques caractéristiques quantitatives et qualitatives de la criminalité à l'intérieur de l'espace urbain.
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Lawrence, Dylan J., Kristie Huda, and Carolyn L. Bayer. "Longitudinal characterization of local perfusion of the rat placenta using contrast-enhanced ultrasound imaging." Interface Focus 9, no. 5 (August 16, 2019): 20190024. http://dx.doi.org/10.1098/rsfs.2019.0024.
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The placenta performs many physiological functions critical for development. Insufficient placental perfusion, due to improper vascular remodelling, has been linked to many pregnancy-related diseases. To study longitudinal in vivo placental perfusion, we have implemented a pixel-wise time–intensity curve (TIC) analysis of contrast-enhanced ultrasound (CEUS) images. CEUS images were acquired of pregnant Sprague Dawley rats after bolus injections of gas-filled microbubble contrast agents. Conventionally, perfusion can be quantified using a TIC of contrast enhancement in an averaged region of interest. However, the placenta has a complex structure and flow profile, which is insufficiently described using the conventional technique. In this work, we apply curve fitting in each pixel of the CEUS image series in order to quantify haemodynamic parameters in the placenta and surrounding tissue. The methods quantified an increase in mean placental blood volume and relative blood flow from gestational day (GD) 14 to GD18, while the mean transit time of the microbubbles decreased, demonstrating an overall rise in placental perfusion during gestation. The variance of all three parameters increased during gestation, showing that regional differences in perfusion are observable using the pixel-wise TIC approach. Additionally, the high-resolution parametric images show distinct regions of high blood flow developing during late gestation. The developed methods could be applied to assess placental vascular remodelling during the treatment of the pathologies of pregnancy.
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Liu, S., K. Benirschke, A. L. Scioscia, and F. L. Mannino. "Intrauterine Death in Multiple Gestation." Acta geneticae medicae et gemellologiae: twin research 41, no. 1 (January 1992): 5–26. http://dx.doi.org/10.1017/s0001566000002464.
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AbstractIntrauterine death of one fetus in a multiple gestation is associated with significant morbidity and mortality in the surviving infant. This study is a retrospective review of 38 twin and 3 triplet gestations involving the intrauterine death of at least one fetus. The obstetrical history, placental pathology, autopsy findings, and neonatal history of the surviving infant are reviewed. Three cases involved the recent stillbirth of both twins, the remaining cases involved a surviving infant. In one case, neonatal death of a surviving twin occurred on day 19. In two sets of triplets, two stillbirths occurred, in the third case two infants were liveborn. The incidence of preterm delivery was 34%, which decreased to 18% if fetal cotwin death had occurred before 20 weeks gestation. Cesarean section was the method of delivery in 16 cases. There was an excess of velamentous cord insertions, which was most pronounced in the stillborn twin. Monochorionic placentation was found in 72%, also an excess.Neurological damage was known to have occurred in 19 of the 39 surviving infants. Fifteen of these 19 (79%) were associated with monochorionic placentation. The neurologically damaged twin infants, when compared to the normal infants, had the cotwin die later in gestation (31 vs 16.5 weeks), had a shorter duration between the death of the cotwin and delivery (2.5 vs 21 weeks), and delivered earlier in gestation (36.5 vs 39.5 weeks). The probable cause of neurological damage, in our opinion, was either exsanguination into the dead twin fetus, or disseminated intravascular coagulation which occurred in at least 13 cases. The incidence of antepartum death in a multiple gestation, and the potential for neurological damage is probably higher than previously thought. A review of the literature is presented and the clinical implications of this phenomenon are discussed.
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Pérez-Pérez, Antonio, Teresa Vilariño-García, Pilar Guadix, José L. Dueñas, and Víctor Sánchez-Margalet. "Leptin and Nutrition in Gestational Diabetes." Nutrients 12, no. 7 (July 2, 2020): 1970. http://dx.doi.org/10.3390/nu12071970.
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Leptin is highly expressed in the placenta, mainly by trophoblastic cells, where it has an important autocrine trophic effect. Moreover, increased leptin levels are found in the most frequent pathology of pregnancy: gestational diabetes, where leptin may mediate the increased size of the placenta and the fetus, which becomes macrosomic. In fact, leptin mediates the increased protein synthesis, as observed in trophoblasts from gestational diabetic subjects. In addition, leptin seems to facilitate nutrients transport to the fetus in gestational diabetes by increasing the expression of the glycerol transporter aquaporin-9. The high plasma leptin levels found in gestational diabetes may be potentiated by leptin resistance at a central level, and obesity-associated inflammation plays a role in this leptin resistance. Therefore, the importance of anti-inflammatory nutrients to modify the pathology of pregnancy is clear. In fact, nutritional intervention is the first-line approach for the treatment of gestational diabetes mellitus. However, more nutritional intervention studies with nutraceuticals, such as polyphenols or polyunsaturated fatty acids, or nutritional supplementation with micronutrients or probiotics in pregnant women, are needed in order to achieve a high level of evidence. In this context, the Mediterranean diet has been recently found to reduce the risk of gestational diabetes in a multicenter randomized trial. This review will focus on the impact of maternal obesity on placental inflammation and nutrients transport, considering the mechanisms by which leptin may influence maternal and fetal health in this setting, as well as its role in pregnancy pathologies.
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Cabrera, Camila, Mackenzy Radolec, Angela Prescott, Carolyn De La Cruz, and Stacy Beck. "Interdisciplinary Approach for the Medical Management of Gestational Gigantomastia." American Journal of Perinatology Reports 10, no. 03 (July 2020): e304-e308. http://dx.doi.org/10.1055/s-0040-1715174.
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Abstract Background Gestational gigantomastia is a rare and debilitating condition that is thought to result from hormone hypersensitivity. Several definitions have been proposed using breast weight and change in body mass index, but the breast growth is best summarized as rapid, diffuse, and excessive. Case We report a case of a 31-year-old woman with a history of infertility and cystic fibrosis that developed pathologic breast growth during hormonal preparation for in vitro fertilization. Her serum laboratories were unremarkable, and she was medically managed until 31 weeks of gestation. After delivery, she experienced rapid decrease in breast size and was followed by plastic surgery with plan to allow spontaneous regression with interval breast reduction Conclusion We highlight a successful interdisciplinary medical management approach, which helped to avoid a morbid, intrapartum breast reduction.
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Oancea, Alexandru, Casiana Stanescu, Diana Maria Anastasiu Popov, Radu Neamtu, Doru Anastasiu, Adrian Gluhovschi, and Marioara Poenaru. "Pregnancy Anemia as a Favorable Factor of Premature Birth." Revista de Chimie 69, no. 7 (August 15, 2018): 1886–88. http://dx.doi.org/10.37358/rc.18.7.6437.
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Hematological physiological changes during gestation are intended to compensate and support pregnancy-related changes in the woman�s body. In pregnancy there is a dilution of the known Hb concentration known as gestational hemodilution or physiological pregnancy anemia. On a group of 300 pregnant women with different forms of anemia, we followed its implications on the evolution of pregnancy, its role in the determinism of premature labor, and its role in the apparition of intrauterine growth retardation. In 46 cases (15.33%) we reported premature births, in 23 (7.66%) of the cases we considered that anemia was the main (unique) cause of premature birth, in other cases (84.67%) anemia associated with other etiologic factors of premature birth. Comparing the incidence of preterm birth with a group of 300 pregnant women without anemia revealed the incidence of premature birth is 3 times less and is represented by 12 cases (4%) and 2 times less for intrauterine growth retardation represented by 16 cases (5.33%). Pregnancy anemia can cause a frequent pathology with major consequences in pregnancy development during birth and fetal development involving 15.33% of preterm births and 12.35% of cases of intrauterine growth retardation. In the current social and economic context, it is necessary to prophylactically administer iron for pregnant women from 20 weeks of gestation, at least 30mg / day for prophylaxis of pathology due to iron deficiency.
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Odubamowo, K. H., O. M. Akinpelu, O. O. Lawal, C. A. Okolo, A. A. Odukogbe, and A. O. Adekunle. "Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman." Case Reports in Obstetrics and Gynecology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/674514.
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Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis.Case Report. Mrs. OB was a 32-year-old G4P3+0(3 alive) woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days’ duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation withSchistosoma haematobiuminduced salpingitis (findings ofSchistosoma haematobiumova noted on slide).Conclusion.Schistosomainduced salpingitis is a rare but possible cause of bilateral tubal gestation.
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Lisova, K., I. Kalinovska, and P. Tokar. "Etiopathogenetic aspects of placental dysfunction in women with miscarriage (literature review)." Bukovinian Medical Herald 24, no. 4 (96) (November 26, 2020): 150–56. http://dx.doi.org/10.24061/2413-0737.xxiv.4.96.2020.118.
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Advances in perinatology have revealed new problems related to the gestational process and antenatal protection of the fetus. Among them, the leading place belongs to chronic placental insufficiency (CPI). One of the main causes of CPI is miscarriage. The aim of the work is to consider the main aspects of the etiology and pathogenesis of the development of placental insufficiency in women with miscarriage. The article covers the issues of etiology, as well as the main pathogenetic ways in the development of placental dysfunction in women with miscarriage. Risk factors, mechanisms of development of placental insufficiency (PI), and also its forms depending on etiological factors are allocated. The peculiarities of the morphological structure of the placenta in women with this pathology in early and late gestation terms, their impact on the subsequent course of pregnancy, development and condition of the fetus are considered in detail. The relationship between structural changes in the placenta and clinical manifestations of PI is shown. The influence of rheology and hemodynamic disorders on the condition of the fetus is highlighted.Conclusions. There are a large number of etiological factors that lead to the development of placental insufficiency. However, for a variety of reasons, this pathology has key pathogenetic ways, which are common for different forms. Knowledge of the causes of placental dysfunction during miscarriage, features of pathogenesis and morphological changes that develop even in early terms of gestation has a great clinical importance, because it will contribute to the development of methods of early prevention and pathogenetically conditioned correction of this pathology.
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Ernst, Linda M., and Vinita Parkash. "Placental Pathology in Fetal Bartter Syndrome." Pediatric and Developmental Pathology 5, no. 1 (January 2002): 76–79. http://dx.doi.org/10.1007/s10024-001-0092-4.
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Bartter syndrome, which presents clinically with polyuria, urinary potassium loss, hypokalemia, hypercalciuria, and alkalosis, is an autosomal recessive disorder with mutations in genes encoding the Na-K-2Cl cotransporter, the chloride channel CLC-NKB, and the potassium channel ROMK. Prenatal diagnosis of Bartter syndrome is now possible; however, there are no reports of the placental pathology associated with fetal Bartter syndrome. We present the placental pathologic findings in two siblings with fetal Bartter syndrome. Both pregnancies were complicated by polyhydramnios and preterm delivery. The first pregnancy delivered at 30 weeks, and Bartter syndrome was diagnosed in the perinatal period. The subsequent pregnancy required periodic therapeutic amniocentesis secondary to massive polyhydramnios and delivered at 32 weeks gestation. The suspicion of fetal Bartter syndrome was very high in this second pregnancy, and the infant was confirmed to have Bartter syndrome subsequently. Both placentas were large for gestational age, weighing greater than the 95th percentile. Microscopic examination showed extensive subtrophoblastic basement membrane mineralization (special stains positive for iron and calcium) in the chorionic villi. This striking finding was present in both placentas. Subtrophoblastic mineralization has been described in the literature in placentas of fetuses with abnormalities including anencephaly, trisomy 21, and other congenital abnormalities; however, it has also been described in normal pregnancies. Mechanisms of calcification in the placenta are not well understood, but these striking cases suggest that defects in fetal renal excretion of ions can lead to dystrophic calcification within the placenta, particularly in a subtrophoblastic pattern.
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Spasojevic, Slobodan, Georgios Konstantinidis, and Aleksandra Doronjski. "Morbidity and mortality of premature neonates after introduction of national in vitro fertilisation programme: Our experience." Srpski arhiv za celokupno lekarstvo 138, no. 1-2 (2010): 67–71. http://dx.doi.org/10.2298/sarh1002067s.
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Introduction. Infertility occurs in approximately10% of couples and in vitro fertilisation (IVF) is its most efficient treatment method. The National IVF Programme started in October 1st, 2006. Objective. Examination of morbidity and mortality of premature neonates conceived by IVF after initiation of the National IVF Programme. Methods. Retrospective analysis of history charts of IVF premature neonates treated at the Neonatal Intensive Care Unit (NICU) of the Institute of Child and Youth Healthcare of Vojvodina, Novi Sad, Serbia, from March 1st, 2007 to March 1st, 2008. Results. Of 189 treated premature neonates, 25 (13.23%) were IVF conceived, with mean gestational age (GA) of 29.46?3.28 gestational weeks (GW), one-minute Apgar score 5.44?2.45, five-minute Apgar score 7.16?1.92 and birth weight (BW) 1299?484.35 g; from singleton 12 (48%), twin 10 (40%), and trigeminal 3 (12%) gestations. The largest number of neonates were of GA between 29 and 31.9 GW (12; 48%) and BW between 1500 and 2499 g (9; 36%). All of them were treated due to respiratory distress syndrome, complicated in 2 (8%) with air leak syndromes and in 4 (16%) with pulmonary haemorrhage. Congenital anomalies were detected in 2 (8%) and intracranial haemorrhage developed subsequently in 21 (84%) neonates. Lethal outcome occurred in 7 (28%) neonates, in all cases in lower gestation groups (<29 GW). Variable analysis showed significantly higher incidence of chorioamnionitis (p=0.0004) and lower GA (p~0.00), BW (p~0.00), one-minute Apgar score (p=0.0007) as well as significant difference in prophylactic surfactant application (p~0.00) and mean arterial pressure on admission (p=0.002). Conclusion. Morbidity and mortality of IVF premature neonates does not differ significantly from that of other premature neonates treated at NICU. Prematurity and low BW are important factors in pathology of these neonates and final outcome is influenced by perinatal asphyxia, risk of systemic infection, prophylactic surfactant application and arterial hypotension.
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Kravchenko, О. V. "Placental dysfunction as a basic pathology of perinatal complications." Reproductive Endocrinology, no. 58 (May 27, 2021): 107–12. http://dx.doi.org/10.18370/2309-4117.2021.58.107-112.
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Research aim was to study the features of perinatal complications depending on the nature and timing of therapy in pregnant women with primary placental dysfunction.Materials and methods. 82 pregnant women with verified placental dysfunction (chorionic hypoplasia at 12–13 weeks) against the background of the threat of pregnancy termination and genital tract infections were included. All examined were divided into 2 groups: group I consisted of 42 pregnant women who started treatment before 16 weeks of gestation, group II consisted of 40 pregnant women whose treatment was started after 16 weeks of gestation. Women in group I received micronized progesterone, venotonic Normoven, Magnicum and Artihol. Antibacterial sanitation was carried out before 16 weeks of gestation. Group II also received micronized progesterone only. Antibacterial sanitation in this group was carried out after 16 weeks of gestation.Research results. After antibiotic therapy in group I monoinfections value decreased from 26.8 to 9.5%, mixed infections value decreased from 56.1 to 20.7%, while in group II the effectiveness of antibacterial therapy after 16 weeks was significantly lower. Statistically significant differences in weight, volume and area of the placenta in patients of studied groups were obtained. Assessing perinatal complications showed that the frequency of gestosis, premature birth, intrauterine growth retardation and intrauterine infection of the fetus were almost 2 times less frequent in group I than in group II.Conclusions. Placental dysfunction, which developed in the first trimester against the background of the threat of pregnancy termination and genital tract infections, is the basic pathology for complications of the perinatal period. A timely prescribed set of medical supplies, including micronized progesterone, venotonic Normoven, Artihol and Magnicum, was as an effective method of preventing perinatal complications in pregnant women with primary placental dysfunction. Antibiotic therapy up to 16 weeks of gestation does not fully prevent the development of perinatal complications, but it can significantly reduce the level of severe gestational pathology.
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Nogueira, Rosete, Sara Sousa, Ana Cristina Braga, Ana Azevedo, Nuno Pereira, Olímpia Carmo, Maria Purificação Tavares, and Jorge Correia Pinto. "Measurements in First-Trimester Abortion Products: A Pathologic Study." Archives of Pathology & Laboratory Medicine 144, no. 2 (June 11, 2019): 207–14. http://dx.doi.org/10.5858/arpa.2018-0181-oa.
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Context.— Related to the advances in prenatal diagnosis and the emergence of medically challenging situations, there has been an increased interest in conducting a pathologic study of first-trimester abortion products. Objective.— To evaluate measurements across a large group of first-trimester spontaneous abortion specimens. Potential goals include a validation of prenatal embryo and gestational-sac measurements as a function of gestational age (GA). Design.— A retrospective case study of first-trimester spontaneous abortions between June 2015 and April 2017 in Centro de Genética Clínica Embryo-Fetal Pathology Laboratory, Porto, Portugal. Considering the inclusion criteria, 585 complete gestational sacs, 182 embryos, and 116 umbilical cords were selected. We recorded the weight of the gestational sacs and embryos and measurements of gestational sacs, umbilical cords, and embryo crown-rump length. Models were computed using regression techniques. Results.— Gestational-sac diameter percentiles 5, 25, 50, 75 and 95 were calculated according to GA, and at each 1-week interval the diameter increased an average of 3 mm. Umbilical cord length percentiles 5, 25, 50, 75 and 95 were calculated according to GA, and at each 1-week interval, the length increased an average of 1.35 mm. Embryo crown-rump length estimated mean ± SD values were GA 6 weeks, 5.3 ± 2.3 mm; GA 7 weeks, 9.4 ± 4.8 mm; GA 8 weeks, 13.7 ± 8.2 mm; GA 9 weeks, 20.8 ± 9.1 mm; GA 10 weeks, 22.6 ± 13.4 mm; GA 11 weeks, 29.4 ± 12.9 mm; and GA 12 weeks, 52 mm. Conclusions.— Pathologic measurements obtained should be compared to expected measurements and correlated with ultrasound findings, clinical information, and microscopic findings. Deviations from expected values could lead to an understanding of early pregnancy loss.