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Artykuły w czasopismach na temat "Placental outcomes"
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Matsuzaki, Shinya, Yutaka Ueda, Satoko Matsuzaki, Hitomi Sakaguchi, Mamoru Kakuda, Misooja Lee, Yuki Takemoto i in. "Relationship between Abnormal Placenta and Obstetric Outcomes: A Meta-Analysis". Biomedicines 11, nr 6 (25.05.2023): 1522. http://dx.doi.org/10.3390/biomedicines11061522.
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The placenta has several crucial physiological functions that help maintain a normal pregnancy. Although approximately 2–4% of pregnancies are complicated by abnormal placentas, obstetric outcomes remain understudied. This study aimed to determine the outcomes and prevalence of patients with abnormal placentas by conducting a systematic review of 48 studies published between 1974 and 2022. The cumulative prevalence of circumvallate placenta, succenturiate placenta, multilobed placenta, and placenta membranacea were 1.2%, 1.0%, 0.2%, and 0.004%, respectively. Pregnancies with a circumvallate placenta were associated with an increased rate of emergent cesarean delivery, preterm birth (PTB), and placental abruption compared to those without a circumvallate placenta. The succenturiate lobe of the placenta was associated with a higher rate of emergent cesarean delivery, whereas comparative results were observed in terms of PTB, placental abruption, and placenta previa in comparison to those without a succenturiate lobe of the placenta. A comparator study that examined the outcomes of multilobed placentas found that this data is usually unavailable. Patient-level analysis (n = 15) showed high-rates of abortion (40%), placenta accreta spectrum (40%), and a low term delivery rate (13.3%) in women with placenta membranacea. Although the current evidence is insufficient to draw a robust conclusion, abnormal placentas should be recognized as a high-risk factor for adverse outcomes during pregnancy.
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Duffley, Eleanor, David Grynspan, Hailey Scott, Anthea Lafrenière, Cherley Borba Vieira de Andrade, Enrrico Bloise i Kristin L. Connor. "Gestational Age, Infection, and Suboptimal Maternal Prepregnancy BMI Independently Associate with Placental Histopathology in a Cohort of Pregnancies without Major Maternal Comorbidities". Journal of Clinical Medicine 13, nr 12 (8.06.2024): 3378. http://dx.doi.org/10.3390/jcm13123378.
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Background: The placenta undergoes morphological and functional adaptations to adverse exposures during pregnancy. The effects ofsuboptimal maternal body mass index (BMI), preterm birth, and infection on placental histopathological phenotypes are not yet well understood, despite the association between these conditions and poor offspring outcomes. We hypothesized that suboptimal maternal prepregnancy BMI and preterm birth (with and without infection) would associate with altered placental maturity and morphometry, and that altered placental maturity would associate with poor birth outcomes. Methods: Clinical data and human placentae were collected from 96 pregnancies where mothers were underweight, normal weight, overweight, or obese, without other major complications. Placental histopathological characteristics were scored by an anatomical pathologist. Associations between maternal BMI, placental pathology (immaturity and hypermaturity), placental morphometry, and infant outcomes were investigated for term and preterm births with and without infection. Results: Fetal capillary volumetric proportion was decreased, whereas the villous stromal volumetric proportion was increased in placentae from preterm pregnancies with chorioamnionitis compared to preterm placentae without chorioamnionitis. At term and preterm, pregnancies with maternal overweight and obesity had a high percentage increase in proportion of immature placentae compared to normal weight. Placental maturity did not associate with infant birth outcomes. We observed placental hypermaturity and altered placental morphometry among preterm pregnancies with chorioamnionitis, suggestive of altered placental development, which may inform about pregnancies susceptible to preterm birth and infection. Conclusions: Our data increase our understanding of how common metabolic exposures and preterm birth, in the absence of other comorbidities or complications, potentially contribute to poor pregnancy outcomes and developmental programming.
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Nair, Vidhu V., Sobha S. Nair i Radhamany K. "Study of placental location and pregnancy outcome". International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, nr 4 (26.03.2019): 1393. http://dx.doi.org/10.18203/2320-1770.ijrcog20191187.
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Background: Placental location can be estimated easily using ultrasonogram by 16 weeks. It can be classified based on its location into central and lateral. Central can be anterior or posterior. Lateral can be left lateral or right lateral. Placental location has been attributed to both normal and abnormal pregnancy and neonatal outcomes.Methods: This is a prospective cohort study conducted in the department of Obstetrics and Gynecology which comprised of 450 singleton gestations between 18 and 24 weeks. The primary objective is to determine the association between placental location and pregnancy outcome and secondary objective is to find out the association between placental location and neonatal outcome. The study population was divided into two groups – central and lateral. Results were analyzed using SPSS version 20, Chi square test and independent two sample t-test.Results: The frequency of central placenta was 377 (83.8%) and lateral placenta in 73 (16.2%). Central placentation had an abnormal outcome in 182(48.3%), lateral placentas with abnormal outcome were 44(60.3%). Abnormal maternal outcomes like hypertensive disorders (33.3%), Intra Uterine Growth Restriction (10.2%), Antepartum haemorrhage (25%), Preterm birth (16.3%) were more in lateral placentation. The number of central placentas having NICU admissions were 62(16.4%) and lateral placenta with NICU admissions were 19(26%).Conclusions: There is a significant association between lateral placentation and abnormal pregnancy and neonatal outcomes. Second trimester ultrasound can be used as non-invasive predictor of adverse pregnancy and neonatal outcomes.
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Wortman, Alison, Stephanie Schaefer, Donald McIntire, Jeanne Sheffield i Diane Twickler. "Complete Placenta Previa: Ultrasound Biometry and Surgical Outcomes". American Journal of Perinatology Reports 08, nr 02 (kwiecień 2018): e74-e78. http://dx.doi.org/10.1055/s-0038-1641163.
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Objective To evaluate the relationship between surgical outcomes and ultrasound measurement of placental extension beyond the cervical os in women with placenta previa. Study Design This is a retrospective cohort study of singleton pregnancies with placenta previa undergoing third-trimester ultrasound and delivering at our institution from 2002 through 2011. For study purposes, an investigator measured placental extension, defined as the placental distance from the internal os across the placenta continuing out to the lowest placental edge. If morbidly adherent placentation was suspected, women were excluded. Receiver operating characteristic (ROC) curves were developed for pertinent surgical outcomes, and multivariate analysis was performed to determine the placental extension with the best predictive discriminatory zone. Results In total, 157 women had placenta previa, ultrasound, and delivery data: 86 (55%) had a placental extension of <40 mm, and 71 (45%) had a placental extension of ≥40 mm. Women with placental extension of ≥40 mm had increased surgical time, blood loss > 2,000 mL, blood transfusion, and rate of peripartum hysterectomy. After multivariate analysis, only peripartum hysterectomy and surgical time > 90 minutes remained significant, p ≤ 0.05 and p ≤ 0.01, respectively. Conclusion In women with placenta previa, the placental extension ultrasound measurement of ≥40 mm is a predictor of adverse surgical outcomes.
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Emeka-Ogbugo, Alerechi, Dumle Jane Gbobie, Aloysius Obinna Ikwuka, Mkpe Abbey, Ada Nkemagu Okocha i Simeon Chijioke Amadi. "Maternal Age as a Determinant of Placental Morphology and Morphometry at Term Pregnancy: A Cross-sectional Study of Selected Hospitals in Rivers State, Southern Nigeria". European Journal of Medical and Health Research 2, nr 4 (1.07.2024): 33–40. http://dx.doi.org/10.59324/ejmhr.2024.2(4).04.
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The placenta which is a crucial intermediary in maternal-fetal exchanges, undergoes intricate structural changes throughout gestation, culminating in its fully developed form at term. The potential impact of maternal age on pregnancy and fetal outcomes has generated interest. This study aimed to investigate the intricate relationships between maternal age, and placental morphology and morphometry at term pregnancy. This study was a hospital-based, cross-sectional study with a systematic sampling technique, which meticulously collected and examined 250 placentae postpartum. Rigorous cleansing under running water preceded comprehensive assessments and precise measurements. Detailed maternal histories were obtained to facilitate comprehensive contextual analysis. Descriptive statistics (frequency and percentage) were complemented by inferential analyses (ANOVA and Pearson correlation), with significance level set at p<0.05. Among the reviewed placentae (n=250), statistically significant relationships exist between maternal age and some placental parameters. Notably, maternal age exhibited positive associations with placental thickness (p=0.048), placental weight (p=0.014), and the number of cotyledons (p=0.028). However, no statistically significant relationships were identified between maternal age and placental shape (p=0.977) or placental diameter (p=0.070). Maternal age significantly influences pregnancy outcomes. Maternal age affects placental morphometry more than placental morphology.
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Hadali, Ndulila, Dismas Matovelo, Richard Kiritta, Oscar Ottoman, Cosmas Mbulwa, Adolfine Hokororo i Edgar Ndaboine. "Insights into Placental Pathology: Analyzing Patterns and Fetal Outcomes in 205 Livebirths at Bugando Medical Centre, Mwanza, Tanzania". EAS Journal of Medicine and Surgery 6, nr 03 (6.02.2024): 80–87. http://dx.doi.org/10.36349/easjms.2024.v06i03.001.
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Background: The placenta facilitates vital nutrient exchange between fetus and mother, offering insights into fetal and maternal health. Despite its significance, research on placental histopathology in Tanzania is scarce. This study investigates placental features, maternal factors, and their impact on fetal outcomes at Bugando Medical Centre from January to May 2022. Methods: This 5-month cohort study included 205 mothers delivering at BMC. Fetal outcomes were evaluated at birth and after seven days, with maternal characteristics recorded at delivery. Participants were from the twenty-eighth week of gestation, excluding those with intrauterine fetal death or multiple pregnancies. Data on placental histology, maternal factors, and fetal outcomes were collected systematically, while statistical analysis employed STATA version 15, utilizing descriptive statistics. Results: In this study of 205 placentas, participants had a median age of 29 years and a mean gestational age of 38 weeks. Histopathological patterns were present in 61% of placentas, with acute inflammation (22%) and maternal vascular malperfusion (20.8%) being most common. Favorable outcomes were observed in 81% of newborns, while 19% experienced poor outcomes, including 1.9% early neonatal deaths. Most placental lesions were mild (53.6%), with severe pathology in 2.9% of cases. Acute inflammation correlated with various admission reasons, especially neonatal sepsis (60%). Maternal vascular lesions were associated with prematurity (63.6%) and birth asphyxia (40%). Chronic inflammation was more prevalent among low-birth-weight infants (18.8%), while very low birth weight was common in cases of maternal vascular lesions (68.8%). Conclusion: The majority of placentas showed normal or mild pathology, associated with positive fetal outcomes. Further research is needed to understand placental changes and their impact on maternal-fetal health.
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Firestein, Morgan R., Harvey J. Kliman, Ayesha Sania, Lucy T. Brink, Parker H. Holzer, Katherine M. Hofmann, Kristin M. Milano i in. "Trophoblast inclusions and adverse birth outcomes". PLOS ONE 17, nr 3 (1.03.2022): e0264733. http://dx.doi.org/10.1371/journal.pone.0264733.
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Objective Trophoblast inclusions—cross sections of abnormal trophoblast bilayer infoldings—have previously been associated with aneuploidy, placenta accreta, and prematurity. This study was conducted to establish the relationship between trophoblast inclusions and a range of placental, pregnancy, and birth outcomes in a patient population with high smoking and alcohol exposure. Specifically, we sought to evaluate the association between the presence of trophoblast inclusions and 1) three primary birth outcomes: full-term birth, preterm birth, and stillbirth; 2) gestational age at delivery; and 3) specific placental pathologies. Methods Two slides containing chorionic villi were evaluated from 589 placentas that were collected from Stellenbosch University in Cape Town, South Africa as part of the prospective, multicenter cohort Safe Passage Study of the Prenatal Alcohol and SIDS and Stillbirth Network. The subsample included 307 full-term live births, 212 preterm live births, and 70 stillbirths. Results We found that the odds of identifying at least one trophoblast inclusion across two slides of chorionic villi was significantly higher for placentas from preterm compared to term liveborn deliveries (OR = 1.74; 95% CI: 1.22, 2.49, p = 0.002), with an even greater odds ratio for placentas from stillborn compared to term liveborn deliveries (OR = 4.95; 95% CI: 2.78, 8.80, p < 0.001). Gestational age at delivery was inversely associated with trophoblast inclusion frequency. Trophoblast inclusions were significantly associated with small for gestational age birthweight, induction of labor, villous edema, placental infarction, and inflammation of the chorionic plate. Conclusions The novel associations that we report warrant further investigation in order to understand the complex network of biological mechanisms through which the factors that lead to trophoblast inclusions may influence or reflect the trajectory and health of a pregnancy. Ultimately, this line of research may provide critical insights that could inform both clinical and research applications.
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Ravikumar, G., J. Crasta, J. S. Prabhu, T. Thomas, P. Dwarkanath, A. Thomas, T. S. Sridhar i A. V. Kurpad. "Eccentric placentae have reduced surface area and are associated with lower birth weight in babies small for gestational age". Journal of Developmental Origins of Health and Disease 9, nr 3 (14.01.2018): 281–86. http://dx.doi.org/10.1017/s2040174417001076.
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AbstractPlacental structure and function determine birth outcomes. Placental mass does not always correlate with fetal birth weight (BW) in uncomplicated pregnancies which raises the possibility of other variables such as placental shape and cord insertion being the determinants of placental efficiency. In total, 160 women with singleton pregnancy, recruited into a pregnancy cohort were studied. Placental weight (PW) was measured and other data were obtained from clinical records. Birth outcomes were classified as small for gestational age (SGA) and appropriate for gestational age (AGA) based on fetal gender, gestational age (GA) and BW. High-resolution images of the chorionic plate were recorded. The shape of the placenta and the insertion of the cord were measured using eccentricity index (EI) and cord centrality index (CCI). Only placentae with eccentrically inserted cords (n=136) were included. The mean BW and PW were 2942 (±435) g and 414 (±82) g with average GA of 38.6 weeks. The mean CCI and EI was 0.483 (±0.17) and 0.482 (±0.16). Neither of these correlated with placental efficiency. However, EI showed negative correlation with placental surface area and breadth. Upon sub-grouping the cohort into SGA (n=32) and AGA (n=104), the SGA babies with the highest EI (third tertile) had significantly lower BW than those with the least eccentric placentae (first tertile). Although eccentric-shaped placentae were present in both SGA and AGA groups, the effect on BW was observed only in the SGA group.
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Nair, Bindu T., i Uma Raju. "Study of Correlation of Neonatal Outcomes with Gross Abnormalities of Placenta and Umbilical Cord". Journal of Nepal Paediatric Society 37, nr 3 (7.06.2018): 254–60. http://dx.doi.org/10.3126/jnps.v37i3.17637.
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Introduction: Perinatal outcome of new-borns is greatly influenced by abnormalities of placenta and umbilical cord. In most of the deliveries, whether home or institutional, the placenta and umbilical cords are discarded without examination. Due to paucity of information on abnormalities of placenta and cord, there is hardly any correlation with foetal outcomes. The aim was to study the correlation between the foetal outcome and the different types of abnormalities of placenta and umbilical cord.Materials and Methods: A prospective, cross-sectional, descriptive, randomised study was conducted from January 2016 to December 2016 in a tertiary care hospital in North India. The study was carried out on 1000 term singleton newborns. The placenta and umbilical cords were obtained from both normal and caesarean section deliveries. A proforma was used to gather data from the patients and new-borns. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 20 (SPSS Inc, Chicago, IL, IBM version) along with Microsoft Excel (2010 version).Results: One thousand placentae and umbilical cords were examined of which high placental weight/birth weight ratio, gross anomalies of placenta (infarctions, calcifications and retro placental haematoma), marginal (battledore and velamentous) umbilical cord insertions, long umbilical cords and single umbilical artery were associated with negative foetal outcomes.Conclusions: There was a high incidence of adverse foetal outcome with placental and umbilical cord abnormalities. Education of our health personnel dealing with deliveries on the importance of proper examination of the placenta and umbilical cords should be emphasised and instituted upon.
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Natarajan, Lalitha, i G. UmaMaheswari. "Gestational hyperglycemia on diet and medication: impact on placental pathology and pregnancy outcomes". International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, nr 8 (26.07.2019): 3350. http://dx.doi.org/10.18203/2320-1770.ijrcog20193564.
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Background: To evaluate the placental morphology and perinatal outcome in patients with gestational hyperglycemia on diet and medication.Methods: Placental examinations performed at the Department of Pathology between August 2016 to August 2018 were retrospectively reviewed. Of the received 140 placentas, 35 of gestational diabetes (GDM) and pre gestational diabetes were identified and segregated into hyperglycemia on diet and on medication. The clinical details, placental findings and perinatal outcome of patients in both the groups (gestational hyperglycemia on diet and medication) were collected and analyzed.Results: Among the 35 cases, there were 24 cases of mild gestational hyperglycemia controlled with diet and 11 cases of hyperglycemia on medication (oral hypoglycemic drugs ± insulin).Most of the placentae in both the groups weighed less than tenth centile. The cord abnormalities such as hyper coiling, velamentous /marginal insertion and furcate cord were observed more in women with GDM on diet. There was no significant gross placental lesion in those on medication. Placental histological features most consistently associated with both the groups include, disturbances of villous maturation (DVM), Derangements in uteroplacental / foetoplacental circulation and villous capillary lesions. Small for gestational age and intrauterine foetal death were found in both the groups, but more commonly in patients with hyperglycemia on medication.Conclusions: Villous maturation defects, uteroplacental / foetoplacental malperfusion are the essential placental changes which can result in adverse perinatal outcomes in women with hyperglycemia irrespective of the diabetic control.
Rozprawy doktorskie na temat "Placental outcomes"
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Mena, Melisa A. "The Dose-Response of Maternal Exercise Volume on Newborn and Placental Outcomes". Scholarly Repository, 2007. http://scholarlyrepository.miami.edu/oa_dissertations/9.
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Current ACOG guidelines recommend exercise during a low-risk pregnancy for 30 minutes on most, if not all days of the week. However, little is known about how the volume of exercise performed during pregnancy affects fetoplacental size. In addition, the confounding effects of maternal nutrient intake and weight gain, and how they interact with exercise volume to influence fetoplacental size have not been appropriately addressed. Therefore, the purpose of this study was to examine the effects of varying maternal exercise volumes on neonatal birthweight and placental volume, while addressing the influence of maternal nutrient intake and weight gain. Subjects evaluated for this study included pregnant women who walked during gestation (n=26), performed non-walking aerobic exercise during gestation (n=30), or remained as sedentary controls (n=32). At 16, 20, 24, 28, 32, 36 weeks gestation, women recorded their nutrient intake for 3 consecutive days. Additionally, they kept monthly exercise logs indicating the type and duration of their exercise. Nutrient variables calculated included average daily Calorie intake, average daily carbohydrate intake, average daily protein intake, average daily fat intake, and average daily fiber intake. Exercise volume was calculated as the average number of minutes per week spent performing exercise. Latent growth modeling was the statistical procedure used to analyze how change in maternal exercise volume and nutrient intake throughout gestation affects neonatal outcomes. Neonatal outcomes measured were birthweight, corrected birthweight for gestational age, sex, race, and socioeconomic status, and placental volume at delivery. Maternal walking volume had no effect on newborn birthweight or corrected birthweight, while it was inversely related to placental size at birth. Maternal non-walking aerobic exercise volume was inversely related with newborn birthweight, while there was a trend toward an inverse relationship with corrected birthweight and placental volume. Controlling for Calorie intake strengthened the relationship between any form of exercise volume and infant birthweight. Calorie intake, carbohydrate intake, and protein intake were all positively related to infant birthweight. Fiber intake was significantly inversely related to placental volume. Finally, maternal exercise volume and nutrient intake were not related to maternal weight gain. This data suggests that neonatal outcome will be affected by variations in exercise protocol. In addition, nutrient intake is a potentially confounding variable that should be examined when undertaking studies addressing the role of maternal exercise on neonatal outcome.
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Sartori, Julie A. "Morning sickness and the placenta". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2023. https://ro.ecu.edu.au/theses/2728.
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Background: Nausea and vomiting in pregnancy (NVP) is considered one of the ultimate reproductive health dilemmas and often misunderstood both biologically and conceptually. This phenomenon occurs in approximately eighty percent of pregnancies worldwide and there are many theories relating to the cause of symptoms, however, no origin has been identified. Morning sickness will be discussed primarily within a physiological framework that focuses on maternal characteristics, placental structure, and related birth outcomes. Interestingly, vomiting in pregnancy appears to be unique to the human species, which from an evolutionary medical perspective is thought to be the result of human adaptation to varying internal and external environments. Some human adaptations or the consequential effects of these adaptations are not always viewed as favourable, from our twenty-first century medical point of view. Women with an absence of NVP symptoms in pregnancy are understudied and therefore, an essential and informative addition to this cohort.
Aims: The primary focus of this research project was to investigate NVP in relation to maternal characteristics, placental structure, and birth outcomes in singleton pregnancies. This study also included an important subset of expectant mothers with no reported NVP symptoms. Characteristics of morning sickness for expectant mothers with pregnancies resulting from ART and non-ART conception were examined. Psychosocial outcome variables and morning sickness status were compared using three specific measures from the maternal health questionnaire (MHQ) [Social Provision Scale (SPS), Pregnancy Distress Scale (PDQ) and the Perceived Stress Scale (PSS)], and the Edinburgh Postnatal Depression Scale (EPDS) from the maternal medical records. Data generated from the MHQ, gross placental morphology, maternal and natal medical records were examined to determine the associations between morning sickness, placental structure, and birth outcomes (e.g., low birth weight, placental weight, and birth weight to placental weight ratio). A unique addition to this study was the consideration of the placental microbiome as a potential contributing factor to differences in women with different NVP status.
Methods: To investigate NVP characteristics and examine the role of the human placenta and NVP status, 625 expectant mothers with singleton pregnancies were recruited from two major hospitals in Perth, Western Australia. Pregnancies were the result of natural and assisted conception and expectant mothers participated in a cross- sectional survey consisting of a MHQ, and gross placental examination using gross morphologic analysis. On completion of placental analyses, data from the maternal and natal medical records were collected and characteristics compared for women with differing nausea and vomiting status. The characteristics of NVP were identified through statistical analyses of the data, including significant medical, clinical, and psychosocial factors. Gross placental morphology measures and birth outcomes were compared according to NVP status.
Results: NVP was experienced by most expectant mothers in this cohort (79%) with 21% of women experiencing no NVP and 3% clinically diagnosed with hyperemesis gravidarum (HG). Nausea was the most prevalent symptom followed by food avoidance and women were more likely to report the frequency of these symptoms as continuous, while retching and vomiting were episodic in nature. Symptoms were self-rated as moderate to severe, and all risk factors were positively correlated with NVP. Women with HG recorded associated variables including increased symptom frequency and severity, medication use and a majority of the risk factors from the MHQ. The severity and frequency of symptoms were significantly associated with a number of maternal characteristics including age of menarche, increased maternal weight/obesity on first antenatal booking and admission for delivery of the baby.
Increased psychosocial measures noted for women with NVP were related to the frequency and severity of symptoms. This was consistent for women who experienced HG and had pregnancies resulting from ART. ART treatments were also associated with an increased frequency and severity of symptoms. Women experiencing NVP reported higher overall scores for the Pregnancy Distress Questionnaire and Perceived Stress Scale when compared to women who had no NVP, and evaluation of the Social Provision Scale identified women with NVP had lower self-rating scores for Nurturance and Attachment.
Women in this study delivered normal healthy babies, with normal BW/PWR and ponderal index ranges. Placental measures were similar for NVP status groups across this cohort and a majority fell within the 10th and 90th centiles for BW and placental weight. Evaluation of placental weight for women with clinically diagnosed HG in ART and non-ART pregnancies found that women who conceived naturally and experienced HG had an increased trimmed placental weight (grams). Women with HG who conceived using ART were more likely to have a lower placental weight.
This was the first study to explore the association between the placental amniochorionic microbiome and morning sickness status in women with singleton pregnancies. Significant differences in microbial diversity were noted between NVP status groups. Women with NVP had a higher species diversity and those in the No NVP group having a lower microbial diversity.
Clinical relevance: This comprehensive study has produced new and insightful information, highlighting the role of maternal characteristics and placental development in maternal health and birth outcomes. A detailed examination of NVP and the relationship between NVP symptoms, have highlighted the need for research that explores symptom frequency and severity rather than the presence or absence of symptoms alone. Examination of medical and clinical characteristics for women with and without NVP have provided new theoretical understanding and this current research provides evidence-based findings linking NVP and placental anatomy that are important for perinatal health. Future research examining the biological mechanisms and NVP symptom expression would be valuable. As part of reproductive health, ongoing research that promotes clinical understanding and the effective management of nausea and vomiting in pregnancy will decrease patient distress and foster practitioner confidence. Documentation of key concepts related to the physiology of nausea and vomiting in pregnancy can provide an understanding of the pathways that lead to NVP. Expectant mothers will be empowered by having access to updated information promoting maternal and natal health outcomes. Importantly, information should be provided to partners, family, friends, and caregivers to assist, nurture and support all expectant mothers.
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Martino, Jole. "Metabolic alterations induced by high maternal BMI and gestational diabetes in maternal, placental and neonatal outcomes". Thesis, University of Nottingham, 2013. http://eprints.nottingham.ac.uk/13714/.
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Maternal obesity and diabetes increase the risk of delivering large for gestational age infants (LGA), who have higher risk of long term obesity or metabolic syndrome [1]. As the underpinning mechanisms of how fetal growth is regulated by the placenta remain unclear [2], this thesis has investigated placental responses to high maternal BMI and gestational diabetes. Spanish pregnant women recruited at 20 gestational weeks were classified according to pre-pregnancy BMI as control (BMI<25kg/m2; n=59), overweight (BMI=25-30kg/m2; n=29) or obese (BMI>30kg/m2; n=22), and gestational diabetes status (GDM) classified at 28 weeks. Maternal anthropometry and gestational weight gain (GWG) were measured during pregnancy. Placenta, cord blood, newborn antrophometry and infant weight were sampled or measured. Expression of genes involved in placental energy sensing pathways, folate transporters and DNA methylation was determined using real-time PCR, and placental triglyceride concentrations, lipid peroxidation and genomic DNA methylation patterns measured. Data were analysed according to their parametric distribution by Kruskal-Wallis or 1-way ANOVA. Despite lower GWG, a greater proportion of obese women exceeded recommended weight gain [3], had higher placental weight and increased numbers of LGA infants. Maternal hyperinsulinaemia and hyperglycaemia with obesity were accompanied by unchanged placental IGFR1 and ISR1 expression, similar cord blood glucose and triglyceride concentrations. Placental mTOR was halved with obesity, whilst SIRT1 and UCP2 gene expression were 1.8 and 1.6 fold upregulated respectively with no differences in TBARS concentrations. Hyperleptinaemia in obese women resulted in unchanged placental leptin and leptin receptor expression, but higher cord blood leptin and monocyte concentrations with placental hypermethylation of genes involved in the immune response. Lower folate concentrations in obese mothers led to similar cord blood folate, and decreased placental FRα, but raised DNMT1, mRNA expression. No major differences were observed with GDM, probably due to small sample size. In conclusion, it appears that the placenta can protect the fetus of obese women by increasing antioxidant capacity, compensating for maternal hyperglycaemia and lower folate. However, maternal obesity was associated with enhanced cord blood leptin and monocyte concentrations, increased placental weight and more LGA delivery, leaving infants at ongoing risk of increased adiposity and inflammation. Therefore, current studies are currently exploring these interacting aspects.
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Jessop, Flora. "Correlation of macroscopic and microscopic placental lesions with obstetric and neonatal outcomes in an unselected population". Thesis, University of East Anglia, 2012. https://ueaeprints.uea.ac.uk/46544/.
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Many abnormalities of the placenta are reported to be significant in the setting of maternal health problems and adverse fetal/neonatal outcomes. In specific clinicopathological circumstances - eg vascular lesions in the growth restricted fetus – correlation does exist between the placental lesion and the clinical event. Relationships between “lower grade” placental lesions and clinical outcomes are less clear. Reports of associations between selected abnormalities and clinical outcomes are largely based on retrospective case control studies: the clinical groups studied tend to be high-risk. Understanding of the significance of these lesions in the wider population is lacking. This study reports on the clinical events and placental lesions documented in 1119 unselected women delivering at the conclusion of a singleton pregnancy in a single obstetric centre. Study methodology was such that the cohort comprised low-risk mothers delivering at or close to term. The incidence of potentially adverse obstetric and neonatal events in the study population was low. 97% delivered at term. Mean birth weight was 3485 g; mean Apgar scores were 9 at 1 minute and 10 at 5 minutes. 5.9% of infants required admission to neonatal intensive care. When classified in accordance with current standard reporting guidelines, 71% of placentas were classified as normal. Inclusion of lower grade histological lesions in the reporting schedule reduced the percentage of histologically normal placentas to 58%. Funisitis was found to be significantly correlated with adverse neonatal outcome. A number of other placental lesions - including cord coiling <10th and >90th centiles, placental infarction, villitis of unknown etiology and lower grades of acute placental inflammation - were not found to be associated with adverse obstetric or neonatal events. It is concluded that a number of placental lesions may not be relevant to adverse pregnancy outcomes in a low-risk population.
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O'Donnell, Kieran J. "Maternal prenatal stress and fetal programming : long term biobehavioural outcomes in the child and potential placental mechanisms". Thesis, Imperial College London, 2010. http://hdl.handle.net/10044/1/6350.
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Mounting evidence suggests prenatal stress can affect child development. Clinical studies of this concept, termed fetal programming, focus predominantly on early childhood. Also, little is known about the mechanisms underlying how maternal stress is transmitted to the fetus. This thesis will test if maternal anxiety during pregnancy is associated with (1) behavioural outcomes from childhood to early adolescence, (2) cortisol output in adolescence and (3) an altered placental phenotype. For Studies 1 and 2 participants were drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC). Psychometric data from 9,871 mother child pairs (5,098 males, 4,773 females) were analysed using latent growth curve analysis. A subsample of the ALSPAC children aged 15 years (n = 899) provided saliva samples on three days at waking, +35mins, after school and before bed, for later cortisol analysis. For Study 3 a new cohort of women (n= 73) was recruited. Maternal psychometric data was collected one day prior to elective caesarean section, and the placenta collected after delivery. Study 1 showed that maternal prenatal anxiety was associated with conduct and emotional problems, and symptoms of ADHD at age 13 years, after allowing for a range of confounders, including postnatal anxiety. There were marked sex differences in the developing patterns. Saliva cortisol demonstrated a marked diurnal profile with a clear sex difference at age 15. Higher maternal prenatal anxiety was associated with a reduced cortisol awakening response. High levels of maternal prenatal anxiety were associated with reduced placental expression and activity of the cortisol metabolising enzyme 11β-Hydroxy steroid dehydrogenase 2 (11β-HSD2) and also with reduced placental weight. This thesis provides evidence that maternal prenatal anxiety can affect behavioural and neuroendocrine outcomes in adolescence. It also provides preliminary evidence that maternal anxiety is associated with alterations in the function of the placenta, which may underlie some aspects of fetal programming. These findings have public health implications. Increasing awareness about the lasting effects of prenatal anxiety may ultimately benefit mothers, the care they receive and their families.
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Tessier, Daniel. "Maternal Obesity Induces a Pro-Inflammatory Uterine Immune Response Associated with Altered Utero-Placental Development and Adverse Fetal Outcomes". Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32451.
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Obese pregnant women have increased risk of a number of pregnancy complications, including poor maternal health, fetal growth restriction (FGR) and fetal demise. The success of pregnancy is dependent on precise regulation of the immune response within the utero-placental environment. Rats as a model for human related pregnancy complications are beginning to be widely used because of the similarities between these species in terms of trophoblast invasion and spiral artery remodeling. However our knowledge of immune cells and cytokine localization in the rat utero-placental tissue relating to these processes is limited. Therefore our first aim was to characterize the immune cell populations, such as uterine natural killer (uNK) cells, neutrophils and macrophages in the rat utero-placental unit at two crucial gestational ages relevant to trophoblast invasion and spiral artery remodeling, gestational day (GD) 15 and GD18. In addition, we characterized the cytokine distribution of TNFα, IFNγ and IL-10 in the utero-placental tissue at both above mentioned gestational ages. Our study has demonstrated co-localization of TNFα and IFNγ with uNK cells in the perivascular region of the spiral arteries in the rat mesometrial triangle. Neutrophils were localized at the maternal fetal interface and in the spiral artery lumen of the rat mesometrial triangle at both gestational ages. TNFα and IL-10 demonstrated a temporal change in the localization from GD15 to GD18 which coincides with the leading edge of trophoblast invasion into the mesometrial triangle. The results of the current study furthers our knowledge of the localization and temporal expression of uterine immune cells and relevant cytokines, and provides a base to research the function of these immune cells and cytokines during rat pregnancy as a model to study human pregnancy and complications related to immune functions.
Since obesity is associated with a peripheral and systemic pro-inflammatory state in humans, our second objective was to investigate whether maternal obesity could alter the utero-placental and systemic immune response in the rats. To characterize maternal obesity induced changes in uterine immune state we used pregnant rats fed a control diet (normal weight; CD) or a high fat diet (obese; HFD) at GD15 and GD18. We performed immunohistochemistry to localize TNFα and IL-10, and quantified the levels of TNFα, IL-1β and IL-10 in the uterine tissue by immunoassay. To assess the systemic immune state, circulating levels of pro-inflammatory cytokine MCP-1 were assessed by immunoassay. We demonstrated an increased concentration of the pro-inflammatory marker TNFα and a reduced anti-inflammatory IL-10-positive cell distribution in the rat mesometrial triangle in response to a HFD. In addition increased circulating MCP-1 was observed in the HFD-fed dams at both gestation ages. HFD induced obesity in our rat model leads to an increase in uterine and systemic pro-inflammatory markers. These markers have demonstrated the potential to alter utero-placental development.
Pregnancy complications such as FGR and fetal demise have been shown to be associated with impaired placental development as a result of altered trophoblast invasion and aberrant maternal spiral artery remodeling. Therefore, our third aim was to compare these parameters between the CD-fed rats and HFD-fed rats at GD15 and GD18. Early trophoblast invasion was increased by approximately 2-fold in HFD-fed dams with a concomitant increase in the expression of matrix metalloproteinase-9 protein, a mediator of tissue remodeling and invasion. By late gestation reduced trophoblast invasion was observed in HFD-fed dams. Furthermore, we also observed in late gestation significantly higher levels of smooth muscle actin surrounding the uterine spiral arteries of HFD-fed dams, suggesting impaired spiral artery remodeling. We also determined the impact of human serum from obese mothers on trophoblast invasion. We compared the invasion of HTR-8/SVneo cells treated with pooled first-trimester serum from obese women with or without fetal growth restriction vs. cells treated with serum from normal-weight women with or without fetal growth restriction. First-trimester serum from obese pregnant women reduced invasion of the trophoblast cell line HTR8/SVneo compared to serum from normal-weight pregnant women. Taken together, the results of this study suggest that maternal obesity can negatively influence crucial utero-placental development processes resulting in the poor pregnancy outcomes and increased fetal demise.
To summarize, the HFD increased the pro-inflammatory marker TNFα which was associated with altered trophoblast invasion profiles and impaired vascular remodeling. These disturbances in utero-placental development were also associated with decreased birth weights (indication of FGR) and increased rates of stillbirths in our obese rat model.
In conclusion, we have made progress in defining the influence of maternal obesity (HFD) on utero-placental development. The importance of these studies is evident since FGR represents a leading cause of perinatal morbidity and mortality. Furthermore, FGR fetuses have an increased risk of becoming obese in their lifetime as a result of fetal programming, therefore resulting in the propagation of a transgenerational obesity cycle. Therefore by understanding the mechanisms by which maternal obesity influences utero-placental development leading to FGR, we may be able to impact short term morbidity and prevent the programming of obesity in future generations. In addition, characterization of maternal obesity’s influence on utero-placental development will also help in the search for therapeutics or intervention strategies to help optimize fetal growth and improve pregnancy outcomes in obese women.
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Ofori, Samuel N. "Isolated oligohydramnios in low-risk pregnancy- a prospective study of the maternal, placental and fetal aetiological factors and associated perinatal outcomes". Thesis, University of Portsmouth, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.516884.
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Background: There is an unsubstantiated conviction among clinicians that a significant reduction In amniotic fluid volume is a poor prognostic sign for pregnancy, even when it is an isolated finding. This belief has led to the inculcation of serial ultrasound assessments of amniotic fluid volume into the antenatal assessment of fetal well being with the aim of improving perinatal outcomes by closer monitoring and earlier delivery. In reality, there is no strong evidence base for this practice, while there are significant risks associated with premature delivery. There may also be cost and resource implications for the practice. Objective: The aim of this thesis was to investigate whether isolated oligohydramnios is significantly associated with adverse pregnancy outcomes in otherwise uncomplicated pregnancies, and to investigate the underlying associated maternal, fetal and placental aetiological factors. Materials and Methods: Amniotic fluid volumes were measured using ultrasound in 3328 low-risk pregnancies between 19 and 41 weeks. These were otherwise uncomplicated pregnancies recruited at the antenatal booking visit following a normal 1st trimester screening result (a negative 11-14 week combined nuchal translucency ultrasound and maternal serum-biochemistry fetal structural and chromosomal abnormality screening test). Maternal characteristics (age, parity, ethnicity, socioeconomic status, weight, smoking and alcohol consumption) during the course of the pregnancy, Placental characteristics (site, position and maturity), and Fetal renal blood flow parameters were also studied and analysed for possible associations. Results: Isolated oligohydramnios occurred more frequently with advancing maternal age and lower parity. However, maternal ethnicity, weight and socioeconomic status did not have any direct influence on the occurrence of isolated oligohydramnios and neither did the maternal life style factors studied. Increasing placental maturity was significantly associated with significantly reduced amniotic fluid but neither the placental site nor location was. There was a significant association between oligohydramnios and poor perinatal outcome as judged by meconium staining of amniotic fluid during labour, emergency Caesarean delivery for fetal compromise, an increased requirement for neonatal resuscitation and endotracheal intubation. In the population of pregnancies studied, there was no significant correlation between isolated oligohydramnios and a suspicious or pathological cardiotocogram during labour. However, a low birth weight less than 2500 g at birth, admission to the neonatal intensive care unit, a prolonged length of neonatal intensive care unit stay, and perinatal deaths were all significantly associated with oligohydramnios. No association was seen with either a low Apgar score or a low fetal arterial cord blood pH. Conclusion: This study showed that an isolated reduction in amniotic fluid volume even in an otherwise uncomplicated pregnancy is significantly associated with a poor perinatal outcome, and can therefore not be safely ignored. This finding justifies the continued assessment of amniotic fluid volumes.
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Goddard, Kalanithi Lucy Emily. "Placental Localization and Perinatal Outcome". Yale University, 2008. http://ymtdl.med.yale.edu/theses/available/etd-08132007-124118/.
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This retrospective case-control study was designed to investigate the relationship between placental localization and intrauterine growth restriction (IUGR). Pregnant women with an anatomic survey from January 1, 2000, to December 31, 2005, and delivery of the pregnancy at Yale-New Haven Hospital (YNHH) were identified using clinical and billing records. Multiple gestation, fetal anomaly, and incomplete medical information were reasons for exclusion. Cases (N=69) were consecutive pregnancies with evidence of IUGR (estimated fetal weight <10th percentile for gestational age) at last follow-up ultrasound. Randomly selected controls (N=258) from the same time period had no evidence of IUGR. Maternal, ultrasound, delivery, and perinatal data were collected by retrospective medical record review, and IUGR cases and non-IUGR controls were compared using the Students t-test, Wilcoxon test, Chi-square analysis, Fishers exact test, and ANOVA. Placental location was determined from the anatomic survey record (obtained at 18.4 ± 1.2 weeks gestation in the IUGR group and 18.2 ± 1.0 weeks gestation in the control group; P=0.18). Multivariate logistic regression with adjustment for confounders was used to investigate the association between IUGR and placental localization. Consistent with known predictors of IUGR, the IUGR group had a higher proportion of black women (36.4% vs. 19.8%, P=0.03), chronic hypertension (26.0% vs. 3.5%, P<0.001), and hypertensive disorders of pregnancy (36.2% vs. 5.0%, P<0.001). Mean birth weights of IUGR and non-IUGR pregnancies differed by 2 kilograms (3244 ± 625 grams vs. 1277 ± 637 grams, P<0.001). IUGR infants were more likely to receive antenatal steroids, deliver preterm, deliver by cesarean section, and be admitted to neonatal intensive care. In both IUGR and non-IUGR pregnancies, the placenta was most commonly anterior or posterior. Unilateral placentas were three times more common in the IUGR group than in the non-IUGR group (17.4% vs. 5.0%, P=0.01). IUGR pregnancies were over four times as likely as control subjects to have unilaterally-located placentas compared to anterior placentas (OR 4.8, 95% confidence interval, 1.9-11.7). Adjusting for ethnicity, chronic hypertension, and hypertensive disorders of pregnancy did not affect this finding (OR 4.6, 95% confidence interval 1.6-13.5). In conclusion, we compared a group of 69 IUGR pregnancies to 258 non-IUGR controls and found intrauterine growth restriction to be associated with unilateral placentation.
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Barjat, Tiphaine. "Vers une meilleure connaissance des pathologies vasculaires placentaires". Thesis, Lyon, 2017. http://www.theses.fr/2017LYSES026/document.
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Les pathologies vasculaires placentaires sont fréquentes et graves. La forme maternelle prédominante est la pré-éclampsie et la forme fœtale le retard de croissance intra-utérin. Les questions posées autour de ce sujet concernent tout d'abord la prédiction de la survenue de ces pathologies suffisamment tôt afin de permettre une surveillance rapprochée, une administration de corticoïdes et une prise en charge dans une maternité de niveau adaptée. La prévention de la survenue et de la récidive ainsi que le traitement de ces pathologies la phase constituée sont aussi des problématiques encore non résolues. Notre objectif était de travailler sur ces différentes questions pa l'intermédiaire de trois études : l'étude ANGIOPRED), l'étude VOLUPLA et l'étude GROWTH. Les résultats de ces travaux et une revue d la littérature mettent en évidence une perturbation des facteurs de l'hémostase et des facteurs angiogéniques dans la pré-éclampsie et dans le retard de croissance. L'association des facteurs maternels, échographiques, angiogéniques et sériques constitue un modèle prédictif efficace principalement du fait d'une excellente valeur prédictive négative. Le volume placentaire est corrélé au taux de D- Dimères et est intéressant pour la prédiction des pathologies vasculaires placentaires. De nouveaux travaux devront poursuivre l'étude d la prédiction, de la prévention et du traitement des pathologies liées au placenta. Le traitement est notamment l'objet de l'étude Growth qui vise à évaluer l'efficacité de l'énoxaparine dans le traitement du retard de croissance vasculaire constituéPlacenta-mediated adverse pregnancy outcomes are frequent and severe pathologies whose predominant maternal form is preeclampsia and fetal form, intrauterine growth retardation. The questions asked about this subject concern first of all the prediction of the occurrence of its pathologies in a sufficiently early way to allow for close monitoring, administration of corticosteroids, and management in an appropriate level of maternity. The prevention of the occurrence and recurrence and the treatment of its pathologies in the constituted phase are also unresolved problems. Our objective was therefore to work on its various questions through three studies: the ANGIOPREI study, the VOLUPLA study and the GROWTH study. The results of his work and of the literature show that the factors of haemostasis anc angiogenic factors are disturbed in preeclampsia and in growth retardation. The association of maternal, ultrasound, angiogenic and serum factors constitutes a predictive model that is effective mainly by an excellent negative predictive value. The placental volume is correlated with the D-dimer level and is interesting for placenta-mediated adverse pregnancy outcomes prediction. New studies will have to continue the exploration of the prediction, prevention and treatment of this pathologies related to the placenta. The treatment is notably the object of the study Growth which aims to evaluate the effectiveness of the Enoxaparin for the treatment of constituted vascular growt retardation
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Jobarteh, Modou Lamin. "The effect of prenatal nutritional intervention on placental nutrient transporter expression and feto-placental outcome in rural Gambian women". Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=225784.
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Iron and zinc deficiency during pregnancy is common among women in low-income nations. In such settings, prenatal nutritional intervention is encouraged to improve pregnancy outcome. The impact of the intervention on transporter proteins involved in fetal nutrient supply is unexplored. This study investigated gene expression of some transporter proteins involved in fetal nutrient supply in the placenta. In a trial in rural Gambia, pregnant women at <20weeks of gestation were randomised to 4 nutritional intervention arms: i) Iron and folic acid (FeFol), representing the usual care ii) Multiple micronutrients (MMN) iii) Protein energy (PE) iv) MMN and PE (PE+MMN). All the intervention arms contained 60mg iron and 400μg of folic acid. FeFol and MMN interventions were given in tablet format, whereas PE and PE+MMN were in food format (lipid-based nutrient supplement- LNS). Maternal blood samples collected at booking, 20 and 30 weeks of gestation were assessed for iron levels, and zinc levels measured only the later samples. Gene expression of proteins involved in fetal iron, zinc, amino acid and glucose transport were measured on placental samples collected at birth. LNS (PE and PE+MMN) intervention was associated with low maternal iron status in late pregnancy and increased placental mRNA expression of the primary iron-uptake protein, transferrin receptor 1(TfR1). Intervention arms with no supplementary zinc (FeFol and PE) had lower maternal plasma zinc levels and increased placental mRNA expression of intracellular zinc-uptake proteins, ZIP1, ZIP4 and ZIP8. Different nutritional intervention strategies are associated with changes in maternal iron and zinc status during pregnancy and corresponding changes in the gene expression of placental iron and zinc uptake proteins. This might suggest differential fetal intrauterine response to the interventions. Understanding the role of the placenta in the delivery of nutrients to the fetus is important when considering intervention strategies.
Książki na temat "Placental outcomes"
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Firestein, Morgan. The Role of the Human Placenta in Regulating Fetal Exposure to Maternal Hormones and Implications for Child Neurobehavioral Outcomes. [New York, N.Y.?]: [publisher not identified], 2020.
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Gluckman, Sir Peter, Mark Hanson, Chong Yap Seng i Anne Bardsley. Maternal stress in pregnancy and breastfeeding. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198722700.003.0033.
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Acute and/or chronic stress in pregnancy is potentially detrimental to the health of both the mother and the developing fetus. The stress response triggers the release of glucocorticoids, mainly cortisol, into the maternal bloodstream, with subsequent effects on energy metabolism, growth processes, and in the functioning of the immune system and brain. The placenta provides a barrier to natural glucocorticoids, buffering the fetus from minor changes in maternal cortisol levels but can be saturated by high maternal levels of cortisol and under conditions of maternal under-nutrition or compromised placental function. Various outcomes can be affected, including birthweight and infant behaviour. Severe stress is not always easily avoided, but daily stress, and specifically that associated with pregnancy itself, should be minimized as much as possible.
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Glover, Vivette, Thomas G. O’Connor i Kieran O’Donnell. Maternal mood in pregnancy: fetal origins of child neurodevelopment. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198749547.003.0003.
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Women experience as many symptoms of anxiety, depression, and stress during pregnancy as in the postnatal period. This can affect not only the woman herself but also the development of her fetus, and have long-term effects on several different outcomes including the cognitive ability and behaviour of her child, although most children are not affected. The particular outcomes affected may depend on the timing of the exposure, specific genetic vulnerabilities, and the quality of postnatal care provided. Recent research has shown that increased maternal anxiety is associated with altered placental function, and a greater association between maternal and fetal cortisol. This interrelationship of hormonal associations during the fetal stage could potentially impact on fetal/infant outcomes, and supports the need for continuing research in the field. Chapter 3 covers studies on maternal mood in pregnancy and explores the underlying mechanisms and types of stress.
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Glover, Vivette. Maternal Stress During Pregnancy and Infant and Child Outcome. Redaktor Amy Wenzel. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199778072.013.006.
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Many independent prospective studies show maternal stress, anxiety, or depression during pregnancy poses an increased risk for her child to have a wide range of adverse outcomes including emotional problems, ADHD or conduct disorder, or impaired cognitive development. Several studies have shown that these adverse outcomes are independent of possible confounding factors, such as postpartum anxiety and depression. Most children are not affected, and those who are can be affected in different ways, probably due to different genetic vulnerabilities and the quality of postpartum care. An evolutionary explanation for the observed changes is proposed. Underlying mechanisms are just starting to be understood: altered function of the placenta, allowing more of the stress hormone cortisol to pass through to the fetus, may well be important, as may epigenetic changes. The implications are that improved emotional care of pregnant women should improve outcomes for their children to a clinically significant degree.
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Pastrakuljic, Aleksandra. The role of the placenta in adverse fetal outcomes associated with maternal cocaine use and cigarette smoking in pregnancy. 2000.
Znajdź pełny tekst źródłaCzęści książek na temat "Placental outcomes"
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Lemos, Daniela, Ana Cristina Braga i Rosete Nogueira. "Nonlinear Regression on Growth Curves for Placental Parameters in R". W Communications in Computer and Information Science, 575–90. Cham: Springer Nature Switzerland, 2024. http://dx.doi.org/10.1007/978-3-031-53025-8_39.
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AbstractGrowth charts play a crucial role in the evaluation and surveillance of paediatric populations, serving as indispensable tools for paediatricians and public health researchers. The development of these growth charts for fetal parameters has been extensively used in recent decades. However, investigation of placental parameters and their relationship with obstetric outcome has been relatively neglected, resulting in a significant gap in understanding their biological significance. This study presents an alternative approach for constructing reference growth curves specific to the placental parameter, Diameter 2. Our methodology uses the generalized additive models for location, scale, and shape (GAMLSS), offering distinct advantages over traditional quantile regression methods. One of the key advantages of GAMLSS is its flexibility to accommodate any statistical distribution, allowing for the modelling of various parameters that characterize the distribution of the response variable. Through the application of our proposed methodology, we demonstrated that by using P-splines as a smoothing function and Box-Cox t (BCT) as a distribution, we can achieve a representative growth curve for the Diameter 2 of the placenta throughout gestational age (GA). The resulting models demonstrated high representativeness, with $$R^2$$ R 2 values of 0.7608 and 0.7673 and AIC scores of 7953 and 7946 for the best two models, respectively. Moreover, our approach has the ultimate goal to facilitate early diagnosis of fetal complications, thereby providing valuable assistance to healthcare professionals.
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Ateya, Mohamed I., Ahmed S. Sedik, Islam A. Ahmed, Mostafa H. Abouzeid i Sherif A. Shazly. "Prediction and Risk Reduction of Clinical Outcomes of Placenta Accreta Spectrum". W Placenta Accreta Spectrum, 107–15. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-10347-6_10.
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Abdel-Aleem, Mahmoud A. "Long-Term Outcomes of Conservative Management of PAS: Long-Term Sequences and Impact on Future Pregnancies". W Placenta Accreta Spectrum, 193–200. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-10347-6_16.
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Gainder, Shalini, i Deepmala Modi. "Management of women with prior hypertension and abruptio placentae in pregnancy". W Recurrent Pregnancy Loss and Adverse Natal Outcomes, 69–76. Boca Raton: CRC Press, 2020.: CRC Press, 2020. http://dx.doi.org/10.1201/9780429435027-8.
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Duttaroy, Asim K., i Sanjay Basak. "Placentation as a Predictor of Feto-Placental Outcome: Effects of Early Nutrition". W Early Nutrition and Lifestyle Factors, 1–12. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-38804-5_1.
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Borowski, Sophia, Nancy Freitag, Iris Urban, Geert Michel, Gabriela Barrientos i Sandra M. Blois. "Examination of the Contributions of Maternal/Placental-Derived Galectin-1 to Pregnancy Outcome". W Methods in Molecular Biology, 603–19. New York, NY: Springer US, 2022. http://dx.doi.org/10.1007/978-1-0716-2055-7_32.
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González-Ortiz, Marcelo, Patricio Castro, Pablo Vergara-Barra, Patricia Huerta i Carlos Escudero. "COVID-19 on Pregnancy Outcomes, Mental Health and Placenta: Focus in Latin America". W Advances in Maternal-Fetal Biomedicine, 269–85. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-32554-0_12.
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Beer, Alan E., James F. Quebbeman, A. Enrico Semprini i Zhu Xiaoyu. "The Association of Mixed Lymphocyte Reaction (MLR) Blocking Factors and Maternal Antipaternal Leukocytotoxic Antibodies with Pregnancy Outcome in Women with Recurrent Abortions Immunized with Paternal or Third Party Leukocytes". W Cellular Biology and Pharmacology of the Placenta, 187–97. Boston, MA: Springer US, 1987. http://dx.doi.org/10.1007/978-1-4757-1936-9_14.
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Bernard, R. P., i S. Sastrawinata. "Placentae Abruptio and Previa, by Age, Fetal Growth, and Outcome: A Closed Control Model for Research, Feedback, and Teaching". W Gynecology and Obstetrics, 180–86. Berlin, Heidelberg: Springer Berlin Heidelberg, 1986. http://dx.doi.org/10.1007/978-3-642-70559-5_62.
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Shah, Ruchit, Carolyn Salafia, Theresa Girardi, Pratipaul Persaud, Jessica Brunner, Emily S. Barrett, Thomas O’Connor i Richard K. Miller. "Placental growth and development analyzed through 2D and 3D fractals." W Fractal Analysis - Applications and Updates [Working Title]. IntechOpen, 2023. http://dx.doi.org/10.5772/intechopen.1001929.
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Fractal geometry has many applications in physiology and anatomy, providing novel insights into the structure and function of biological systems and organs, including the placenta. The placenta is a vital fetal organ that is the means by which essential nutrients and oxygen are extracted from maternal blood and transferred to the developing fetus. Anatomically, the placenta is a highly intricate structure exhibiting self-similarity at different scales. The complex relationship between placental function in nutrient transfer and fetal growth follows the allometric metabolic scaling law. Variability of shape of the placental chorionic plate, a 2D plane which contains the major chorionic arteries and veins, has been linked to measures of child health and neurodevelopmental outcomes. The microscopic arrangement of chorionic villi have also been demonstrated to have fractal properties that vary by gestational age and in different pathological conditions. Geographical Information Systems theory could be used to analyze the placental topography in the context of its surface vasculature and measures of spatial autocorrelation can model placental growth and development over gestation. An ideal model would mark timing, nature, and severity of gestational pathology modifying placental growth and, by extension, fetal development that leads to poor pregnancy outcomes.
Streszczenia konferencji na temat "Placental outcomes"
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Cunha, Eriadne Barbosa da Silva, Maria Jayane de Oliveira Silva Calheiros, Pedro Henrique da Costa Lima, André Luis Silva de Sousa, Thayane de Souza Oliveira i Glória Stéphany Silva de Araújo. "DESCOLAMENTO PREMATURO DA PLACENTA E O IMPACTO NA SAÚDE NEONATAL". W Anais do I Congresso Brasileiro de Urgência e Emergência, 88–89. Recife, Brasil: Even3, 2025. https://doi.org/10.29327/1484146.1-3.
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O descolamento prematuro da placenta (DPP) é uma complicação obstétrica grave caracterizada pela separação precoce da placenta da parede uterina, afetando cerca de 1% das gestações. Sua associação com comorbidades como hipertensão e pré-eclâmpsia aumenta a incidência do DPP, levando a sérias consequências para a saúde materna e neonatal. Entre os riscos neonatais estão o parto prematuro, baixo peso ao nascer e morte fetal, além de complicações neurológicas a longo prazo. A detecção precoce e o manejo adequado são cruciais para melhorar os desfechos neonatais. Ainda, torna-se imprescindível conhecer quais são os possíveis impactos na saúde e neonatal. Objetivo: Evidenciar o impacto do descolamento prematuro da placenta na saúde neonatal. Materiais e métodos: Trata- se de um método de estudo baseado na revisão narrativa de literatura realizada no mês de dezembro de 2024, utilizou-se as bases de dados da Biblioteca Virtual em Saúde (BVS), Scientific Electronic Library Online (SciELO) e U. S. National Library of Medicine (Pubmed) com recorte temporal entre 2019 a 2024, os descritores aplicados foram “abruptio placentae/descolamento prematuro de placenta”, “high risk pregnancy/gravidez de alto risco” e fetal outcome/resultado fetal, posteriormente foram associados ao agente booleano AND no sistema de busca. Os critérios de inclusão de publicações foram: Recorte temporal dos últimos cinco anos; disponibilidade completa e gratuita; resposta ao objetivo da pesquisa; redação em português ou em inglês. Já os de exclusão foram trabalhos repetidos nas bases, teses e protocolos clínicos, assim como textos que não atendiam aos critérios de inclusão. A análise dos trabalhos, realizada em duas triagens, se deu a partir da leitura dos títulos e resumos, seguidas da leitura na íntegra para identificar padrões e associações relevantes entre as variáveis estudadas a partir do título e da leitura dos resumos. Com isso, foram eleitas nove pesquisas para a construção do presente trabalho. Resultados e discussão: O descolamento prematuro da placenta é um dos fatores associados à natimortalidade, sendo a principal causa de morte fetal quando se trata de condições placentárias, além de estar relacionada às morbidades do neurodesenvolvimento do feto. Os estudos mostraram que o DPP tem repercussões neurais no feto, como maiores chances de apresentar paralisia cerebral e outros danos neuronais histopatológicos. Isso acontece, em vista do descolamento prematuro que acarreta uma instabilidade no elo entre a gestante e o feto, lesando a troca gasosa e causando disfunção endotelial. Dessa forma, tais complicações resultam na acidemia fetal, sendo prejudicial para o desenvolvimento do feto. Ademais, o DPP causa repercussões maternas variadas a depender da gravidade da situação, podendo aumentar a chance de haver uma hemorragia pós- parto, causar uma insuficiência cardíaca ou até mesmo provocar a morte materna e fetal. Essa complicação gestacional está associada a fatores de risco como a hipertensão crônica, pré-eclâmpsia grave, uso de cocaína, idade materna avançada, endometriose, dentre outros. Todavia, ainda não se sabe ao certo sobre a fisiopatologia por traz da associação entre os fatores de risco e o descolamento prematuro da placenta. Portanto, diante de tudo o que foi abordado, tal emergência obstétrica normalmente tem indicação de cesárea, a fim de evitar os riscos para a gestante e para o feto. Considerações Finais: Objetivo central do estudo foi alcançado ao evidenciar que descolamento DPP é uma das principais complicações obstétricas e a principal causa de morte fetal. Além disso, as repercussões para o feto incluem morte fetal, paralisia cerebral e outras complicações neurológicas, enquanto para a gestante, pode ocasionar hemorragia pós-parto, insuficiência cardíaca e até morte materna. A cesárea é frequentemente indicada para evitar complicações, e a detecção precoce dos fatores de risco é essencial para garantir o melhor manejo da gestação e o desenvolvimento adequado do feto.
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Murphy, Vanessa E., Jennifer A. Namazy, Heather Powell, Peter Gibson, Christina Chambers, John Attia i Michael Schatz. "A Meta-Analysis Of Adverse Perinatal Outcomes In Asthmatic Women: Effect Of Asthma On Placental And Neonatal Outcomes". W American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a1883.
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Rossner, Pavel, Nana Tabashidze, Miroslav Dostal, Zuzana Novakova, Irena Chvatalova, Milada Spatova i Radim J. Srám. "Abstract 4392: Oxidative damage to placental DNA, air pollution, genetic polymorphisms and pregnancy outcomes". W Proceedings: AACR 101st Annual Meeting 2010‐‐ Apr 17‐21, 2010; Washington, DC. American Association for Cancer Research, 2010. http://dx.doi.org/10.1158/1538-7445.am10-4392.
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Snurdel, Matija, Ana Batista, Nathaniel Kirkpatrick, Carmen Almodovar, Lars Riedemann, Teresa Peterson, Napoleone Ferrara i in. "Abstract IA17: Targeting placental growth factor/ neuropilin-1 pathway inhibits growth and spread of medulloblastoma". W Abstracts: AACR Special Conference: Pediatric Cancer at the Crossroads: Translating Discovery into Improved Outcomes; November 3-6, 2013; San Diego, CA. American Association for Cancer Research, 2014. http://dx.doi.org/10.1158/1538-7445.pedcan-ia17.
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Wang, Zhiwei, Xinyao Jiao, Weiwu Liu, Han Song, Jiapeng Li, Jing Hu i Sa Huang. "A Systematic Review on MRI Signs of Placental Accreta Spectrum and Their Predictive Potential for Adverse Postpartum Outcomes". W ICPHDS 2024: 2024 3rd International Conference on Public Health and Data Science, 224–31. New York, NY, USA: ACM, 2024. https://doi.org/10.1145/3718677.3718713.
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Bajaj, Kanika. "Poster Abstract". W 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685361.
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Tuberous sclerosis (TS) is a genetic disorder that is inherited in an autosomal dominant fashion with variable clinical manifestations including seizures, mental retardation, renal failure and pneumothorax. The literature on TS in pregnancy is largely based upon case reports which have shown a 43% complication rate including oligohydramnios, polyhydramnios, IUGR, hemorrhage from ruptured renal tumors, PPROM, renal failure, placental abruption and perinatal demise. We reporting a case of 33 yr old female with gravida 3 para 2 and live 2 with period of gestation 9 months with tuberous sclerosis, with severe oligohydramnios with fetal cardiomegaly and mild pericardial effusion and pleural effusion. She had facial angiofibromas along with bilateral renal angiomyolipomas. The previous fetal outcomes were normal, with facial angiofibroma. We report such a unique case having all clinically diagnostic physical sings of tuberous sclerosis with good fetal outcomes.
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Thompson, Jaylyn D., Jenna Zappetti i Clarence Julian II Clark. "Management Strategies for Traumatic Injuries in Pregnant Women: A Comprehensive Literature Review". W 28th Annual Rowan-Virtua Research Day. Rowan University Libraries, 2024. http://dx.doi.org/10.31986/issn.2689-0690_rdw.stratford_research_day.122_2024.
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Introduction: Traumatic injuries in pregnant women are the leading cause of non-obstetric death and affect 6% to 8% of all pregnancies. Therefore, it is imperative to maintain updated guidelines to construct a framework for the optimal management strategies for traumatic injuries in pregnant women, considering the perspectives of obstetrics/gynecology, emergency medicine, and orthopedics. Methods: To conduct this study, research was done via a database search through the Rowan-Virtua School of Osteopathic Medicine’s research library. PubMed was the sole database used to review 8 peer-reviewed sources. Articles that were published within the last 10 years were chosen. Results: Every woman with significant traumatic injuries must have pregnancy ruled out given its unique physiologic characteristics. First responders gather history surrounding fetal movement, contractions, and vaginal bleeding. Stabilization includes fetal monitoring, fluid resuscitation, blood transfusions, and maternal repositioning. Laboratory studies and diagnostic imaging (ultrasound) do not harm the mother or baby and reflect fetal status. Sometimes, emergency cesarean delivery (≤ 5 minutes of arrest) is indicated. There are some reports of fetal survival and maternal benefit beyond 15 minutes of arrest. Domestic violence is the most common trauma mechanism for pregnant women and triggers several obstetric complications (fetal loss, pre-term delivery, and placental abruption). Conclusion: Adverse outcomes of pregnancy happen more frequently following trauma. Non-emergent trauma may be managed conservatively, delaying treatment until after delivery. Surgical positioning, medication administration, and diagnostic imaging determine the best outcomes for the mother and child.
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de Boer, K., I. Lecander, J. W. ten Cate, J. J. J. Borm i P. E. Treffers. "PLASMINOGEN ACTIVATOR INHIBITOR OF PLACENTAL TYPE IN PREECLAMPSIA". W XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644461.
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In 24 patients with preeclampsia and in 24 normal pregnant controls, matched for gestational age, fibrinolytic parameters were determined. Aim of the study was to investigate plasminogen activator inhibitory activity (PAI activity) levels and plasminogen activator inhibitor of placental type (PAI 2) in preeclamptic and normal pregnancy and to establish the clinical relevance of these assays. PAI activity was measured by titrating the plasma with single chain t-PA. PAI 2 was measured by means of an ELISA using monoclonal and polyclonal antibodies against the placental inhibitor. Therefore we related testresubts to a predefined relevant clinical endpoint i.e. fetal outcome. The following results were obtained:PAI 2 levels below 43% had a positive predictive value of 91% for poor fetal outcome, levels above 43% had a negative predictive value of 95%. PAI activity levels didn't have a significant predictive value.. It is concluded that high levels of PAI activity in preeclampsia are not due to PAI 2 and that low levels of PAI 2 are related with a poor fetal outcome.
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Kaur, Paramjeet, Ashok K. Chauhan, Anil Khurana, Yashpal Verma i Nupur Bansal. "Gestational trophoblastic neoplasia: Retrospective analysis of clinical profile, treatment pattern and outcome". W 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685377.
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Background: Gestational trophoblastic disease is a spectrum of cellular proliferation arising from the placental villous trophoblast. Gestational triphoblastic neoplasia (GTN) is a collective term for GTD that invade locally or metastasize. GTD includes hydatidiform mole (complete and partial) and GTN include invasive mole, choricocarcinoma, placental site trophoblastic tumor and epitheliod trophoblastic tumor. Aim: To evaluate clinicopathological profile, treatment pattern and clinical outcome in patients with gestational trophoblastic neoplasia (GTN). Materials and Methods: Twelve cases of gestational trophoblastic neoplasia treated between 2012 to November 2015 in deptt of Radiotherapy – II, PGIMS, Rohtak were evaluated in this retrospective study. Data was analyzed on the basis of age, histopathology, stage, type of treatment received and treatment related toxicities. Disease free survival was estimated. Results: Out of 12 women 7 (58 %) had hydatidiform mole, 4 (33%) invasive mole and 01 (8%) had choriocarcinoma. All the cases were given chemotherapy. Two patients had low risk disease. Among high risk group seven patients had score of less than 7 and five patients had risk score of 7 or higher. Five patients were given single agent methotrexate, seven patients received multidrug regimens. All patients are on regular follow up. One patient (high risk group) expired as she did not receive treatment. Conclusion: GTN are rare and proliferative disorders with proper diagnosis and treatment most of the cases are amenable to treatment with favorable outcome.
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Kaur, Paramjeet, Ashok K. Chauhan, Anil Khurana, Yashpal Verma i Nupur Bansal. "Gestational trophoblastic neoplasia: Retrospective analysis of clinical profile, treatment pattern and outcome". W 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685306.
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Background: Gestational trophoblastic disease is a spectrum of cellular proliferation arising from the placental villous trophoblast. Gestational triphoblastic neoplasia (GTN) is a collective term for GTD that invade locally or metastasize. GTD includes hydatidiform mole (complete and partial) and GTN include invasive mole, choricocarcinoma, placental site trophoblastic tumor and epitheliod trophoblastic tumor. Aim: To evaluate clinicopathological profile, treatment pattern and clinical outcome in patients with gestational trophoblastic neoplasia (GTN). Materials and Methods: Twelve cases of gestational trophoblastic neoplasia treated between 2012 to November 2015 in Department of Radiotherapy – II, PGIMS, Rohtak were evaluated in this retrospective study. Data was analyzed on the basis of age, histopathology, stage, type of treatment received and treatment related toxicities. Disease free survival was estimated. Result: Out of 12 women 7 (58 %) had hydatidiform mole, 4 (33%) invasive mole and 1 (8%) had choriocarcinoma. All the cases were given chemotherapy. Two patients had low risk disease. Among high risk group seven patients had score of less than 7 and five patients had risk score of 7 or higher. Five patients were given single agent methotrexate, seven patients received multidrug regimens. All patients are on regular follow up. One patient (high risk group) expired as she did not receive treatment. Conclusion: GTN are rare and proliferative disorders with proper diagnosis and treatment most of the cases are amenable to treatment with favorable outcome.
Raporty organizacyjne na temat "Placental outcomes"
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Neykova, Konstantsa, Violeta Dimitrova i Rumen Dimitrov. Antithrombotic Medication Outcome on Uteroplacental Blood Flow in Patients with Previous Obstetric History of Placental Mediated Disorders. "Prof. Marin Drinov" Publishing House of Bulgarian Academy of Sciences, marzec 2021. http://dx.doi.org/10.7546/crabs.2021.03.16.
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Moza, Andreea, Florentina Duica, Panagiotis Antoniadis, Elena Silvia Bernad, Diana Lungeanu, Marius Craina, Brenda Cristiana Bernad i in. Outcome of newborns in case of SARS-CoV-2 vertical infection. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, grudzień 2022. http://dx.doi.org/10.37766/inplasy2022.12.0093.
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Review question / Objective: To identify the types and examine the range of available evidence of vertical transmission of SARS-CoV-2 from mother to newborn. To clarify the key concepts and criteria for diagnosis of SARS-CoV-2 vertical infection in neonates. To summarize the existing evidence and advance the awareness on SARS-CoV-2 vertical infection in pregnancy. Background: Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2), the virus that causes 2019 coronavirus disease (COVID-19), has been isolated from various tissues and body fluids, including the placenta, amniotic fluid, and umbilical cord of newborns. In the last few years, much scientific effort has been directed towards studying SARS-CoV-2, focusing on the different features of the virus, such as its structure and mechanisms of action. Moreover, much focus has been on developing accurate diagnostic tools and various drugs or vaccines to treat COVID-19.