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Sample records for abruptio placentae

  1. Placenta abruptio

    Science.gov (United States)

    ... Philadelphia, PA: Elsevier; 2017:chap 18. Hull AD, Resnik R. Placenta previa, placenta accreta, abruptio placentae, and vasa previa. In: Creasy RK, Resnik R, Iams JD, Lockwood CJ, Moore TR, Greene ...

  2. Tetany following resuscitation after abruptio placentae.

    Science.gov (United States)

    Powner, David J; Bessinger, Victoria J

    2002-05-01

    Serum ionized calcium and magnesium are normally decreased during later stages of pregnancy. A further rapid decline may be caused by the rapid infusion of blood bank products in which citrate is used as an anticoagulant/preservative. Tetany, as reported here, may be precipitated by such infusions. A gravid woman presented in hemorrhagic shock due to abruptio placentae. Rapid infusion of packed red blood cells and fresh frozen plasma precipitated signs of tetany, muscle rigidity, posturing, high airway pressure during mechanical ventilation, etc. Ionized calcium and magnesium blood levels were very low (0.58 mmol/L and 1.0 mg/dL, respectively), but responded to rapid electrolyte administration. Binding of calcium and magnesium by citrate may lead to hypo-ionized calcemic and hypomagnesemic tetany after rapid replacement of blood products in the pregnant patient. This consequence is worsened when extreme alkalemia due to respiratory or metabolic causes is also present.

  3. Retrospective Analysis of Abruptio Placentae Cases and Comparision of Normal Pregnancies

    Directory of Open Access Journals (Sweden)

    Ahmet Kale

    2005-01-01

    Full Text Available The aim of this study was to analyze of 94 abruptio placentae cases retrospectively during 1 years period.We evaluated of 94 abruptio placentae cases (group1 retrospectively during 5 years period in our clinic. Maternal age, parity, prepartum estimated gestasional week, birth weight, cesarean section ratio, hypertension pregnancies were evaluated and compared with 127 normal pregnancies (group2 who had given births . The ratio of abruptio placentae was 1.38% during five years period. Prepartum estimated mean gestasional week in group 1 was 32.0±3.3 and 15.35 % of women had pregnancy induced hypertension. Cesarean section was performed 81.91 % of cases. All of cesarean endications was abruptio placentae (p0.05. Mean 1.minute APGAR score was 3.02±1.10 in grup 1 and 6.80±2.5 in group 2 (p<0.001. Mean 5.minute APGAR score was 3.99 ± 1.17 in grup 1 and 8.42±1.50 in group 2 (p<0.001. Early neonatal mortality ratio was 69.14 %in group 1 and, %3.9 in group 2 (p<0.001.Abruptio placentae still remains as an important obstetric problem which is associated with a high perinatal mortality rate.

  4. MEASURES TO IMPROVE THE OUTCOME OF ABRUPTIO PLACENTA IN A TERTIARY REFERRAL CENTRE

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    Vijaya

    2015-12-01

    Full Text Available AIM To analyze the outcome of 135 patients admitted with Abruptio Placenta during a period of 9 months managed at Tertiary Referral Centre, Modern Govt. Maternity Hospital, Petalburz, Hyderabad, Telangana State. MATERIALS AND METHODS A study of 135 cases of Abruptio Placenta over a period of 9 months at a tertiary level referral centre. They were analyzed regarding age, parity, socio economic status, period of gestation, antenatal care, management of Abruption and maternal and fetal outcome, and the measures to improve the condition were analyzed. RESULTS Abruptio placenta is a dreadful threat to maternal and fetal life. In our study unbooked cases were 110(81.48%, Hypertension is the main risk factor almost in 90(66.66% cases, 65% of them were between 28-36 weeks of GA, and 6 were grandmultis, 6 cases ended up with HELLP syndrome with DIC. All these 6 cases were near misses, 5 unbooked cases had eclampsia. One case of unbooked eclampsia had abruption DIC and could not be saved as it was the late referral. Total number of vaginal deliveries were 66(48.88% and total no. of abdominal deliveries were 67(49.62% in this LSCS 66 and one hysterotomy. IUD at the time of admission total were 100(74%. CONCLUSION To improve the outcome in Abruptio Placentae Good antenatal care, Educating the patient, Strengthening the Primary Health Centers in identifying the risk factors like Pre-eclampsia thereby avoiding eclampsia. Regular antenatal checkups timely delivery and availability of blood and blood products with good Neonatal care unit will help in improving the outcome of Abruptio.

  5. Maternal and fetal outcome among abruptio placentae cases at a rural tertiary hospital in Karnataka, India: a retrospective analysis

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    Vartika Shrivastava

    2014-08-01

    Conclusion: In our setup, frequency of abruptio placenta is comparable with local and international literature. Abruptio placenta is associated with high rate of maternal and fetal morbidity and mortality, Because of this association, the conditions predisposing it should be carefully evaluated in order to reduce the occurrence of placental abruption. Unfortunately neither accurate prediction nor prevention of abruption is possible at the present time. Despite advances in medical technology, the diagnosis of abruption is still a clinical one. [Int J Res Med Sci 2014; 2(4.000: 1655-1658

  6. A STUDY ON FETAL OUTCOME WITH RESPECT TO SURVIVAL IN MOTHERS WITH ABRUPTIO PLACENTA IN A LARGE REFERRAL HOSPITAL

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    Vidyasagar

    2015-09-01

    Full Text Available Abruption placenta is a serious condition affecting survival of pregnant mother and baby. This study on fetal outcome with respect to survival in mothers with abruptio placentae in a large referral hospital is a observational study . Study involved about 100 cases out of 19000 deliveries, which were managed according to standard protocols in a resource limited large referral hospital. The incidence of APH was 0.89% in the present study, t he i ncidence of abruption was highest in parity 2 to 5 as majority of deliveries were in the same age group. Based on the grading of abruption 49% were grade 2. Acceleration of labour was done using different methods . Syntocin was used in 21 cases. LSCS was do ne in 16 cases, 6 among them for maternal indications and 10 cases LSCS was done immediately without trial of labour with a live foetus of more than 34 weeks gestation. Fetal fate based on the grading of abruption, with grade 0, two cases delivered vaginal ly and both survived. In grade 2 abruptio placenta, 17 fetuses were live at admission among which 15 delivered vaginally and 2 delivered by LSCS. Out of the 17 aforesaid cases 14 died intrapartum and 2 died due to perinatal asphyxia. With grade 3 abruption none of the fetuses survived. Foetal deaths were probably due to foetal bradycardia and asphyxia and early timely intervention like blood transfusion and LSCS could have saved the foetus.

  7. Cesárea prévia como fator de risco para o descolamento prematuro da placenta Previous cesarean section as a risk factor for abruptio placentae

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    Fábio Roberto Cabar

    2004-10-01

    relationship between previous cesarean section and abruptio placentae. METHODS: a retrospective study reviewed 6495 deliveries between April 2001 and January 2004. The adopted inclusion criteria were: clinical diagnosis of abruptio placentae confirmed by placental examination after delivery, single pregnancy, birth weight >500 g, gestational age >22 weeks and no history of abdominal trauma. Five controls were selected for each abruptio placentae case and were matched for the following parameters: parity, gestational age ( 30 weeks, maternal arterial hypertension during pregnancy, presence of nonobstetrical uterine scar, premature rupture of membranes and polyhydramnios. Statistical analysis of continuous variables was perfomed by Student's t test. Statistical significance of the comparisons of categorical variables was evaluated by the chi2 test or by the Fisher exact test. p values <0.05 were considered to be significant. RESULTS: thirty-four cases of abruptio placentae were included (incidence 0.52%. The control group included 170 cases that fulfilled the matching criteria. The incidence of previous cesarean section in the abruptio placentae group was 26.5% (9 cases and in the control group it was 21.2% (36 cases. No significant difference was found between the groups (p=0.65, OR=1.34, CI 95%=0.53-3.34. CONCLUSION: the present study was not able to demonstrate association between abruptio placentae and previous cesarean section.

  8. Placenta abruption - definition

    Science.gov (United States)

    ... PA: Elsevier Saunders; 2014:chap 178. Hull AD, Resnik R. Placenta previa, placenta accreta, abruptio placentae, and ... R, Iams JD, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. ...

  9. Risk Factors for Severe Abruptio Placenta in Mulago Hospital ...

    African Journals Online (AJOL)

    Administrator

    2002-11-30

    Nov 30, 2002 ... African Health Sciences Vol 5 No 4 December 2005. 285. ORIGINAL ARTICLES. Risk factors .... one or both women selected did not satisfy the selection criteria, the next women were selected. The cases and controls selected ...

  10. Placenta accreta with placenta previa. Case report

    National Research Council Canada - National Science Library

    Hernández-Ojeda, Humberto; Torres-Hernández, Rosa María; Rivera-Hernández, Jorge Onasis

    2014-01-01

    The placenta praevia and acretism placental were concurrently and are conditions of abnormal placenta, in which the villus sampling invade the myometrium at the site of implantation and is associated...

  11. [Placenta accreta with placenta previa. Case report].

    Science.gov (United States)

    Hernández-Ojeda, Humberto; Torres-Hernández, Rosa María; Rivera-Hernández, Jorge Onasis

    2014-08-01

    The placenta praevia and acretism placental were concurrently and are conditions of abnormal placenta, in which the villus sampling invade the myometrium at the site of implantation and is associated with the partial or complete absence of the decidua. Clinical case: Patient's 32 years of age, with 34 weeks pregnancy. Obstetric history of previous cesarean section, transvaginal bleeding several times; the diagnosis by ultrasound showed placenta praevia occlusive. Surgical treatment was abdominal total hysterectomy.

  12. Placenta: How It Works, What's Normal

    Science.gov (United States)

    ... the most common placental problems include placental abruption, placenta previa and placenta accreta. These conditions can cause potentially ... nutrients. In some cases, early delivery is needed. Placenta previa. This condition occurs when the placenta partially or ...

  13. Management of placenta percreta

    DEFF Research Database (Denmark)

    Clausen, Caroline; Lönn, Lars; Langhoff-Roos, Jens

    2014-01-01

    in the management of the conditions. A PubMed search was performed in April 2013 and the final review included 119 published placenta percreta cases. Conservative management, where the placenta is left in situ for resorption, seems to be associated with severe long-term complications of hemorrhage and infections...... cases for the local resection technique might in part explain the lower complication rates with that approach. Future prospective data collection activities should include intended as well as actual management, and long-term follow-up of all cases is of vital importance....

  14. De placenta bij rhesus antagonisme

    NARCIS (Netherlands)

    Wormgoor, Bernard Hendrikus

    1952-01-01

    In de inleiding worden de te behandelen problemen aan de orde gesteld. Het uitganspunt hiervan is de studie van de morphologie van de placenta. Bij het histologisch onderzoek van de placenta waren het vooral de afwijkingen in de placenta bij Erythroblastosis Foetalis (verderop aan te duiden als E.F.

  15. Ultrasonography evaluations of placenta previa

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    Lee, Hak Seo; Yim, Neung Jae; Oh, Eun Ock [Korea General Hospital, Seoul (Korea, Republic of); Park, Soo Soung [Chung Ang University College of Medicine, Seoul (Korea, Republic of)

    1984-12-15

    Diagnostic ultrasound has become one of the most useful tools in the practice of obstetrics. It has been of particular utility in the placental localization. We analyzed 34 patients of placenta previa scanned by ultrasound. The results were as follows; 1. The age of patient ranged from 22 to 39 years, showing the highest incidence in 26 to 30 years. 2. The accuracy of correct localization was 70.6%. 3. Among 13 cases diagnosed by ultrasound as total placenta previa, 2 cases were partial placental previa and 1 was low-lying placenta at the time of delivery. 4. Among 9 cases diagnosed by ultrasound as partial placenta previa, 1 case was total placenta previa and 1 case was low-lying placenta and 1 case was upper segment placenta. 5. Among 10 cases diagnosed by ultrasound as low-lying placenta, 2 cases were partial placenta previa. 6. Among 2 cases diagnosed by ultrasound as upper segment placenta, 1 case was total placenta previa and 1 case was partial placenta previa. 7. Among 9 cases done serial ultrasound, 3 cases revealed that the placenta migrates toward fundus in the course of pregnancy. Therefore, the placental scanning should be repeated in the last month before term to decide the mode of delivery. Conclusively, ultrasonography is the imaging modality of choice in the evaluation of placenta localization because it provides speedy and repeatable way without any known risk to both mother and fetus itself. Careful performance and accurate interpretation should be needed for more correct placental localization.

  16. Placenta associated pregnancy complications in pregnancies complicated with placenta previa

    National Research Council Canada - National Science Library

    Yael Baumfeld; Reli Herskovitz; Zehavi Bar Niv; Salvatore Andrea Mastrolia; Adi Y. Weintraub

    2017-01-01

    Objectives: The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications...

  17. Ultrasound, normal placenta - Braxton Hicks (image)

    Science.gov (United States)

    ... performed at 17 weeks gestation. It shows the placenta during a normal (Braxton Hicks) contraction. Throughout the ... contracts to facilitate better blood flow through the placenta and the fetus. In this ultrasound, the placenta ...

  18. Placenta associated pregnancy complications in pregnancies complicated with placenta previa

    Directory of Open Access Journals (Sweden)

    Yael Baumfeld

    2017-06-01

    Conclusions: Our study demonstrated an increased rate of placental insufficiency associated complications in women with placenta previa. This is of clinical relevance and suggests that a careful surveillance for women with placenta previa may help in minimizing maternal, fetal and neonatal complications.

  19. Placenta associated pregnancy complications in pregnancies complicated with placenta previa.

    Science.gov (United States)

    Baumfeld, Yael; Herskovitz, Reli; Niv, Zehavi Bar; Mastrolia, Salvatore Andrea; Weintraub, Adi Y

    2017-06-01

    The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications (IUGR, preeclampsia, placental abruption and perinatal mortality). Our study included all deliveries that occurred at Soroka University Medical Center (Beer Sheva, Israel) between January 1998 and December 2013. Of them 1,249 were complicated by placenta previa and represented our study group. A composite outcome was created to include conditions associated with placental insufficiency. It included hypertensive disorders (i.e. gestational hypertension, mild and severe preeclampsia, HELLP and eclampsia), small for gestational age neonates and placental abruption. Patients with pregnancy complicated by placenta previa had significantly different obstetrical characteristics including bad obstetric history (8% vs. 4%, p placenta previa had higher rates of vaginal bleeding in the second half of pregnancy (3% vs. 0%, p placenta (4% vs. 0.5%, p placenta previa group (21% vs. 13%, p placenta previa. This is of clinical relevance and suggests that a careful surveillance for women with placenta previa may help in minimizing maternal, fetal and neonatal complications. Copyright © 2017. Published by Elsevier B.V.

  20. Placenta accreta and anesthesia: A multidisciplinary approach

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    R S Khokhar

    2016-01-01

    Full Text Available Placenta accreta (an abnormally adherent placenta is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.

  1. Placenta accreta and anesthesia: A multidisciplinary approach.

    Science.gov (United States)

    Khokhar, R S; Baaj, J; Khan, M U; Dammas, F A; Rashid, N

    2016-01-01

    Placenta accreta (an abnormally adherent placenta) is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.

  2. Placenta accreta: the silent invader

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    Seema Dwivedi

    2016-05-01

    Conclusions: Incidence of placenta accrete has increased now a days because of increased incidence of cesarian sections, placenta accreta was seen in primi due to uterine procedures done deliberately in both diagnostic and therapeutic indications. Morbidly adherent placenta is always a nightmare for the obstetrician. Suspicion of a case on history, preoperative confirmation of diagnosis, planned management with bundle of care, with multi-disciplinary approach can save many patients from the clutches of inevitable death. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1501-1505

  3. Ultrasonographic findings of placenta lacunae and a lack of a clear zone in cases with placenta previa and normal placenta.

    Science.gov (United States)

    Hamada, Shoko; Hasegawa, Junichi; Nakamura, Masamitsu; Matsuoka, Ryu; Ichizuka, Kiyotake; Sekizawa, Akihiko; Okai, Takashi

    2011-11-01

    To evaluate whether the frequencies of placenta lacunae and lack of a clear zone are higher in cases of placenta previa compared with those without it. Ultrasonographic findings just before delivery, including placenta lacunae and lack of a clear zone were prospectively evaluated in consecutive subjects. After collection, a case-control study with 1:5 matched pairs was conducted. The frequencies of ultrasonographic findings were analyzed in cases with placenta previa and normal placenta. Seventy cases with placenta previa and 350 cases with normal placentas were observed. Five and zero cases with abnormal placental adherence were observed in cases with placenta previa and normal placenta, respectively. Lack of a clear zone was observed in 60 and 1.5% of cases with and without the placental adherence (p = 0.001). Placenta lacunae and lack of a clear zone were observed in 31.4 and 9.7% of cases with and without placenta previa [odds ratio (OR) 4.2]. Lack of a clear zone was observed in 5.7 and 0.9% of cases with and without placenta previa (OR 7.0). Placenta lacunae and lack of a clear zone are frequently observed in placenta previa even when there is no adherence of the placenta. Copyright © 2011 John Wiley & Sons, Ltd.

  4. Placenta accreta: adherent placenta due to Asherman syndrome

    DEFF Research Database (Denmark)

    Engelbrechtsen, Line; Langhoff-Roos, Jens; Kjer, Jens Jørgen

    2015-01-01

    It is important to be aware of the risk of abnormally invasive placenta in patients with a history of Asherman syndrome and uterine scarring. A prenatal diagnosis by ultrasonography is useful when planning of mode of delivery.......It is important to be aware of the risk of abnormally invasive placenta in patients with a history of Asherman syndrome and uterine scarring. A prenatal diagnosis by ultrasonography is useful when planning of mode of delivery....

  5. Placenta Praevia: Incidence, Risk Factors

    African Journals Online (AJOL)

    6,7,8,9 caesarean section, myomectomy or metroplasty . The risk of occurrence of ... erythroblastosis, assisted conception, structural .... 7,16 maternal death were reported from other studies . Placenta praevia is common in our environment.

  6. Histological and histochemical changes in placenta of diabetic pregnant females and its comparision with normal placenta

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    Vineeta Tewari

    2011-03-01

    Full Text Available Objective: To investigate the histological and histochemical changes in placenta of diabetic pregnant females and compare them with normal placenta. Methods: The histological and histochemical features of 60 placenta, 30 obtained from normal pregnant females and 30 from diabetic pregnant females, were studied. These placenta were obtained from Department of Obstetrics and Gynaecology, GSVM Medical College Kanpur and ERA ’s Lucknow Medical College and Hospital Lucknow. Results: On histological examination, the diabetic placenta showed increased syncytial knots, fibrinoid necrosis, trophoblastic basement membrane thickening, villous stromal fibrosis, villous oedema, crowding of villi, thickening of vessel wall and fibrin deposition. On histochemical study it was found that the PAS reactivity was stronger in diabetic placenta as compared to normal. Sudan Black reactivity was higher among diabetic placenta in comparison to normal placenta. Conclusions: It is concluded that distinct histological and histochemical changes could be seen in placenta of diabetic pregnant females.

  7. MATERNAL AND FOETAL OUTCOME IN PLACENTA PREVIA

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    Basa Akkamamba

    2016-11-01

    Full Text Available BACKGROUND The aim of the study is to study the-  Risk factors for placenta previa.  Signs of placenta previa.  Modes of delivery.  Maternal and foetal outcome.  Incidence of placenta previa. MATERIALS AND METHODS This is a longitudinal prospective study group consisting of 75 cases of pregnancies with placenta previa. Analysis of maternal and neonatal outcome in cases of placenta previa occurring over a period of 2 years from November 2013 to October 2016. This study was carried out at Government General Hospital, Kakinada, attached to Rangaraya Medical College. RESULTS Maternal morbidity in placenta previa is due to antepartum, intrapartum and postpartum complications. Maternal mortality due to placenta previa was nil. Perinatal death with minor placenta previa was 5.12% with major placenta previa was 47.22%. The general perinatal mortality was 28 per 1000 live births and that due to placenta previa 280 per 1000 live births, i.e. approximately 4 times higher than general perinatal mortality rate. The maternal mortality rate due to placenta previa in this study was nil. CONCLUSIONS In the present study, incidence of antepartum haemorrhage was 0.87% and placenta previa contributed to 37.12% of cases. The general perinatal mortality was 28 per 1000 live births and that due to placenta previa 280 per 1000 live births, i.e. approximately 4 times higher than general perinatal mortality rate. The maternal mortality rate due to placenta previa in this study was nil. But, maternal morbidity was high that is more than 60% of cases had antenatal, intranatal and postnatal complications and anaemia worsened the clinical state of patient.

  8. Abnormal Placentation: Placenta Previa, Vasa Previa, and Placenta Accreta.

    Science.gov (United States)

    Silver, Robert M

    2015-09-01

    Placental disorders such as placenta previa, placenta accreta, and vasa previa are all associated with vaginal bleeding in the second half of pregnancy. They are also important causes of serious fetal and maternal morbidity and even mortality. Moreover, the rates of previa and accreta are increasing, probably as a result of increasing rates of cesarean delivery, maternal age, and assisted reproductive technology. The routine use of obstetric ultrasonography as well as improving ultrasonographic technology allows for the antenatal diagnosis of these conditions. In turn, antenatal diagnosis facilitates optimal obstetric management. This review emphasizes an evidence-based approach to the clinical management of pregnancies with these conditions as well as highlights important knowledge gaps.

  9. Postpartum MR diagnosis of retained placenta accreta

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Yumiko Oishi; Itai, Yuji [Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki (Japan); Shigemitsu, Sadahiko [Department of Obstetrics and Gynecology, Ryugasaki Saiseikai General Hospital, Ryagasaki (Japan); Ichikawa, Yoshihito; Sohda, Satoshi; Yoshikawa, Hiroyuki [Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki (Japan)

    2004-06-01

    Retained placenta accreta can cause catastrophic postpartum hemorrhage. This study aims to determine whether MR imaging can differentiate retained placenta accreta from postpartum hemorrhage caused by other conditions. Fourteen cases suspicious for retained placenta were examined with MR imaging. Signal intensity, the enhancing pattern of uterine contents, and flow voids within the myometrium were retrospectively studied. As hysterectomy was performed in only two cases, final diagnosis was based on clinical outcome and analysis of uterine contents. Final diagnoses were retained placenta accreta in seven cases, retained normally attached placenta in four, hematoma in two, and placental site trophoblastic tumor (PSTT) in one. All seven cases with placenta accreta had a very hyperintense area on T2-weighted images, showing transient early enhancement. None demonstrated delayed strong enhancement around the hyperintense area. In two cases with retained normally attached placenta and in both with hematomas, there were no hyperintense areas on T2-weighted images. Of these, only one showed transient early enhancement. Flow voids were observed in four cases with placenta accreta, one with normally attached placenta, and the case with PSTT. A markedly hyperintense area on T2-weighted images and transient early enhancement without delayed strong enhancement between the mass and the myometrium can indicate retained placenta accreta. (orig.)

  10. Adenomyosis in pregnancy mimicking morbidly adherent placenta

    Science.gov (United States)

    Tongsong, Theera; Khunamornpong, Surapan; Sirikunalai, Panarat; Jatavan, Thanate

    2014-01-01

    The objective of this study was to illustrate a false-positive diagnosis of adherent placenta due to underlying adenomyosis. A 34-year-old woman was diagnosed for placenta previa totalis with adherent placenta at 33 weeks, based on the findings of loss of clear space or distinguishing outline separating the placenta and uterine wall, presence of intraplacental lacunae and densely atypical vessels in the lesion. Caesarean hysterectomy was performed at 35 weeks. Pathological findings revealed placenta previa totalis with adenomyosis beneath the placenta at the lower segment, with no adherent placenta. In conclusion, this report underlines the importance of possible false-positive test of prenatal ultrasound and MRI findings of adherent placenta caused by underlying adenomyosis which could obliterate the outline distinguishing the placenta and myometrium and atypical vessels secondary to decidualisation and hypervascularity from pregnancy. This case may probably encourage physician to beware of false-positive test of adherent placenta due to adenomyosis. PMID:24722709

  11. Optimal transport and the placenta

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, Simon [Los Alamos National Laboratory; Xia, Qinglan [NON LANL; Salafia, Carolym [NON LANL

    2010-01-01

    The goal of this paper is to investigate the expected effects of (i) placental size, (ii) placental shape and (iii) the position of insertion of the umbilical cord on the work done by the foetus heart in pumping blood across the placenta. We use optimal transport theory and modeling to quantify the expected effects of these factors . Total transport cost and the shape factor contribution to cost are given by the optimal transport model. Total placental transport cost is highly correlated with birth weight, placenta weight, FPR and the metabolic scaling factor beta. The shape factor is also highly correlated with birth weight, and after adjustment for placental weight, is highly correlated with the metabolic scaling factor beta.

  12. Prediction of adherent placenta in pregnancy with placenta previa using ultrasonography and magnetic resonance imaging.

    Science.gov (United States)

    Tanimura, Kenji; Yamasaki, Yui; Ebina, Yasuhiko; Deguchi, Masashi; Ueno, Yoshiko; Kitajima, Kazuhiro; Yamada, Hideto

    2015-04-01

    Adherent placenta is a life-threatening condition in pregnancy, and is often complicated by placenta previa. The aim of this prospective study was to determine prenatal imaging findings that predict the presence of adherent placenta in pregnancies with placenta previa. The study included 58 consecutive pregnant women with placenta previa who underwent both ultrasonography and magnetic resonance imaging prenatally. Ultrasonographic findings of anterior placental location, grade 2 or higher placental lacunae (PL≥G2), loss of retroplacental hypoechoic clear zone (LCZ) and the presence of turbulent blood flow in the arteries were evaluated, in addition to MRI findings. Forty-three women underwent cesarean section alone; 15 women with adherent placenta underwent cesarean section followed by hysterectomy with pathological examination. To determine imaging findings that predict adherent placenta, univariate and multivariate logistic regression analyses were performed. Univariate logistic regression analyses demonstrated that anterior placental location, PL≥G2, LCZ, and MRI were associated with the presence of adherent placenta. Multivariate analyses revealed that LCZ (pplacenta in women with placenta previa. This prospective study demonstrated for the first time that US findings, especially LCZ, might be useful for identifying patients at high risk for adherent placenta among pregnant women with placenta previa. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen Christine Leth; Bergholt, Thomas; Nikolajsen, Sys

    2013-01-01

    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....

  14. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Nikolajsen, Sys; Løkkegaard, Ellen Christine Leth; Bergholt, Thomas

    2013-01-01

    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....

  15. Effect of Placenta Previa on Fetal Growth

    Science.gov (United States)

    HARPER, Lorie M.; ODIBO, Anthony O.; MACONES, George A.; CRANE, James P.; CAHILL, Alison G.

    2011-01-01

    Objective To estimate the association between placenta previa and abnormal fetal growth. Study Design Retrospective cohort study of consecutive women undergoing ultrasound between 15–22 weeks. Groups were defined by the presence or absence of complete or partial placenta previa. The primary outcome was intrauterine growth restriction (IUGR), defined as a birth weight placenta previa on fetal growth restriction. Results Of 59,149 women, 724 (1.2%) were diagnosed with a complete or partial previa. After adjusting for significant confounding factors (black race, gestational diabetes, preeclampsia, and single umbilical artery,), the risk of IUGR remained similar (adjusted odds ratio 1.1, 95% CI 0.9–1.5). The presence of bleeding did not impact the risk of growth restriction. Conclusion Placenta previa is not associated with fetal growth restriction. Serial growth ultrasounds are not indicated in patients with placenta previa. PMID:20599185

  16. Placenta percreta: methotrexate treatment and MRI findings.

    Science.gov (United States)

    Heiskanen, Nonna; Kröger, Jaana; Kainulainen, Sakari; Heinonen, Seppo

    2008-02-01

    Our patient was a 24-year-old gravida 2 para 0 woman. After delivery, placenta percreta was noticed. There was no postpartum hemorrhage, and the patient desired future pregnancies. Although placenta percreta is rare, its sequelae include potentially lethal hemorrhage and loss of reproduction function. Placenta percreta was confirmed histologically and with ultrasonography and magnetic resonance imaging (MRI). Placenta percreta was treated conservatively with methotrexate. On follow-up, MRI showed a small calcified transmural extension of the placenta throughout the uterus in the right fundal area. Color Doppler ultrasonography showed no blood flow in the corresponding area, and maternal serum human chorionic gonadotropin (hCG) was undetectable. Use of MRI is a new method to detect abnormal placentation, and it could be used on follow-up in selective cases with other follow-up modalities. However, it seems likely that conservative management to preserve future fertility remains a secured and reasonable alternative when a patient has no active bleeding.

  17. Induction of apoptosis in placentas of pregnant mice exposed to lipopolysaccharides: possible involvement of Fas/Fas ligand system.

    Science.gov (United States)

    Ejima, K; Koji, T; Tsuruta, D; Nanri, H; Kashimura, M; Ikeda, M

    2000-01-01

    To explore the pathogenesis in placental dysfunction and abruptio placentae, we analyzed the occurrence of placental cell apoptosis and the role of Fas and Fas ligand (L) in that process in an inflammatory placental dysfunction model of pregnant mice, using lipopolysaccharides (LPS). In the present study, Day 13 pregnant mice were injected i.p. with LPS (50 microg/kg) or saline as a control, and the placentas were isolated at various time points after the injection. Analysis of the isolated DNA in agarose-gel electrophoresis revealed a typical ladder pattern of bands consisting of 180-200 base pairs (bp), which is regarded as a hallmark of apoptosis. The intensity of the bands increased time-dependently, reaching a maximum level at 12 h after LPS injection. In accord with the biochemical data, histochemical analysis using terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) revealed that nuclei positive for double-stranded DNA breaks were found in decidua, diploid trophoblasts in the basal zone, and spongiotrophoblasts. The number of positive nuclei was maximized at 12 h after LPS injection. As a next step, we investigated the possible involvement of Fas and Fas L in the induction of apoptosis of the placental cells after LPS injection. Western blot analysis indicated that LPS increased the expression of Fas and Fas L in the placenta by about 4-fold at 12 h and 18 h, respectively, after injection. The cells expressing Fas and Fas L were identified, using immunohistochemistry and nonradioactive in situ hybridization, as decidua, diploid trophoblasts in the basal zone, and spongiotrophoblasts. Furthermore, when the expression of 4-hydroxy-2-nonenal (HNE)-modified proteins was assessed to evaluate the relation of oxidative stress elicited by LPS to the induction of apoptosis, once again decidua, diploid trophoblasts in the basal zone, and spongiotrophoblasts were positive. Therefore, the placental dysfunction by LPS may be brought about

  18. Optimal management strategies for placenta accreta.

    Science.gov (United States)

    Eller, A G; Porter, T F; Soisson, P; Silver, R M

    2009-04-01

    To determine which interventions for managing placenta accreta were associated with reduced maternal morbidity. Retrospective cohort study. Two tertiary care teaching hospitals in Utah. All identified cases of placenta accreta from 1996 to 2008. Cases of placenta accreta were identified using standard ICD-9 codes for placenta accreta, placenta praevia, and caesarean hysterectomy. Medical records were then abstracted for maternal medical history, hospital course, and maternal and neonatal outcomes. Maternal and neonatal complications were compared according to antenatal suspicion of accreta, indications for delivery, preoperative preparation, attempts at placental removal before hysterectomy, and hypogastric artery ligation. Early morbidity (prolonged maternal intensive care unit admission, large volume of blood transfusion, coagulopathy, ureteral injury, or early re-operation) and late morbidity (intra-abdominal infection, hospital re-admission, or need for delayed re-operation). Results Seventy-six cases of placenta accreta were identified. When accreta was suspected, scheduled caesarean hysterectomy without attempting placental removal was associated with a significantly reduced rate of early morbidity compared with cases in which placental removal was attempted (67 versus 36%, P=0.038). Women with preoperative bilateral ureteric stents had a lower incidence of early morbidity compared with women without stents (18 versus 55%, P=0.018). Hypogastric artery ligation did not reduce maternal morbidity. Scheduled caesarean hysterectomy with preoperative ureteric stent placement and avoiding attempted placental removal are associated with reduced maternal morbidity in women with suspected placenta accreta.

  19. Iron transportation across the placenta

    Directory of Open Access Journals (Sweden)

    Claudia M. de Oliveira

    2012-12-01

    Full Text Available According to the classification of placental types among animals, the transfer of iron through the placenta can occur via: absorption connected to transferin through the outer surface of the trophoblast in direct contact with circulating maternal blood; absorption of the erythrocytes by the chorionic epithelium in direct contact with accumulation of blood extravased from haemotophagous areas; absorption by the chorionic epithelium in direct contact with iron enriched secretions from the endometrial glands and absorption by extravasations of the blood in the maternal-fetal surface and the subsequent phagocytosis of the erythrocytes by trophoblast cells described in bovine, small ruminants, canine and feline. The function of erythrophagocytosis observed after the extravasation of blood in the maternal-fetal interface is undefined in several species. Possibly, the iron is transferred to the fetus through the trophoblastic erythrophagocytosis in the hemophogous area of the placenta and also in the endometrial glands. In this literature survey, new methods of studies regarding placental transfer involving iron and other nutrients necessary for survival and maintenance of embryonic fetus to birth are proposed.De acordo com a classificação dos tipos de placenta existentes entre os animais e em relação com a passagem de substâncias pela barreira inter-hemática, a transferência de ferro pode ser realizada através da: absorção de ferro ligado a transferrina através da superfície externa do trofoblasto em contato direto com o sangue materno circulante; absorção de eritrócitos pelo epitélio coriônico em contato direto com acúmulos de sangue materno extravasado em áreas hematófagas, absorção de ferro pelo epitélio coriônico em contato direto com secreções ricas em ferro provenientes de glândulas endometriais e fagocitose dos eritrócitos pelas células trofoblásticas, a qual foi descrita em bovinos, pequenos ruminantes, caninos e

  20. Placenta previa percreta with bladder invasion

    Directory of Open Access Journals (Sweden)

    Siniša Šijanović

    2011-02-01

    Full Text Available A 43- year old woman, with ten previous deliveries and history of two cesarean sections was admitted to our Department at 32 weeks of gestation with massive vaginal hemorrhage from an ultrasound diagnosed placenta previa. An emergency cesarean section with vertical abdominal incision was performed. A healthy 2300 g female infant was delivered. Attempts to manually remove the placenta caused massive hemorrhage. The lower uterine segment was widened due to placenta previa with suspicious placental invasion of the posterior wall of the bladder. Persistent hemorrhage demanded bilateral anterior internal iliac artery ligation and suture ligation of the bleeding vessels with supracervical hysterectomy done.

  1. Autophagy in term normal human placentas.

    Science.gov (United States)

    Signorelli, P; Avagliano, L; Virgili, E; Gagliostro, V; Doi, P; Braidotti, P; Bulfamante, G P; Ghidoni, R; Marconi, A M

    2011-06-01

    Autophagy is an inducible catabolic process that responds to environment and is essential for cell survival during stress, starvation and hypoxia. Its function in the human placenta it is not yet understood. We collected 14 placentas: 7 at vaginal delivery and 7 at elective caesarean section after uneventful term pregnancies. The presence of autophagy was assessed in different placental areas by immunoblotting, immunohistochemistry and electron microscopy. We found that autophagy is significantly higher in placentas obtained from cesarean section than in those from vaginal delivery. Moreover there is a significant inverse relationship between autophagy and umbilical arterial glucose concentration.

  2. Abdomen agudo y embarazo: placenta percreta

    OpenAIRE

    2001-01-01

    La ruptura uterina espontánea por placenta percreta, sin historia de trauma o infección, es una patología extremadamente rara y responsable de una alta morbimortalidad materna. El diagnóstico prenatal de placenta percreta es importante para evitar resultados catastróficos debido a este desorden obstétrico, y diversos procedimientos son utilizados para lograr esta meta. Se presenta un caso de placenta percreta, con búsqueda de expedientes clínicos por esta patología, en el Hospital Monseñor Sa...

  3. Cervical varicosities may predict placenta accreta in posterior placenta previa: a magnetic resonance imaging study.

    Science.gov (United States)

    Ishibashi, Hiroki; Miyamoto, Morikazu; Shinnmoto, Hiroshi; Murakami, Wakana; Soyama, Hiroaki; Nakatsuka, Masaya; Natsuyama, Takahiro; Yoshida, Masashi; Takano, Masashi; Furuya, Kenichi

    2017-07-14

    The aim of this study was to prenatally predict placenta accreta in posterior placenta previa using magnetic resonance imaging (MRI). This retrospective study was approved by the Institutional Review Board of our hospital. We identified 81 patients with singleton pregnancy who had undergone cesarean section due to posterior placenta previa at our hospital between January 2012 and December 2016. We calculated the sensitivity and specificity of several well-known findings, and of cervical varicosities quantified using magnetic resonance imaging, in predicting placenta accreta in posterior placenta previa. To quantify cervical varicosities, we calculated the A/B ratio, where "A" was the minimum distance from the most dorsal cervical varicosity to the deciduous placenta, and "B" was the minimum distance from the most dorsal cervical varicosity to the amniotic placenta. The appropriate cut-off value of the A/B ratio was determined using a receiver operating characteristic (ROC) curve. Three patients (3.7%) were diagnosed as having placenta accreta. The sensitivity and specificity of the well-known findings were 0 and 97.4%, respectively. Furthermore, the A/B ratio ranged from 0.02 to 0.79. ROC curve analysis revealed that the area under the combined placenta accreta and A/B ratio curve was 0.96. When the cutoff value of the A/B ratio was set 0.18, the sensitivity and specificity were 100 and 91%, respectively. It was difficult to diagnose placenta accreta in the posterior placenta previa using the well-known findings. The quantification of cervical varicosities could effectively predict placenta accreta.

  4. Obstetric complications of placenta previa percreta

    Directory of Open Access Journals (Sweden)

    Sparić Radmila

    2014-01-01

    Full Text Available Introduction. Placenta previa is related to severe maternal and fetal morbidity. The increasing incidence of cesarean delivery rate causes a marked increase in abnormally invasive placenta over the past decades. The abnormally invasive placenta is becoming the foremost cause of obstetric hemorrhage and postpartum hysterectomy, causing a significant maternal and fetal morbidity and even mortality. Maternal morbidity in such cases also comprise politransfusion, development of disseminated intravascular coagulation, uterine rupture, cystostomy, fistula formation, ureteral stricture, intensive care unit admission, infection, and prolonged hospitalization, adult respiratory distress syndrome, renal failure, septicemia and even death. Case report. A 38-year-old gravida 3, para 2, was admitted to our hospital at 27 weeks of gestation as an emergency due to vaginal bleeding, previously diagnosed with an anterior placenta previa. Following tocolytic therapy, bleeding stopped. The patient was informed on the diagnosis and the possibility of lifethreatening hemorrhage necessitating preterm delivery. She was given corticosteroids to enhance fetal lung maturity. At 28 weeks of gestation, she experienced massive vaginal bleeding, and a decision was made to perform emergency cesarean section. We made a corporeal transverse uterine incision well above the uterovesical fold and tortuous vessels, at the same time avoiding the superior edge of the placenta. The placenta was found to be densely adherent to the lower uterine segment, penetrating through it and infiltrating the posterior wall of the urinary bladder. An attempt to remove the placenta resulted in injury to the bladder wall and the uterine rupture at a previous cesarean scar. The decision was made to perform total abdominal hysterectomy with placenta left in situ. At present, both mother and the baby are well. Conclusion. Anticipation and the surgeon's judgment are leading factors for surgery, from the

  5. Abdomen agudo y embarazo: placenta percreta

    Directory of Open Access Journals (Sweden)

    Horacio Massotto Chaves

    2001-10-01

    Full Text Available La ruptura uterina espontánea por placenta percreta, sin historia de trauma o infección, es una patología extremadamente rara y responsable de una alta morbimortalidad materna. El diagnóstico prenatal de placenta percreta es importante para evitar resultados catastróficos debido a este desorden obstétrico, y diversos procedimientos son utilizados para lograr esta meta. Se presenta un caso de placenta percreta, con búsqueda de expedientes clínicos por esta patología, en el Hospital Monseñor Sanabria, desde 1994 hasta 1999, y con revisión de la bibliografía.Spontaneous uterine rupture, without a history of trauma or associated infection by placenta percreta is an extremely rare pathology and it's responsible for high maternal morbidity and mortality. The prenatal diagnosis of placenta precreta is important to avoid catastrophic results after the obstetrical disorder and different procedures are used to get to this goal. We present here a case of placenta percreta and a revision of cases with this diagnosis from 1994 to 1999 at the Monseñor Sanabria Hospital, and a review of the literature.

  6. Relationship between placenta location and resolution of second trimester placenta previa.

    Science.gov (United States)

    Feng, Yun; Li, Xue-Yin; Xiao, Juan; Li, Wei; Liu, Jing; Zeng, Xue; Chen, Xi; Chen, Kai-Yue; Fan, Lei; Chen, Su-Hua

    2017-06-01

    This prospective study was conducted to assess the rate of resolution of second trimester placenta previa in women with anterior placenta and posterior placenta, and that in women with and without previous cesarean section. In this study, placenta previa was defined as a placenta lying within 20 mm of the internal cervical os or overlapping it. We recruited 183 women diagnosed with previa between 20(+0) weeks and 25(+6) weeks. They were grouped according to their placenta location (anterior or posterior) and history of cesarean section. Comparative analysis was performed on demographic data, resolution rate of previa and pregnancy outcomes between anterior group and posterior group, and on those between cesarean section group and non-cesarean section group. Women with an anterior placenta tended to be advanced in parity (P=0.040) and have increased number of dilatation and curettage (P=0.044). The women in cesarean section group were significantly older (P=0.000) and had more parity (P=0.000), gravidity (P=0.000), and dilatation and curettage (P=0.048) than in non-cesarean section group. Resolution of previa at delivery occurred in 87.43% women in this study. Women with a posterior placenta had a higher rate of resolution (P=0.030), while history of cesarean section made no difference. Gestational age at resolution was earlier in posterior group (P=0.002) and non-cesarean section group (P=0.008) than in anterior group and cesarean section group correspondingly. Placenta location and prior cesarean section did not influence obstetric outcomes and neonatal outcomes. This study indicates that it is more likely to have subsequent resolution of the previa when the placenta is posteriorly located for women who are diagnosed with placenta previa in the second trimester.

  7. The placenta in toxicology. Part IV : Battery of toxicological test systems based on human placenta

    NARCIS (Netherlands)

    Göhner, Claudia; Svensson-Arvelund, Judit; Pfarrer, Christiane; Häger, Jan-Dirk; Faas, Marijke; Ernerudh, Jan; Cline, J Mark; Dixon, Darlene; Buse, Eberhard; Markert, Udo R

    2014-01-01

    This review summarizes the potential and also some limitations of using human placentas, or placental cells and structures for toxicology testing. The placenta contains a wide spectrum of cell types and tissues, such as trophoblast cells, immune cells, fibroblasts, stem cells, endothelial cells, ves

  8. Reproductive performance of Friesian mares after retained placenta and manual removal of the placenta

    NARCIS (Netherlands)

    Sevinga, M; Hesselink, JW; Barkema, H.W.

    2002-01-01

    Because the incidence of retained placenta in Friesian mares is estimated to be high, and no reports have been published on the reproductive performance of Friesian mares after retained placenta, we studied postpartum reproductive performance in Friesian brood mares with (n = 54) and without (n = 50

  9. Placenta Accreta and Total Placenta Previa in the 19th Week of Pregnancy

    Science.gov (United States)

    Findeklee, S.; Costa, S. D.

    2015-01-01

    Placentation disorders are the result of impaired embedding of the placenta in the endometrium. The prevalence of these disorders is estimated to be around 0.3 %. A history of previous prior uterine surgery (especially cesarean section and curettage) is the most common risk factor. Impaired placentation is differentiated into deep placental attachment; marginal, partial and total placenta previa; and placenta accreta, increta and percreta. Treatment depends on the severity of presentation and ranges from expectant management to emergency hysterectomy. In most cases, preterm termination of pregnancy is necessary. We report here on the case of a 39-year-old woman with placenta accreta and total placenta previa who underwent hysterectomy in the 19th week of pregnancy. PMID:26366004

  10. [Management of placenta previa and accreta].

    Science.gov (United States)

    Kayem, G; Keita, H

    2014-12-01

    Produce recommendations for the management of placenta previa and placenta accrete. A literature search was conducted using Medline and the Cochrane Library over a period from 1950 to 31/12/2013. Recommendations of the latest scientific societies have also been consulted. In cases of placenta previa, if bleeding episode before 34weeks gestation occurs, a short hospitalization and tocolysis may help stop bleeding (grade C). Vaginal delivery is preferable when the distance between the internal cervical os and the placental edge is greater than 20mm. When this distance is less than 20mm, vaginal delivery is possible (professional consensus). Caesarean section is recommended in cases of placenta overlapping the internal os (professional consensus). Antenatal screening placenta accreta could improve care (EL3). Upon discovery of a placenta accreta during childbirth, it is better to avoid a forced removal of the placenta (grade C). Conservative treatment or cesarean hysterectomy are possible (grade C). The management of placental abnormalities should be planned and managed with a multidisciplinary team (professional consensus). The use of blood-saving techniques such as "cell saver" is possible in situations where early intraoperative bleeding would be>1500mL (grade C). There are no studies that have sufficient methodological value to recommend an anesthetic technique [general anaesthesia (GA) or neuraxial anaesthesia] over another in the context of placental abnormalities (grade B). When a major bleeding risk is identified, GA can be chosen in order to avoid emergency conversions in difficult conditions (professional consensus). Placental insertion abnormalities require anesthetic and obstetric coordination. Delivery must be planned in a suitable structure. Copyright © 2014. Published by Elsevier Masson SAS.

  11. Endothelial and lipoprotein lipases in human and mouse placenta

    DEFF Research Database (Denmark)

    Lindegaard, Marie Louise Skakkebæk; Olivecrona, Gunilla; Christoffersen, Christina;

    2005-01-01

    Placenta expresses various lipase activities. However, a detailed characterization of the involved genes and proteins is lacking. In this study, we compared the expression of endothelial lipase (EL) and LPL in human term placenta. When placental protein extracts were separated by heparin...... protein associated with both cell types. In mouse placentas, lack of LPL expression resulted in increased EL mRNA expression. These results suggest that the cellular expression of EL and LPL in human placenta is different. Nevertheless, the two lipases might have overlapping functions in the mouse...... placenta. Our data also suggest that the major portions of both proteins are stored in an inactive form in human term placenta....

  12. Diagnosis of Placenta Accreta by Uterine Artery Doppler Velocimetry in Patients With Placenta Previa.

    Science.gov (United States)

    Cho, Hee Young; Hwang, Han Sung; Jung, Inkyung; Park, Yong Won; Kwon, Ja-Young; Kim, Young Han

    2015-09-01

    To evaluate the potential value of uterine artery Doppler velocimetry in diagnosing placenta accreta. Clinical records of all deliveries between April 1991 and March 2013 were retrospectively analyzed. Cases of intrauterine growth restriction, pregnancy-induced hypertension, multiple pregnancies, fetal anomalies, chromosomal abnormalities, and maternal medical illnesses such as cardiovascular disease, renal disease, and diabetes mellitus were excluded. A total of 11,210 cases were evaluated, including 403 cases of placenta previa without accreta (placenta previa) and 39 cases of placenta previa with accreta (placenta accreta). All patients underwent uterine artery Doppler velocimetry to measure the mean resistive index and pulsatility index (PI) in the third trimester. The analysis included participant characteristics such as age, parity, abortion history, previous cesarean delivery, gestational age at delivery, neonatal sex, and birth weight. The mean uterine artery PI was significantly lower in the placenta accreta group compared to previa alone (0.51 versus 0.57; P = .002). The odds ratios for placenta accreta were 2.4 for 2 or more previous abortions (P = .011) and 5.3 and 7.0 for 1 and 2 or more previous cesarean deliveries (P = .001 and .005). With an increase in the mean PI by 0.01, the odds ratio for placenta accreta decreased by 0.94 (P placenta accreta compared to those without accreta. The diagnostic accuracy of placenta accreta can be potentially improved if uterine artery Doppler values and the history of cesarean delivery are combined. © 2015 by the American Institute of Ultrasound in Medicine.

  13. Placenta percreta in primigravida, an unsuspected situation

    Directory of Open Access Journals (Sweden)

    Bhuvaneshwari Rajkumar

    2014-02-01

    Full Text Available Placenta percreta, the most severe form of placenta accreta, is a rare pregnancy disorder in which the placenta penetrates the uterine myometrium and serosa and can invade the surrounding organs. It is a potentially life-threatening condition with risk of severe maternal morbidity and mortality. Although recognized obstetric risk factors allow the identification of most cases during the prenatal period, diagnosis is occasionally made at the time of delivery. Both sonography and MRI have fairly good sensitivity for prenatal diagnosis of placenta accreta. Prenatal diagnosis allows management of these patients in specialized tertiary centers, where a multidisciplinary approach will improve the outcome. Even in undiagnosed cases discovered at the time of delivery involving a team of anesthesiologist, obstetrician, urologist, neonatologist, and blood bank officer is needed for successful management of these patients. In this report we present the case of a primigravida with no known risk factors who was diagnosed to have placenta percreta at the time of caesarean delivery. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 239-241

  14. Abdomen agudo y embarazo: placenta percreta

    Directory of Open Access Journals (Sweden)

    Horacio Massotto Chaves

    2001-10-01

    Full Text Available La ruptura uterina espontánea por placenta percreta, sin historia de trauma o infección, es una patología extremadamente rara y responsable de una alta morbimortalidad materna. El diagnóstico prenatal de placenta percreta es importante para evitar resultados catastróficos debido a este desorden obstétrico, y diversos procedimientos son utilizados para lograr esta meta. Se presenta un caso de placenta percreta, con búsqueda de expedientes clínicos por esta patología, en el Hospital Monseñor Sanabria, desde 1994 hasta 1999, y con revisión de la bibliografía.

  15. RUPTURA UTERINA ESPONTANEA POR PLACENTA PERCRETA

    OpenAIRE

    2003-01-01

    La rotura uterina en un útero sin cicatriz previa, y temprano en el tercer trimestre, es un evento raro. Se expone el caso clínico de una paciente que se presenta con abdomen agudo, cursando embarazo de aproximadamente 25 semanas, se realiza laparotomía exploradora encontrando hemoperitoneo, feto y placenta libres en la cavidad peritoneal y útero roto en el fondo invadido por la placenta, que compromete epiplón mayor. Se realiza histerectomía y se confirma el diagnóstico con biopsia

  16. Intraoperative aortic balloon occlusion in patients with placenta previa and/or placenta accreta: a retrospective study

    Directory of Open Access Journals (Sweden)

    Fangyuan Luo

    2017-04-01

    Conclusion: Intraoperative aortic balloon occlusion is a relatively safe method for treating placenta previa and/or placenta accreta during scheduled and emergency CS and might be helpful to prevent hysterectomy and embolization in women wishing to preserve fertility.

  17. Nitroglycerin for management of retained placenta.

    Science.gov (United States)

    Abdel-Aleem, Hany; Abdel-Aleem, Mahmoud A; Shaaban, Omar M

    2015-11-12

    Retained placenta affects 0.5% to 3% of women following delivery, with considerable morbidity if left untreated. Use of nitroglycerin (NTG), either alone or in combination with uterotonics, may be of value to minimise the need for manual removal of the placenta in theatre under anaesthesia. To evaluate the benefits and harms of NTG as a tocolytic, either alone or in addition to uterotonics, in the management of retained placenta. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (14 January 2015), reference lists of retrieved studies and contacted experts in the field. Any adequately randomised controlled trial (RCT) comparing the use of NTG, either alone or in combination with uterotonics, with no intervention or with other interventions in the management of retained placenta. All women having a vaginal delivery with a retained placenta, regardless of the management of the third stage of labour (expectant or active). We included all trials with haemodynamically stable women in whom the placenta was not delivered at least within 15 minutes after delivery of the baby. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included three randomised controlled trials (RCTs) with 175 women. The three published RCTs compared NTG alone versus placebo. The detachment status of retained placenta was unknown in all three RCTs. Collectively, among the three included trials, two were judged to be at low risk of bias and the third trial was judged to be at high risk of bias for two domains: incomplete outcome data and selective reporting. The three trials reported seven out of 23 of the review's pre-specified outcomes.The primary outcome "manual removal of the placenta" was reported in all three studies. No differences were seen between NTG and placebo for manual removal of the placenta (average risk ratio (RR) 0.83, 95% confidence interval (CI) 0.47 to 1.46; women = 175; I

  18. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta.

    Science.gov (United States)

    Matsuzaki, Satoko; Matsuzaki, Shinya; Ueda, Yutaka; Tanaka, Yusuke; Kakuda, Mamoru; Kanagawa, Takeshi; Kimura, Tadashi

    2015-04-01

    Objective Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta), the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM). Study Design Case report and review of the literature. Results A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

  19. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Satoko Matsuzaki

    2015-04-01

    Full Text Available Objective - Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta, the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM. Study Design - Case report and review of the literature. Results - A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion - Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

  20. Review: Placenta, evolution and lifelong health.

    Science.gov (United States)

    Lewis, R M; Cleal, J K; Hanson, M A

    2012-02-01

    The intrauterine environment has an important influence on lifelong health, and babies who grew poorly in the womb are more likely to develop chronic diseases in later life. Placental function is a major determinant of fetal growth and is therefore also a key influence on lifelong health. The capacity of the placenta to transport nutrients to the fetus and regulate fetal growth is determined by both maternal and fetal signals. The way in which the placenta responds to these signals will have been subject to evolutionary selective pressures. The responses selected are those which increase Darwinian fitness, i.e. reproductive success. This review asks whether in addition to responding to short-term signals, such as a rise in maternal nutrient levels, the placenta also responds to longer-term signals representing the mother's phenotype as a measure of environmental influences across her life course. Understanding how the placenta responds to maternal signals is therefore not only important for promoting optimal fetal growth but can also give insights into how human evolution affected developmental history with long-term effects on health and disease.

  1. Modeling Oxygen Transport in the Human Placenta

    Science.gov (United States)

    Serov, Alexander; Filoche, Marcel; Salafia, Carolyn; Grebenkov, Denis

    Efficient functioning of the human placenta is crucial for the favorable pregnancy outcome. We construct a 3D model of oxygen transport in the placenta based on its histological cross-sections. The model accounts for both diffusion and convention of oxygen in the intervillous space and allows one to estimate oxygen uptake of a placentone. We demonstrate the existence of an optimal villi density maximizing the uptake and explain it as a trade-off between the incoming oxygen flow and the absorbing villous surface. Calculations performed for arbitrary shapes of fetal villi show that only two geometrical characteristics - villi density and the effective villi radius - are required to predict fetal oxygen uptake. Two combinations of physiological parameters that determine oxygen uptake are also identified: maximal oxygen inflow of a placentone and the Damköhler number. An automatic image analysis method is developed and applied to 22 healthy placental cross-sections demonstrating that villi density of a healthy human placenta lies within 10% of the optimal value, while overall geometry efficiency is rather low (around 30-40%). In a perspective, the model can constitute the base of a reliable tool of post partum oxygen exchange efficiency assessment in the human placenta. Also affiliated with Department of Chemistry and Biochemistry, UCLA, Los Angeles, CA 90095, USA.

  2. THE PLACENTA INFECTED BY HIV AND HPV

    Directory of Open Access Journals (Sweden)

    Castejón Sandoval OC

    2013-09-01

    Full Text Available Background: The connection HIV/HPV reaches the placenta through the maternal-fetal transmission from an infected uterus. In this connection HPV has epitheliotropic and cytolytic capabilities which can cause severe alterations to the structure of the placental villi associating with the activity of antivirals that can increase the proportion of these lesions. Objective: To evaluate morphological changes in placental villi of patient with coinfection HIV/HPV. Material and Method: Placenta obtained of patient with low socioeconomic resources and coinfection HIV/HPV at 38 weeks of pregnancy, without another signs of disease, live newborn, which was analized by Light microscopy. Normal placenta was used as control. A protocol of observation that described syncytial nodules,fibrinoid, edema, fibrosis, calcification and immaturity was used. Results: Stem villi appeared with vascular damage to the level of endothelium, muscular layer and tissue that surround to the vessels. Severe degenerative changes in the syncytium and stromal region were observed in different types of villi. Arborization of villi was scarcity. Fibrosis, deposition of fibrinoid and infarcts are notorious. Immature intermediate villi were seen abundant and degenerate. Conclusions: An unknown interaction of HIV/HPV has provoked on the structure of placental villi an effect higher compared when the viral activity of each one virus is produced individually. This viral attack leads to a destructive effect very strong on the placenta.

  3. Placenta previa and maternal hemorrhagic morbidity.

    Science.gov (United States)

    Gibbins, Karen J; Einerson, Brett D; Varner, Michael W; Silver, Robert M

    2017-02-21

    Placenta previa is associated with maternal hemorrhage, but most literature focuses on morbidity in the setting of placenta accreta. We aim to characterize maternal morbidity associated with previa and to define risk factors for hemorrhage. This is a secondary cohort analysis of the NICHD Maternal-Fetal Medicine Units Network Cesarean Section Registry. This analysis included all women undergoing primary Cesarean delivery without placenta accreta. About 496 women with previa were compared with 24,201 women without previa. Primary outcome was composite maternal hemorrhagic morbidity. Non-hemorrhagic morbidities and risk factors for hemorrhage were also evaluated. Maternal hemorrhagic morbidity was more common in women with previa (19 versus 7%, aRR 2.6, 95% CI 1.9-3.5). Atony requiring uterotonics (aRR 3.1, 95% CI 2.0-4.9), red blood cell transfusion (aRR 3.8, 95% CI 2.5-5.7), and hysterectomy (aRR 5.1, 95% CI 1.5-17.3) were also more common with previa. For women with previa, factors associated with maternal hemorrhage were pre-delivery anemia, thrombocytopenia, diabetes, magnesium use, and general anesthesia. Placenta previa is an independent risk factor for maternal hemorrhagic morbidity. Some risk factors are modifiable, but many are intrinsic to the clinical scenario.

  4. PLACENTA PREVIA PERCRETA CON INVASION VESICAL

    OpenAIRE

    Perucca,Ernesto; Cazenave,Henry; Barra,Alejandro; Ochoa,Nelson; Villagrán,Gabriel; Espinoza,Rosemary; Estay,Ricardo; Bustamante,Rodrigo; Siebert,Alejandra

    2002-01-01

    Se presentan 3 nuevos casos de placenta percreta con invasión a vejiga ocurridos en nuestro Servicio. Uno de ellos fue diagnosticado durante el embarazo, los otros dos casos fueron hallazgos intraoperatorios. La evolución clínica de las tres pacientes fue satisfactoria

  5. Evolution of the Placenta in Eutherian Mammals

    DEFF Research Database (Denmark)

    Carter, Anthony Michael; Mess, A

    2007-01-01

    of eutherian mammals had an endotheliochorial placenta or a haemochorial one. Research has been stimulated by improved understanding of the relations between the orders of mammals provided by molecular phylogenetics. In part, the uncertainties arise from doubt about how to root the mammalian tree. Resolution...

  6. Central placenta previa with placenta percreta partially invading bladder: a case report

    Directory of Open Access Journals (Sweden)

    Hasina Banu

    2015-06-01

    Full Text Available Placenta previa, placenta accreta, increta and percreta are increasing day by day due to increased number of cesarean sections now days, but central placenta previa with placenta percreta invading bladder is a very rare obstetrical complication. A case of central placenta previa with placenta percreta partially invading bladder in woman who was G2P1L1 with 32+6 weeks of gestation and with history of previous cesarean section is presented in this manuscript. The patient was managed with intrapartum cesarean hysterectomy with bilateral ureter J stents and bladder repair following cesarean delivery of a preterm baby. Total estimated blood loss was 6000 mL. The patient was discharged on 28th December 2014 that is 29th day of admission with a healthy baby. The aim of this study is to bring awareness of such case and to discuss the risk factor, presentation, diagnosis, management and choice of anesthesia for the same. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 859-862

  7. Stereological Analysis of Human Placenta in Cases of Placenta Previa in Comparison with Normally Implanted Controls

    Science.gov (United States)

    Heidari, Zahra; Sakhavar, Nahid; Mahmoudzadeh-Sagheb, Hamidreza; Ezazi-Bojnourdi, Tahmine

    2015-01-01

    Background Placenta previa (PP) is an obstetric complication that can affect maternal and fetal morbidity and mortality. Its prevalence is rising due to cesarean sections. There is no quantitative data of placenta in PP. In this study, quantitative parameters of placenta in cases with PP in comparison with normally implanted controls were investigated. Methods In this quasi experimental study, placentas from pregnancies with PP and normally implanted controls (n = 10) were obtained from women who underwent cesarean section. Three full-thickness columns of each placenta were sampled using systematic uniform random sampling (SURS). Columns were cut into slices and slices were sectioned with 4 µm thickness. SURS selected sections were stained by Masson's trichrome. Stereological analysis was done on 8-10 SURS microscopic fields of each section. Absolute volume and volume density of chorionic villi, intervillous space, syncytiotrophoblast, fibrin and blood vessels in chorionic villi were estimated in both groups. Statistical analysis was done using Mann Whitney-U test and significant level was set at p placenta. These changes probably can be influential on the evolution and survival of fetus. PMID:25927025

  8. Review: Toward an integrated evolutionary understanding of the mammalian placenta.

    Science.gov (United States)

    Wildman, D E

    2011-03-01

    The placenta is fundamentally important for the success of pregnancy. Disruptions outside the normal range for placental function can result in pregnancy failure and other complications. The anatomy of the placenta varies greatly across mammals, as do key parameters in pregnancy such as neonatal body mass, length of gestation and number of offspring per pregnancy. An accurate understanding of the evolution of the mammalian placenta will require at minimum the integration of anatomical, developmental, physiological, genetic, and epigenetic data. Currently available data suggest that the placenta is a dynamic organ that has evolved rapidly in a lineage specific manner. Examination of the placenta from the perspective of human evolution shows that many anatomical features of the human placenta are relatively conserved. Despite the anatomical conservation of the human placenta there are many recently evolved placenta-specific genes (e.g. CGB, LGALS13, GH2) that are important in the development and function of the human placenta. Other mammalian genomes have also evolved specific suites of placenta-expressed genes. For example, rodents have undergone expansions of the cathepsin and prolactin families, and artiodactyls have expanded their suite of pregnancy-associated glycoproteins. In addition to lineage specific birth and death of gene family members, the pattern of imprinted loci varies greatly among species. Taken together, these studies suggest that a strategy reliant upon the sampling of placentally expressed and imprinted genes from a phylogenetically diverse range of species is appropriate for unraveling the conserved and derived aspects of placental biology.

  9. Coagulation and Placenta-Mediated Complications

    Directory of Open Access Journals (Sweden)

    Anat Aharon

    2014-10-01

    Full Text Available Pregnancy is a physiological hypercoagulable state, preparing the mother for the hemostatic challenge of delivery. However, this is associated with an increased risk of venous thrombosis and placenta-mediated complications, which present major challenges for mother and fetus. Although these conditions are heterogeneous in their pathophysiology, hereditary and acquired thrombophilia has been associated with recurrent pregnancy loss and gestational vascular complications, such as early-onset pre-eclampsia and placental abruption. Prevention of such placenta-mediated complications, which collectively complicate up to 15% of pregnancies, is a major issue for women’s health. Prospective interventional studies stratified by current knowledge of pathophysiological mechanisms related to placental and systemic hemostatic alterations will impact on the management of pregnancies at risk of these complications.

  10. Placenta Percreta Presenting with Delayed Haematuria.

    Science.gov (United States)

    Wagaskar, Vinayak Gorakhanath; Daga, Sudarshan Omprakash; Patwardhan, Sujata Kiran

    2015-12-01

    Placenta percreta presents as life threatening complications with bladder invasion. A condition of placenta invading urinary bladder presented with differential diagnosis of gestational trophoblastic neoplasia on imaging and responded to chemotherapy. A 35-year-old primi-gravida presented at term with per vaginal bleeding. During caesarian section placental mass totally invading uterine myometrium was found. She was given single dose of Methotrexate. After 2 months she presented with gross haematuria with clot retention two times. Her MRI was suggestive of gestational trophoblastic neoplasia of size 19 X 10 X 13cm. Her beta-Human Chorionic Gonadotropin levels were 691.23 mIU/ml. She was given total four doses of methotrexate. At present size of mass was 1.6 X1.3X 1.1cm. Her beta Human Chorionic Gonadotropin level dropped down to 2mIU/ml. Patient was not willing for further intervention or for follow up.

  11. Metalloprotease Dependent Release of Placenta Derived Fractalkine

    OpenAIRE

    Monika Siwetz; Astrid Blaschitz; Julia Kremshofer; Jelena Bilic; Gernot Desoye; Berthold Huppertz; Martin Gauster

    2014-01-01

    The chemokine fractalkine is considered as unique since it exists both as membrane-bound adhesion molecule and as shed soluble chemoattractant. Here the hypothesis was tested whether placental fractalkine can be shed and released into the maternal circulation. Immunohistochemical staining of human first trimester and term placenta sections localized fractalkine at the apical microvillous plasma membrane of the syncytiotrophoblast. Gene expression analysis revealed abundant upregulation in pla...

  12. Impact of placenta praevia on obstetric outcome

    Directory of Open Access Journals (Sweden)

    Neelam Meena

    2015-02-01

    Conclusions: It was concluded that increased maternal age and parity, history of previous caesarean section are identified risk factors which are same as reported in western literature. Sonographic determination of the placental position where its location be-Neath the uterine incision is very important to predict maternal outcomes in placenta praevia patients, and such cases, close attention should be paid for massive haemorrhage. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 76-80

  13. Natural killer cells and HLA-G expression in the basal decidua of human placenta adhesiva.

    NARCIS (Netherlands)

    Beekhuizen, H.J. van; Joosten, I.; Lotgering, F.K.; Bulten, J.; Kempen, L.C.L.T. van

    2010-01-01

    Retained placenta is caused by abnormal adherence of the placenta to the uterine wall, leading to delayed expulsion of the placenta and causing postpartum haemorrhage. The mildest form of retained placenta is the placenta adhesiva (PA), of which the cause is unknown. The aim of our study was to expl

  14. Magnetic resonance imaging of the normal placenta.

    Science.gov (United States)

    Blaicher, Wibke; Brugger, Peter C; Mittermayer, Christoph; Schwindt, Jens; Deutinger, Josef; Bernaschek, Gerhard; Prayer, Daniela

    2006-02-01

    The goal of this study was to provide a representative description of the normal placenta with contrast medium-free magnetic resonance imaging (MRI) in order to determine a standard of reference. One hundred consecutive singleton pregnancies were investigated by MRI without application of a contrast medium. The mean gestational age (GA) at the time of investigation was 29.5 weeks (range 19-40). Patients with suspected utero-placental insufficiency (UPI) or placental anomalies were excluded. Signal intensities were assessed and correlated with the respective GA. Antenatal MRI without contrast medium was able to depict placental status and morphological changes during gestation. A regular homogeneous structure was found in weeks 19-23. Subsequently, sporadic, slightly marked lobules appeared, which increased in number and markedness with ongoing gestation. Stratification of the lobules was observed after 36 weeks. The ratio of placental and amniotic fluid signal intensities decreased significantly with higher GA and with placental grading. MRI is well suited as an imaging method for the placenta. Our data may be used as a reference in the assessment of the placenta on MRI, and may have further clinical impact with respect to the determination of UPI.

  15. Magnetic resonance imaging of the normal placenta

    Energy Technology Data Exchange (ETDEWEB)

    Blaicher, Wibke [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria)]. E-mail: wibke.blaicher@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, University Hospital of Vienna (Austria); Mittermayer, Christoph [Department of Pediatrics, Division of Neonatology and Intensive Care, University Hospital of Vienna (Austria); Schwindt, Jens [Department of Pediatrics, Division of Neonatology and Intensive Care, University Hospital of Vienna (Austria); Deutinger, Josef [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria); Bernaschek, Gerhard [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria); Prayer, Daniela [Department of Radiology, Division of Neuroradiology, University Hospital of Vienna (Austria)

    2006-02-15

    The goal of this study was to provide a representative description of the normal placenta with contrast medium-free magnetic resonance imaging (MRI) in order to determine a standard of reference. One hundred consecutive singleton pregnancies were investigated by MRI without application of a contrast medium. The mean gestational age (GA) at the time of investigation was 29.5 weeks (range 19-40). Patients with suspected utero-placental insufficiency (UPI) or placental anomalies were excluded. Signal intensities were assessed and correlated with the respective GA. Antenatal MRI without contrast medium was able to depict placental status and morphological changes during gestation. A regular homogeneous structure was found in weeks 19-23. Subsequently, sporadic, slightly marked lobules appeared, which increased in number and markedness with ongoing gestation. Stratification of the lobules was observed after 36 weeks. The ratio of placental and amniotic fluid signal intensities decreased significantly with higher GA and with placental grading. MRI is well suited as an imaging method for the placenta. Our data may be used as a reference in the assessment of the placenta on MRI, and may have further clinical impact with respect to the determination of UPI.

  16. Automated vasculature extraction from placenta images

    Science.gov (United States)

    Almoussa, Nizar; Dutra, Brittany; Lampe, Bryce; Getreuer, Pascal; Wittman, Todd; Salafia, Carolyn; Vese, Luminita

    2011-03-01

    Recent research in perinatal pathology argues that analyzing properties of the placenta may reveal important information on how certain diseases progress. One important property is the structure of the placental blood vessels, which supply a fetus with all of its oxygen and nutrition. An essential step in the analysis of the vascular network pattern is the extraction of the blood vessels, which has only been done manually through a costly and time-consuming process. There is no existing method to automatically detect placental blood vessels; in addition, the large variation in the shape, color, and texture of the placenta makes it difficult to apply standard edge-detection algorithms. We describe a method to automatically detect and extract blood vessels from a given image by using image processing techniques and neural networks. We evaluate several local features for every pixel, in addition to a novel modification to an existing road detector. Pixels belonging to blood vessel regions have recognizable responses; hence, we use an artificial neural network to identify the pattern of blood vessels. A set of images where blood vessels are manually highlighted is used to train the network. We then apply the neural network to recognize blood vessels in new images. The network is effective in capturing the most prominent vascular structures of the placenta.

  17. Metalloprotease Dependent Release of Placenta Derived Fractalkine

    Directory of Open Access Journals (Sweden)

    Monika Siwetz

    2014-01-01

    Full Text Available The chemokine fractalkine is considered as unique since it exists both as membrane-bound adhesion molecule and as shed soluble chemoattractant. Here the hypothesis was tested whether placental fractalkine can be shed and released into the maternal circulation. Immunohistochemical staining of human first trimester and term placenta sections localized fractalkine at the apical microvillous plasma membrane of the syncytiotrophoblast. Gene expression analysis revealed abundant upregulation in placental fractalkine at term, compared to first trimester. Fractalkine expression and release were detected in the trophoblast cell line BeWo, in primary term trophoblasts and placental explants. Incubation of BeWo cells and placental explants with metalloprotease inhibitor Batimastat inhibited the release of soluble fractalkine and at the same time increased the membrane-bound form. These results demonstrate that human placenta is a source for fractalkine, which is expressed in the syncytiotrophoblast and can be released into the maternal circulation by constitutive metalloprotease dependent shedding. Increased expression and release of placental fractalkine may contribute to low grade systemic inflammatory responses in third trimester of normal pregnancy. Aberrant placental metalloprotease activity may not only affect the release of placenta derived fractalkine but may at the same time affect the abundance of the membrane-bound form of the chemokine.

  18. Fibulin-5 expression in the human placenta.

    Science.gov (United States)

    Gauster, Martin; Berghold, Veronika M; Moser, Gerit; Orendi, Kristina; Siwetz, Monika; Huppertz, Berthold

    2011-02-01

    Fibulin-5 is a secreted extracellular matrix glycoprotein and displays a diverse panel of biological functions, which can be segregated into elastogenic as well as extra-elastogenic functions. While elastogenic functions of fibulin-5 include essential roles in early steps of elastic fibre assembly, extra-elastogenic functions are widespread. Depending on the cell type used, fibulin-5 mediates cell adherence via a subset of integrins, antagonizes angiogenesis and inhibits migration as well as proliferation of endothelial and smooth muscle cells. In this study, we focused on the spatiotemporal expression of fibulin-5 in the human placenta. With progressing gestation, placental fibulin-5 expression increased from first trimester towards term. At term, placental fibulin-5 mRNA expression is lower when compared with other well-vascularized organs such as lung, kidney, heart, uterus and testis. In first trimester, placenta immunohistochemistry localized fibulin-5 in villous cytotrophoblasts and extravillous cytotrophoblasts of the proximal cell column. In term placenta, fibulin-5 was detected in the endothelial basement membrane and adventitia-like regions of vessels in the chorionic plate and stem villi. Cell culture experiments with the villous trophoblast-derived cell line BeWo showed that fibulin-5 expression was downregulated during functional differentiation and intercellular fusion. Moreover, cultivation of BeWo cells under low oxygen conditions impaired intercellular fusion and upregulated fibulin-5 expression. The spatiotemporal shift from the trophoblast compartment in first trimester to the villous vasculature at term suggests a dual role of fibulin-5 in human placental development.

  19. The placenta: a multifaceted, transient organ.

    Science.gov (United States)

    Burton, Graham J; Fowden, Abigail L

    2015-03-01

    The placenta is arguably the most important organ of the body, but paradoxically the most poorly understood. During its transient existence, it performs actions that are later taken on by diverse separate organs, including the lungs, liver, gut, kidneys and endocrine glands. Its principal function is to supply the fetus, and in particular, the fetal brain, with oxygen and nutrients. The placenta is structurally adapted to achieve this, possessing a large surface area for exchange and a thin interhaemal membrane separating the maternal and fetal circulations. In addition, it adopts other strategies that are key to facilitating transfer, including remodelling of the maternal uterine arteries that supply the placenta to ensure optimal perfusion. Furthermore, placental hormones have profound effects on maternal metabolism, initially building up her energy reserves and then releasing these to support fetal growth in later pregnancy and lactation post-natally. Bipedalism has posed unique haemodynamic challenges to the placental circulation, as pressure applied to the vena cava by the pregnant uterus may compromise venous return to the heart. These challenges, along with the immune interactions involved in maternal arterial remodelling, may explain complications of pregnancy that are almost unique to the human, including pre-eclampsia. Such complications may represent a trade-off against the provision for a large fetal brain.

  20. Paternally expressed genes predominate in the placenta.

    Science.gov (United States)

    Wang, Xu; Miller, Donald C; Harman, Rebecca; Antczak, Douglas F; Clark, Andrew G

    2013-06-25

    The discovery of genomic imprinting through studies of manipulated mouse embryos indicated that the paternal genome has a major influence on placental development. However, previous research has not demonstrated paternal bias in imprinted genes. We applied RNA sequencing to trophoblast tissue from reciprocal hybrids of horse and donkey, where genotypic differences allowed parent-of-origin identification of most expressed genes. Using this approach, we identified a core group of 15 ancient imprinted genes, of which 10 were paternally expressed. An additional 78 candidate imprinted genes identified by RNA sequencing also showed paternal bias. Pyrosequencing was used to confirm the imprinting status of six of the genes, including the insulin receptor (INSR), which may play a role in growth regulation with its reciprocally imprinted ligand, histone acetyltransferase-1 (HAT1), a gene involved in chromatin modification, and lymphocyte antigen 6 complex, locus G6C, a newly identified imprinted gene in the major histocompatibility complex. The 78 candidate imprinted genes displayed parent-of-origin expression bias in placenta but not fetus, and most showed less than 100% silencing of the imprinted allele. Some displayed variability in imprinting status among individuals. This variability results in a unique epigenetic signature for each placenta that contributes to variation in the intrauterine environment and thus presents the opportunity for natural selection to operate on parent-of-origin differential regulation. Taken together, these features highlight the plasticity of imprinting in mammals and the central importance of the placenta as a target tissue for genomic imprinting.

  1. Risk Factors of Neonatal Anemia in Placenta Previa

    Directory of Open Access Journals (Sweden)

    Dong Gyu Jang, Yun Sung Jo, Sung Jong Lee, Gui Se Ra Lee

    2011-01-01

    Full Text Available Objectives: Placenta previa is a major cause of neonatal anemia. The purpose of this study was to elucidate the risk factors of neonatal anemia in placenta previa.Methods: The study was conducted on 158 placenta previa patients at 3 hospitals in affiliation with the Catholic Medical Center, Seoul, Korea from May 1999 through December 2009. The subjects were divided in to 2 groups: 47 placenta previa patients with neonatal anemia, and 113 placenta previa patients without neonatal anemia. The subjects' characteristics were compared. Logistic regression was used to control for confounding factors.Results: Anterior placental location (OR 2.48; 95% CI: 1.20-5.11 was an independent risk factor of neonatal anemia after controlling for potential confounders.Conclusion: To manage neonatal anemia in placenta previa patients, obstetricians should do their best to detect placental location. Pediatricians should consider the high possibility of neonatal anemia in cases involving anterior placental location.

  2. Human placenta secretes apolipoprotein B-100-containing lipoproteins

    DEFF Research Database (Denmark)

    Munk-Madsen, Eva; Lindegaard, Marie Louise Skakkebæk; Andersen, Claus B;

    2004-01-01

    early during pregnancy in the placenta. To examine whether the human placenta produces lipoproteins, we examined apoB and microsomal triglyceride transfer protein (MTP) mRNA expression in placental biopsies. ApoB and MTP are mandatory for assembly and secretion of apoB-containing lipoproteins. Both...... genes were expressed in placenta and microsomal extracts from human placenta contained triglyceride transfer activity, indicating expression of bioactive MTP. To detect lipoprotein secretion, biopsies from term placentas were placed in medium with [(35)S]methionine and [(35)S]cysteine for 3-24 h. Upon...... lipoproteins secreted from placental tissue showed spherical particles with a diameter of 47 +/- 10 nm. These results demonstrate that human placenta expresses both apoB and MTP and consequently synthesize and secrete apoB-100-containing lipoproteins. Placental lipoprotein formation constitutes a novel pathway...

  3. Risk Factors of Neonatal Anemia in Placenta Previa

    Science.gov (United States)

    Jang, Dong Gyu; Jo, Yun Sung; Lee, Sung Jong; Lee, Gui Se Ra

    2011-01-01

    Objectives: Placenta previa is a major cause of neonatal anemia. The purpose of this study was to elucidate the risk factors of neonatal anemia in placenta previa. Methods: The study was conducted on 158 placenta previa patients at 3 hospitals in affiliation with the Catholic Medical Center, Seoul, Korea from May 1999 through December 2009. The subjects were divided in to 2 groups: 47 placenta previa patients with neonatal anemia, and 113 placenta previa patients without neonatal anemia. The subjects' characteristics were compared. Logistic regression was used to control for confounding factors. Results: Anterior placental location (OR 2.48; 95% CI: 1.20-5.11) was an independent risk factor of neonatal anemia after controlling for potential confounders. Conclusion: To manage neonatal anemia in placenta previa patients, obstetricians should do their best to detect placental location. Pediatricians should consider the high possibility of neonatal anemia in cases involving anterior placental location. PMID:21960747

  4. Risk factors of neonatal anemia in placenta previa.

    Science.gov (United States)

    Jang, Dong Gyu; Jo, Yun Sung; Lee, Sung Jong; Lee, Gui Se Ra

    2011-01-01

    Placenta previa is a major cause of neonatal anemia. The purpose of this study was to elucidate the risk factors of neonatal anemia in placenta previa. The study was conducted on 158 placenta previa patients at 3 hospitals in affiliation with the Catholic Medical Center, Seoul, Korea from May 1999 through December 2009. The subjects were divided in to 2 groups: 47 placenta previa patients with neonatal anemia, and 113 placenta previa patients without neonatal anemia. The subjects' characteristics were compared. Logistic regression was used to control for confounding factors. Anterior placental location (OR 2.48; 95% CI: 1.20-5.11) was an independent risk factor of neonatal anemia after controlling for potential confounders. To manage neonatal anemia in placenta previa patients, obstetricians should do their best to detect placental location. Pediatricians should consider the high possibility of neonatal anemia in cases involving anterior placental location.

  5. Autophagy in the human placenta throughout gestation.

    Directory of Open Access Journals (Sweden)

    Tai-Ho Hung

    Full Text Available BACKGROUND: Autophagy has been reported to be essential for pre-implantation development and embryo survival. However, its role in placental development and regulation of autophagy during pregnancy remain unclear. The aims of this study were to (1 study autophagy by characterizing changes in levels of beclin-1, DRAM, and LC3B in human placenta throughout gestation; (2 determine whether autophagy is involved in regulation of trophoblast invasion in JEG-3 cells (a choriocarcinoma cell line; (3 examine the effects of reduced oxygen and glucose on the autophagic changes; and (4 investigate the effect of reoxygenation and supplementation of glucose after oxygen-glucose deprivation (OGD on the autophagic changes in primary cytotrophoblasts obtained from normal term pregnancy. METHODOLOGY/PRINCIPAL FINDINGS: An analysis of 40 placental samples representing different gestational stages showed (1 no significant differences in beclin-1, DRAM, and LC3B-II levels in placentas between early and mid-gestation, and late gestation with vaginal delivery; (2 placentas from late gestation with cesarean section had lower levels of LC3B-II compared to early and mid-gestation, and late gestation with vaginal delivery; levels of DRAM were also lower compared to placentas from early and mid-gestation; and (3 using explant cultures, villous tissues from early and late gestation had similar rates of autophagic flux under physiological oxygen concentrations. Knockdown of BECN1, DRAM, and LC3B had no effects on viability and invasion activity of JEG-3 cells. On the other hand, OGD caused a significant increase in the levels of LC3B-II in primary cytotrophoblasts, while re-supplementation of oxygen and glucose reduced these changes. Furthermore, there were differential changes in levels of beclin-1, DRAM, and LC3B-II in response to changes in oxygen and glucose levels. CONCLUSIONS/SIGNIFICANCE: Our results indicate that autophagy is involved in development of the human

  6. Abnormal placentation: evidence-based diagnosis and management of placenta previa, placenta accreta, and vasa previa.

    Science.gov (United States)

    Rao, Kiran Prabhaker; Belogolovkin, Victoria; Yankowitz, Jerome; Spinnato, Joseph A

    2012-08-01

    Placenta previa, placenta accreta, and vasa previa cause significant maternal and perinatal morbidity and mortality. With the increasing incidence of both cesarean delivery and pregnancies using assisted reproductive technology, these 3 conditions are becoming more common. Advances in grayscale and Doppler ultrasound have facilitated prenatal diagnosis of abnormal placentation to allow the development of multidisciplinary management plans to achieve the best outcomes for mother and baby. We present a comprehensive review of the literature on abnormal placentation including an evidence-based approach to diagnosis and management.

  7. Pathological And Clinical Evaluation of Hypertensive Pregnants and Their Placentas

    Directory of Open Access Journals (Sweden)

    Havva Erdem

    2015-10-01

    Full Text Available Aim: To investigate the effects of hypertension on the placenta and fetus in pregnancy. Method: 25 hypertensive pregnants, 114 control women, and their infants were included in the study. Results: There was significant correlation between to the body mass index, weight before pregnancy, gestational week, hematocrit, birth weight, placenta size and weight between two groups (p=.002, .003, .003, .004, .000, .050, .032, respectively. The age, gravida, parity, abortus, living child, height, weight gain in pregnancy, hemoglobin, placenta diameter and thickness, volume of clot were similar between groups. Conclusion: As a result, hypertension in pregnancy affects the development of the fetus and placenta as well.

  8. Effect of placenta previa on fetal growth restriction and stillbirth.

    Science.gov (United States)

    Yeniel, A Ozgur; Ergenoglu, A Mete; Itil, Ismail Mete; Askar, Niyazi; Meseri, Reci

    2012-08-01

    To examine the association between placenta previa and adverse perinatal outcomes such as low birth weight, preterm delivery, stillbirth and fetal growth restriction (FGR). This retrospective cohort study includes 12,034 delivered pregnant women who were recruited for the study between 2004 and 2010 in Ege University Hospital. Data were collected by browsing the clinic's archives. The association between placenta previa and adverse perinatal outcomes was determined via Chi-square tests and Student's t test. Logistic regression analysis was used to adjust for confounding factors in evaluating the association between placenta previa and the adverse perinatal outcomes. There was no significant relationship between placenta previa and FGR or stillbirth. Low birth weight and preterm delivery were significantly higher in the placenta previa group. According to logistic regression analysis, low birth weight was associated with an OR of 3.01 (95 % CI 2.05-4.52) and preterm delivery was associated with an OR of 8.14 (95 % CI 5.60-11.83); while, placenta previa did not affect FGR and stillbirth significantly. Although there is no consensus on the association between placenta previa and FGR in previous studies, we suggest that placenta previa is not a reason for placental insufficiency. Management of placenta previa especially depends on maternal hemodynamic parameters such as heavy hemorrhage and hypotensive shock rather than fetal well-being protocols based on serial growth ultrasound and fetal Doppler investigation.

  9. Conservative management of placenta previa complicated by abnormal placentation.

    Science.gov (United States)

    Bręborowicz, Grzegorz H; Markwitz, Wiesław; Gaca, Michał; Koziołek, Agnieszka; Ropacka-Lesiak, Mariola; Dera, Anna; Brych, Mariusz; Szymankiewicz-Bręborowicz, Marta; Kruszyński, Grzegorz; Gruca-Stryjak, Karolina; Madejczyk, Mateusz; Szpera-Goździewicz, Agata; Krzyścin, Mariola

    2013-07-01

    Abnormal implantation of placenta previa is life-threatening condition. The purpose of this study was to evaluate the impact of the conservative management of pregnancies with such complication on maternal morbidity rate and the chance for uterine preservation (fertility). Eleven patients with abnormal implantation of placenta previa were analyzed prospectively. This complication was diagnosed antenatally by two-dimensional ultrasound and color flow Doppler. The following outcomes were analyzed: need for blood transfusion, admission and duration of stay in intensive care unit, infections, coagulopathies, time between cesarean section and delivery of placenta, hysterectomy and preservation of uterus. Among the 20 085 women who had a singleton gestation, 11 (0.054%) were identified with placenta previa with abnormal placentation. In five patients (group A), hysterectomy was performed because of hemorrhage or placenta ablation. In six patients (group B), conservative management succeeded and placenta were preserved. In group A, placenta were delivered earlier (2 d-8 weeks) in comparison with group B (6-15 weeks). Estimated blood loss during the delayed delivery of placenta was higher in the group with hysterectomy (respectively, 450-1600 and 300-500 ml). Conservative management of placenta previa with abnormal implantation decreases the risk of severe hemorrhage at the time of delivery and can preserve fertility.

  10. The placenta in toxicology. Part III : Pathologic assessment of the placenta

    NARCIS (Netherlands)

    Cline, J Mark; Dixon, Darlene; Ernerudh, Jan; Faas, Marijke M; Göhner, Claudia; Häger, Jan-Dirk; Markert, Udo R; Pfarrer, Christiane; Svensson-Arvelund, Judit; Buse, Eberhard

    2014-01-01

    This short review is derived from the peer-reviewed literature and the experience and case materials of the authors. Brief illustrated summaries are presented on the gross and histologic normal anatomy of rodent and macaque placentas, including typical organ weights, with comments on differences fro

  11. Placenta changes in pregnancy with gestational diabetes.

    Science.gov (United States)

    Edu, Antoine; Teodorescu, Cristina; Dobjanschi, Carmen Gabriela; Socol, ZiŢa Zsuzsana; Teodorescu, Valeriu; Matei, Alexandru; Albu, Dinu Florin; Radulian, Gabriela

    2016-01-01

    Placental damage may be responsible for the fetal complications in pregnancies complicated by diabetes. We have analyzed the prevalence of gestational diabetes (GD) in a population of 109 pregnant women, the risk factors and the placental changes associated with gestational diabetes. Tests carried out were oral glucose tolerance test at 24-28 weeks of gestation, using the IADPSG (International Association of Diabetes and Pregnancy Study Groups) criteria for gestational diabetes, glycated hemoglobin, fasting insulin, total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, triglycerides, two-dimensional (2D) ultrasound and, also, there were analyzed macro and microscopic placental fragments from pregnant women with÷without GD. It has been recorded the weight of placenta at birth and there were analyzed the possible pathological changes. The prevalence of GD was 11.9%. We have applied the direct logistic regression to determine the impact of some factors over the probability of association with gestational diabetes. The most powerful predictor was the placental maturity grade, the patients with decreased maturity grade having chances 52.6 times higher than those with an increased placental maturity grade to associate gestational diabetes. Sizes of placentas in patients with gestational diabetes mellitus were significantly increased than in patients without this diagnosis (p=0.012) from week 24-28. Pathological changes were discovered in six of the 13 placentas of women with gestational diabetes mellitus, independent of the level of glycated hemoglobin (p=0.72). The level of hyperglycemia is only partially associated with the presence of placental changes, which may be caused by other maternal factors.

  12. Placenta-on-a-chip: a novel platform to study the biology of the human placenta.

    Science.gov (United States)

    Lee, Ji Soo; Romero, Roberto; Han, Yu Mi; Kim, Hee Chan; Kim, Chong Jai; Hong, Joon-Seok; Huh, Dongeun

    2016-01-01

    Studying the biology of the human placenta represents a major experimental challenge. Although conventional cell culture techniques have been used to study different types of placenta-derived cells, current in vitro models have limitations in recapitulating organ-specific structure and key physiological functions of the placenta. Here we demonstrate that it is possible to leverage microfluidic and microfabrication technologies to develop a microengineered biomimetic model that replicates the architecture and function of the placenta. A "Placenta-on-a-Chip" microdevice was created by using a set of soft elastomer-based microfabrication techniques known as soft lithography. This microsystem consisted of two polydimethylsiloxane (PDMS) microfluidic channels separated by a thin extracellular matrix (ECM) membrane. To reproduce the placental barrier in this model, human trophoblasts (JEG-3) and human umbilical vein endothelial cells (HUVECs) were seeded onto the opposite sides of the ECM membrane and cultured under dynamic flow conditions to form confluent epithelial and endothelial layers in close apposition. We tested the physiological function of the microengineered placental barrier by measuring glucose transport across the trophoblast-endothelial interface over time. The permeability of the barrier study was analyzed and compared to that obtained from acellular devices and additional control groups that contained epithelial or endothelial layers alone. Our microfluidic cell culture system provided a tightly controlled fluidic environment conducive to the proliferation and maintenance of JEG-3 trophoblasts and HUVECs on the ECM scaffold. Prolonged culture in this model produced confluent cellular monolayers on the intervening membrane that together formed the placental barrier. This in vivo-like microarchitecture was also critical for creating a physiologically relevant effective barrier to glucose transport. Quantitative investigation of barrier function was

  13. Circadian Kisspeptin expression in human term placenta.

    Science.gov (United States)

    de Pedro, M A; Morán, J; Díaz, I; Murias, L; Fernández-Plaza, C; González, C; Díaz, E

    2015-11-01

    Kisspeptin is an essential gatekeeper of reproductive function. During pregnancy high circulating levels of kisspeptin have been described, however the clear role of this neuropeptide in pregnancy remains unknown. We tested the existence of rhythmic kisspeptin expression in human full-term placenta from healthy pregnant women at six different time points during the day. The data obtained by Western blotting were fitted to a mathematical model (Fourier series), demonstrating, for the first time, the existence of a circadian rhythm in placental kisspeptin expression.

  14. Kinetics of silica nanoparticles in the human placenta

    DEFF Research Database (Denmark)

    Poulsen, Marie Sønnegaard; Mose, Tina; Maroun, Lisa Leth;

    2015-01-01

    choriocarcinoma cell line and the ex vivo perfused human placenta. Nanotoxicity in BeWo cells was examined by the MTT assay which demonstrated decreased cell viability at concentrations >100 µg/mL. In the placental perfusion experiments, antipyrine crossed the placenta rapidly, with a foetal:maternal ratio of 0...

  15. Proposal for standardised ultrasound descriptors of abnormally invasive placenta (AIP)

    DEFF Research Database (Denmark)

    Collins, Sally L; Ashcroft, Anna; Braun, Thorsten;

    2016-01-01

    Abnormally invasive placenta (AIP) is a clinical term used to describe a placenta that does not separate spontaneous during normal delivery and cannot be removed without causing high blood loss. Maternal outcome in cases with AIP is improved by antenatal diagnosis that currently relies...

  16. Predictors for Emergency Cesarean Delivery in Women with Placenta Previa

    NARCIS (Netherlands)

    Ruiter, Laura; Eschbach, Sanne J; Burgers, Mara; Rengerink, Katrien Oude; Pampus, Mariëlle G van; Goes, Birgit Y van der; Mol, Ben W J; Graaf, Irene M de; Pajkrt, Eva

    2016-01-01

    Objective The objective of this study was to identify the predictors of emergency delivery in women with placenta previa. Methods This is a retrospective study of pregnancies complicated by placenta previa, scheduled for a cesarean delivery between 2001 and 2011. Using univariable and multivariable

  17. Predictors for Emergency Cesarean Delivery in Women with Placenta Previa

    NARCIS (Netherlands)

    Ruiter, Laura; Eschbach, Sanne J; Burgers, Mara; Rengerink, Katrien Oude; Pampus, Mariëlle G van; Goes, Birgit Y van der; Mol, Ben W J; Graaf, Irene M de; Pajkrt, Eva

    2016-01-01

    Objective The objective of this study was to identify the predictors of emergency delivery in women with placenta previa. Methods This is a retrospective study of pregnancies complicated by placenta previa, scheduled for a cesarean delivery between 2001 and 2011. Using univariable and multivariable

  18. Characterization and partial purification of phospholipase D from human placenta

    DEFF Research Database (Denmark)

    Vinggaard, Anne Marie; Hansen, Harald S.

    1995-01-01

    We report the existence in the human placenta of a phosphatidylcholine- hydrolyzing phospholipase D (PLD) activity, which has been characterized and partially purified. Triton X-100 effectively solubilized PLD from the particulate fraction of human placenta in a dose-dependent manner. However....... The present results form the basis for further purification of a PLD from human tissue....

  19. The Programming Power of the Placenta

    Science.gov (United States)

    Sferruzzi-Perri, Amanda N.; Camm, Emily J.

    2016-01-01

    Size at birth is a critical determinant of life expectancy, and is dependent primarily on the placental supply of nutrients. However, the placenta is not just a passive organ for the materno-fetal transfer of nutrients and oxygen. Studies show that the placenta can adapt morphologically and functionally to optimize substrate supply, and thus fetal growth, under adverse intrauterine conditions. These adaptations help meet the fetal drive for growth, and their effectiveness will determine the amount and relative proportions of specific metabolic substrates supplied to the fetus at different stages of development. This flow of nutrients will ultimately program physiological systems at the gene, cell, tissue, organ, and system levels, and inadequacies can cause permanent structural and functional changes that lead to overt disease, particularly with increasing age. This review examines the environmental regulation of the placental phenotype with particular emphasis on the impact of maternal nutritional challenges and oxygen scarcity in mice, rats and guinea pigs. It also focuses on the effects of such conditions on fetal growth and the developmental programming of disease postnatally. A challenge for future research is to link placental structure and function with clinical phenotypes in the offspring. PMID:27014074

  20. Adenyl cyclase in the human placenta.

    Science.gov (United States)

    Sato, K; Ryan, K J

    1971-09-21

    This study demonstrated that the human placenta possesses an adenyl cyclase system responsive to catecholamines and sodium flouride (NaF). 2.5 gm human term placentas were homogenized, centrifuged, washed, resuspended, and used as the enzyme system when placed with various agents. Incubations and the determination of adenosine 3', 5' monophosphate (cyclic AMP) formed were performed. Samples stimulated by .0001 M catecholamines (L-epinephrine or L-norepinephrine) or .01 M NaF had higher levels of cyclic AMP than the controls (p. 005 for catecholamine-treated samples and p. 001 for NaF-treated samples). A concentration of .0001 M L-epinephrine or L-norepinephrine appeared to be a maximum effective dose and .0000001 M a minimum. L=epinephrine was 10 times as effective in the stimulation as L-norepinephrine. With .0001 M, 499 and 439 pmoles/10 minutes per 25 mg of tissue was formed, whereas in the control (no added hormones) 256 pmoles/10 minutes were formed. 3.2% ethanol activated the system by a small amount (p.02). Propranolol alone did not appear to have any effect; however, the effect of .0001 M L-epinephrine was reduced by 95% in the presence of .00001 M propranolol. Propranolol had no effect on NaF-stimulated activity.

  1. The programming power of the placenta

    Directory of Open Access Journals (Sweden)

    Amanda N Sferruzzi-Perri

    2016-03-01

    Full Text Available Size at birth is a critical determinant of life expectancy, and is dependent primarily on the placental supply of nutrients. However, the placenta is not just a passive organ for the materno-fetal transfer of nutrients and oxygen. Studies show that the placenta can adapt morphologically and functionally to optimise substrate supply, and thus fetal growth, under adverse intrauterine conditions. These adaptations help meet the fetal drive for growth, and their effectiveness will determine the amount and relative proportions of specific metabolic substrates supplied to the fetus at different stages of development. This flow of nutrients will ultimately program physiological systems at the gene, cell, tissue, organ, and system levels, and inadequacies can cause permanent structural and functional changes that lead to overt disease, particularly with increasing age. This review examines the environmental regulation of the placental phenotype with particular emphasis on the impact of maternal nutritional challenges and oxygen scarcity in mice, rats and guinea pigs. It also focuses on the effects of such conditions on fetal growth and the developmental programming of disease postnatally. A challenge for future research is to link placental structure and function with clinical phenotypes in the offspring.

  2. The Programming Power of the Placenta.

    Science.gov (United States)

    Sferruzzi-Perri, Amanda N; Camm, Emily J

    2016-01-01

    Size at birth is a critical determinant of life expectancy, and is dependent primarily on the placental supply of nutrients. However, the placenta is not just a passive organ for the materno-fetal transfer of nutrients and oxygen. Studies show that the placenta can adapt morphologically and functionally to optimize substrate supply, and thus fetal growth, under adverse intrauterine conditions. These adaptations help meet the fetal drive for growth, and their effectiveness will determine the amount and relative proportions of specific metabolic substrates supplied to the fetus at different stages of development. This flow of nutrients will ultimately program physiological systems at the gene, cell, tissue, organ, and system levels, and inadequacies can cause permanent structural and functional changes that lead to overt disease, particularly with increasing age. This review examines the environmental regulation of the placental phenotype with particular emphasis on the impact of maternal nutritional challenges and oxygen scarcity in mice, rats and guinea pigs. It also focuses on the effects of such conditions on fetal growth and the developmental programming of disease postnatally. A challenge for future research is to link placental structure and function with clinical phenotypes in the offspring.

  3. Vascular distribution patterns in monochorionic twin placentas.

    Science.gov (United States)

    De Paepe, M E; DeKoninck, P; Friedman, R M

    2005-07-01

    Several recent publications have focused on the association between the occurrence of twin-to-twin transfusion syndrome (TTTS) in diamniotic-monochorionic twins and the presence of a number of selected anatomic placental characteristics (distribution of vascular territory, cord insertion, type and number of inter-twin anastomoses). In contrast, the potential importance of the vascular distribution patterns of the individual twins remains to be elucidated. Based on its gross architectural distribution pattern, chorionic vasculature is traditionally described as disperse, magistral or mixed. The aim of this study was (1) to determine the relative prevalence of these vascular distribution patterns in monochorionic twin placentas, and (2) to correlate these patterns with the presence of TTTS and known anatomic placental features linked to TTTS. The placentas of 89 consecutive diamniotic-monochorionic twins (15 with TTTS, 74 without TTTS), examined at Women and Infants Hospital, were studied. Disperse vascular patterns were seen in 53% of twins, and magistral or mixed patterns in 47%. The prevalence of magistral/mixed vascular patterns was significantly higher in TTTS gestations than in non-TTTS gestations (60% versus 44%, Ppatterns and marginal/velamentous cord insertion, low number of inter-twin anastomoses, and uneven distribution of the vascular territories. These findings suggest that the magistral/mixed vascular distribution pattern may represent an important placental architectural feature contributing to the complex pathophysiology of TTTS.

  4. Fibrinogen

    Science.gov (United States)

    ... during pregnancy if the placenta separates from its attachment to the uterus wall ( placenta abruptio ). Risks There ... most often performed on people who have bleeding disorders. The risk of excessive bleeding is slightly greater ...

  5. Aflatoxin B1 transfer and metabolism in human placenta.

    Science.gov (United States)

    Partanen, Heidi A; El-Nezami, Hani S; Leppänen, Jukka M; Myllynen, Päivi K; Woodhouse, Heather J; Vähäkangas, Kirsi H

    2010-01-01

    Aflatoxin B1 (AFB1), a common dietary contaminant, is a major risk factor of hepatocellular carcinoma (HCC). Early onset of HCC in some countries in Africa and South-East Asia indicates the importance of early life exposure. Placenta is the primary route for various compounds, both nutrients and toxins, from the mother to the fetal circulation. Furthermore, placenta contains enzymes for xenobiotic metabolism. AFB1, AFB1-metabolites, and AFB1-albumin adducts have been detected in cord blood of babies after maternal exposure during pregnancy. However, the role that the placenta plays in the transfer and metabolism of AFB1 is not clear. In this study, placental transfer and metabolism of AFB1 were investigated in human placental perfusions and in in vitro studies. Eight human placentas were perfused with 0.5 or 5microM AFB1 for 2-4 h. In vitro incubations with placental microsomal and cytosolic proteins from eight additional placentas were also conducted. Our results from placental perfusions provide the first direct evidence of the actual transfer of AFB1 and its metabolism to aflatoxicol (AFL) by human placenta. In vitro incubations with placental cytosolic fraction confirmed the capacity of human placenta to form AFL. AFL was the only metabolite detected in both perfusions and in vitro incubations. Since AFL is less mutagenic, but putatively as carcinogenic as AFB1, the formation of AFL may not protect the fetus from the toxicity of AFB1.

  6. Placenta previa and immediate outcome of the term offspring.

    Science.gov (United States)

    Walfisch, Asnat; Sheiner, Eyal

    2016-10-01

    Immediate neonatal outcome in pregnancies complicated by placenta previa is largely dependent on gestational age. We aimed to investigate whether placenta previa increases the risk for perinatal mortality and immediate morbidity of the offspring born at term. A population-based cohort study included all singleton pregnancies, with and without placenta previa, delivered at term. Maternal and pregnancy characteristics as well as immediate neonatal morbidity and mortality were compared. Deliveries occurred between the years 1991-2013 in a tertiary medical center. Multiple pregnancies, and fetal congenital malformations were excluded. During the study period 233,123 consecutive term deliveries met the inclusion criteria; 0.2 % of the babies were born to mothers diagnosed with placenta previa. Women with placenta previa were significantly older and more likely to have had a previous cesarean section. Pregnancies were more likely to be complicated with pathological presentations and cesarean hysterectomies. Babies born at term following pregnancies with placenta previa were more likely to weigh less than 2500 g (OR 2.78 CI 1.9-3.9, p placenta previa pregnancies involve higher maternal morbidity rates, term offsprings are not at an increased risk for immediate adverse outcome.

  7. Determinants of placenta previa: a case-control study

    Directory of Open Access Journals (Sweden)

    Fatemeh Shobeiri

    2017-06-01

    Full Text Available Background: The risk factors of placenta previa differ around the world. This study evaluated risk factors of pregnancies complicated with placenta previa during a 5-year period in a referral center in Hamadan, Iran. Methods: This case control study was conducted in Hamadan city (Hamadan Province of Iran from April 2013 to March 2017. The cases were women whose deliveries were complicated by placenta previa and the controls were those who delivered without placenta previa. We recruited 130 cases and 130 controls. Multivariate unconditional logistic regression analysis was conducted, and odds ratios (ORs and 95% confidence intervals (CIs were calculated. Results: The OR of placenta previa was 4.08 (95% CI= 1.44, 11.58 by maternal age, 4.08 (95% CI =1.44, 11.58 by preterm labor, and 6.64 (95% CI =1.09, 40.45 by prior operations of the uterine cavity, compared to normal deliveries and after adjusting for other variables. Multiparity, prior spontaneous abortions, and prior cesarean sections were not statistically significant risk factors for placenta previa, when adjusted for other variables.  Conclusion: Our study suggests that high maternal age and prior operations of the uterine cavity are risk factors for placenta previa.

  8. Maternal Morbidity in Women with Placenta Previa Managed with Prediction of Morbidly Adherent Placenta by Ultrasonography

    Directory of Open Access Journals (Sweden)

    Midori Fujisaki

    2017-01-01

    Full Text Available Objective. To determine maternal morbidity in women with placenta previa managed with prediction of morbidly adherent placenta (MAP by ultrasonography. Methods. A retrospective cohort study was undertaken comprising forty-one women who had placenta previa with or without risk factors for MAP. Women who had all three findings (bladder line interruption, placental lacunae, and absence of the retroplacental clear zone were regarded as high suspicion for MAP and underwent cesarean section followed by hysterectomy. We attempted placental removal for women having two findings or less. Results. Among 28 women with risk, nine with high suspicion underwent hysterectomy and were diagnosed with MAP. Three of 19 women with two findings or less eventually underwent hysterectomy and were diagnosed with MAP. The sensitivity and positive predictive value for the detection of MAP were 64% and 100%. The pathological severity of MAP was significantly correlated with the cumulative number of findings. There were no cases of MAP among 13 women without risk. There was no difference of blood loss between women with high suspicion and those without risk (2186±1438 ml versus 1656±848 ml, resp.; p=0.34. Conclusion. Management with prediction of MAP by ultrasonography is useful for obtaining permissible morbidity.

  9. Maternal Morbidity in Women with Placenta Previa Managed with Prediction of Morbidly Adherent Placenta by Ultrasonography

    Science.gov (United States)

    Maki, Yohei; Oohashi, Masanao

    2017-01-01

    Objective. To determine maternal morbidity in women with placenta previa managed with prediction of morbidly adherent placenta (MAP) by ultrasonography. Methods. A retrospective cohort study was undertaken comprising forty-one women who had placenta previa with or without risk factors for MAP. Women who had all three findings (bladder line interruption, placental lacunae, and absence of the retroplacental clear zone) were regarded as high suspicion for MAP and underwent cesarean section followed by hysterectomy. We attempted placental removal for women having two findings or less. Results. Among 28 women with risk, nine with high suspicion underwent hysterectomy and were diagnosed with MAP. Three of 19 women with two findings or less eventually underwent hysterectomy and were diagnosed with MAP. The sensitivity and positive predictive value for the detection of MAP were 64% and 100%. The pathological severity of MAP was significantly correlated with the cumulative number of findings. There were no cases of MAP among 13 women without risk. There was no difference of blood loss between women with high suspicion and those without risk (2186 ± 1438 ml versus 1656 ± 848 ml, resp.; p = 0.34). Conclusion. Management with prediction of MAP by ultrasonography is useful for obtaining permissible morbidity. PMID:28523191

  10. File list: His.Plc.05.AllAg.Placenta [Chip-atlas[Archive

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  8. D2-40/podoplanin expression in the human placenta.

    Science.gov (United States)

    Wang, Y; Sun, J; Gu, Y; Zhao, S; Groome, L J; Alexander, J S

    2011-01-01

    Placental tissue expresses many lymphatic markers. The current study was undertaken to examine if D2-40/podoplanin, a lymphatic endothelial marker, was expressed in the human placenta, and how it is altered developmentally and pathologically. We examined D2-40/podoplanin and VEGFR-3 expressions in placentas from normotensive pregnancies at different gestational ages and in placentas from women with clinically defined preeclampsia. D2-40 expression in systemic lymphatic vessel endothelium served as a positive control. Protein expression for D2-40, VEGFR-3, and β-actin was determined by Western blot in placentas from normotensive (n = 6) and preeclamptic (n = 5) pregnancies. Our results show that D2-40/podoplanin was strongly expressed in the placenta, mainly as a network plexus pattern in the villous stroma throughout gestation. CD31 was limited to villous core fetal vessel endothelium and VEGFR-3 was found in both villous core fetal vessel endothelium and trophoblasts. D2-40/podoplanin expression was significantly decreased, and VEGFR-3 significantly increased in preeclamptic placental tissues compared to normotensive placental controls. Placental villous stroma is a reticular-like structure, and the localization of D2-40 to the stroma suggests that a lymphatic-like conductive network may exist in the human placenta. D2-40/podoplanin is an O-linked sialoglycoprotein. Although little is known regarding biological functions of sialylated glycoproteins within the placenta, placental D2-40/podoplanin may support fetal vessel angiogenesis during placenta development and reduced D2-40/podoplanin expression in preeclamptic placenta may contribute to altered interstitial fluid homeostasis and impaired angiogenesis in this pregnancy disorder.

  9. Multidisciplinary management of invasive placenta previa.

    Science.gov (United States)

    Walker, Melissa G; Allen, Lisa; Windrim, Rory C; Kachura, John; Pollard, Lindsay; Pantazi, Sophia; Keating, Sarah; Carvalho, Jose C A; Kingdom, John C P

    2013-05-01

    Objectif : Évaluer l’efficacité d’une approche d’équipe multidisciplinaire visant l’atténuation de la morbidité maternelle grave chez les femmes qui présentent un placenta prævia invasif. Méthodes : Nous avons mené une étude prospective auprès de 33 femmes qui présentaient un placenta prævia et increta-percreta (diagnostiqué par échographie et/ou imagerie par résonance magnétique) et qui accouchaient au Mount Sinai Hospital de Toronto, à la suite du lancement (en janvier 2008) d’une approche d’équipe visant les femmes qui présentaient une telle placentation. Nous avons inclus les accouchements chez les femmes visées jusqu’en juin 2012. Nous avons analysé les dossiers prénataux (services externes et services hospitaliers) en vue d’y repérer l’utilisation par l’obstétricien titulaire de six composantes d’équipe prédéfinies : (1) consultation prénatale en médecine fœto-maternelle; (2) consultation en chirurgie gynécologique; (3) IRM prénatale; (4) consultation en radiologie interventionnelle et mise en place préopératoire de sondes à ballonnet dans les divisions antérieures des artères iliaques internes; (5) planification à l’avance de la date de chirurgie; et (6) chirurgie menée par des membres de l’équipe chirurgicale vouée aux cas de placenta invasif. Les détails de l’évolution prénatale, de l’accouchement et de la période postpartum ont été consignés afin d’établir un score composite de morbidité maternelle grave en cinq points fondé sur la présence ou l’absence de ce qui suit : (1) admission à l’USI à la suite de l’accouchement; (2) transfusion de plus de deux unités de sang; (3) anesthésie générale (administration ou conversion); (4) temps opératoire se situant dans le quartile le plus élevé (> 125 minutes); et (5) complications postopératoires significatives (réhospitalisation, hospitalisation postpartum prolongée et/ou embolie pulmonaire). R

  10. Placenta Percreta With Invasion into the Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Zachary L. Smith

    2014-01-01

    Full Text Available Placenta percreta is a rare condition, which can lead to significant morbidity and potentially mortality. We present a case of a 38-year-old woman who presented at 24 weeks gestation with vaginal bleeding and was found to have complete placenta previa with placenta percreta invading the urinary bladder. Her hospital course was complicated by bilateral pulmonary emboli. She underwent an exploratory laparotomy, repeat Caesarean section, and total abdominal hysterectomy. Because of placental invasion into the bladder, the procedure was complicated by bladder and ureteral injuries for which urology carried out repair. Postoperatively, the patient had a persistent bladder leak until postoperative day #39.

  11. Prevalence of placenta previa among deliveries in Mainland China

    Science.gov (United States)

    Fan, Dazhi; Wu, Song; Wang, Wen; Xin, Lihong; Tian, Guo; Liu, Li; Feng, Jinping; Guo, Xiaoling; Liu, Zhengping

    2016-01-01

    Abstract Background: Placenta previa is characterized by the abnormal placenta overlying the endocervical os, and it is known as one of the most feared adverse maternal and fetal-neonatal complications in obstetrics. Objectives: We aimed to obtain overall and regional estimates of placenta previa prevalence among deliveries in Mainland China. Methods: The research was performed a systematic review, following the Meta-analysis of observational studies in epidemiology (MOOSE) guidelines for systematic reviews of observational studies, and the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement for reporting systematic reviews and meta-analysis. Electronic databases were searched and included hospital-based studies that reported placenta previa prevalence in Mainland China. Random-effects meta-analyses were used to pool prevalence estimates of placenta previa. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. For exploring the geographical distributions of placenta previa, the ArcGIS software (Esri) was used to construct the map of prevalence. Results: A total of 80 articles and 86 datasets (including 1,298,548 subjects and 14,199 placenta previa cases) from 1965 through 2015 were included. The pooled overall prevalence of placenta previa among deliveries was 1.24% (95% confidence interval [CI], 1.12–1.36) in Mainland China during 1965 to 2015. And, the trend in the prevalence of placenta previa was steady. The occurrence rate of placenta previa in the region groups Northeast, North, Northwest, Central China, East, South, and Southwest was 1.20%, 1.01%, 1.10%, 1.15%, 0.93%, 1.42%, and 2.01%, respectively. The prevalence map based on a geographic information system showed an unequal geographic distribution. Conclusions: The results showed that placenta previa is currently a high-burden disease in Mainland China. This review would be useful for the design of placenta previa

  12. Intraoperative aortic balloon occlusion in patients with placenta previa and/or placenta accreta: a retrospective study.

    Science.gov (United States)

    Luo, Fangyuan; Xie, Lan; Xie, Ping; Liu, Siwei; Zhu, Yue

    2017-04-01

    To introduce the primary experience of using aortic balloon catheters during cesarean section for placenta previa and/or placenta accreta. From January 2013 to May 2015, 43 patients who were preoperatively diagnosed with major placenta previa and/or placenta accreta and who underwent prophylactic aortic catheterization before caesarean section (CS) were included in the study. We analyzed the clinical data of the study population. Surgery- and catheterization-related complications were also reported. Major placenta previa or placenta accreta was surgically confirmed in 42 patients, 28 of whom had both conditions. The mean patient age was 32.3 ± 5.5 years, whereas the median gestational age at delivery was 260 (range, 153-280) days. Twenty-nine (67.4%) patients had previously undergone CS, and 13 (30%) patients had undergone emergency surgery for antenatal hemorrhage. The median estimated blood loss during surgery was 500 (range, 100-3,000) mL, and the median duration of occlusion was 20 (range, 5-32) minutes. Hysterectomy was performed in five (11.6%) patients and uterine artery embolization in two (4.6%) patients. Two patients with placenta percreta experienced surgery-related complications, and two patients required hospital readmission. No major catheterization-related complications were observed. Forty-two live births were recorded, and the Apgar score of the infants at 5 minutes was > 7. Intraoperative aortic balloon occlusion is a relatively safe method for treating placenta previa and/or placenta accreta during scheduled and emergency CS and might be helpful to prevent hysterectomy and embolization in women wishing to preserve fertility. Copyright © 2017. Published by Elsevier B.V.

  13. A Marked Increase in Obstetric Hysterectomy for Placenta Accreta

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    Xiao-Yu Pan

    2015-01-01

    Conclusion: As the multiple cesarean delivery rates have risen, there has been a dramatic increase in OH for placenta accreta. An advance antenatal diagnosis of ultrasonography, and MRI, and a multidisciplinary teamwork can maximize patients' safety and outcome.

  14. PLACENTA ACCRETA AND THE DEVELOPING WORLD – A REVIEW

    African Journals Online (AJOL)

    2010-12-12

    Dec 12, 2010 ... the incidence of placenta accreta might be on the increase and this might worsen the maternal .... many speculations and theories have been proposed during the ... vascular endothelial damage which occurs with aging,.

  15. Placenta as a source of hematopoietic stem cells

    OpenAIRE

    Dzierzak, Elaine; Robin, Catherine

    2010-01-01

    The placenta is a large, highly vascularised hematopoietic tissue that functions during the embryonic and foetal development of eutherian mammals. Although recognised as the interface tissue important in the exchange of oxygen, nutrients and waste products between the foetus and mother, the placenta has increasingly become a focus of research concerning the ontogeny of the blood system. Here, we describe recent data showing the intrinsic hematopoietic potential and appearance of hematopoietic...

  16. Effect of Placenta Previa on Preeclampsia

    Science.gov (United States)

    Ying, Hao; Lu, Yi; Dong, Yi-Nuo; Wang, De-Fen

    2016-01-01

    Background The correlation between gestational hypertension-preeclampsia (GH-PE) and placenta previa (PP) is controversial. Specifically, it is unknown whether placenta previa has any effect on the various types of preeclampsia (PE), and the role PP with concurrent placenta accreta (PA) play in the occurrence of GH-PE are not well understood. Objective The aim of this study was to identify the effects of PP on GH, mild and severe preeclampsia (MPE and SPE), and early- and late-onset preeclampsia (EPE and LPE). Another aim of the study was to determine if concurrent PA impacts the relationship between PP and GH-PE. Methods A retrospective single-center study of 1,058 patients having singleton pregnancies with PP was performed, and 2,116 pregnant women were randomly included as controls. These cases were collected from a tertiary hospital and met the inclusion criteria for the study. Clinical information, including PP and the gestational age at the onset of GH-PE were collected. Binary and multiple logistic regression analyses were conducted after the confounding variables were controlled to assess the effects of PP on different types of GH-PE. Results There were 155 patients with GH-PE in the two groups. The incidences of GH-PE in the PP group and the control group were 2.5% (26/1058) and 6.1% (129/2116), respectively (P = 0.000). Binary and multiple regression analyses were conducted after controlling for confounding variables. Compared to the control group, in the PP group, the risk of GH-PE was reduced significantly by 78% (AOR: 0.216; 95% CI: 0.135–0.345); the risks of GH and PE were reduced by 55% (AOR: 0.451; 95% CI: 0.233–0.873) and 86% (AOR: 0.141; 95% CI: 0.073–0.271), respectively; the risks of MPE and SPE were reduced by 73% (AOR: 0.269; 95% CI: 0.087–0828) and 88% (AOR: 0.123; 95% CI: 0.055–0.279), respectively; and the risks of EPE and LPE were reduced by 95% (AOR: 0.047; 95% CI: 0.012–0.190) and 67% (AOR: 0.330; 95% CI: 0.153–0

  17. [The role of placenta in hepatitis B virus intrauterine transmission].

    Science.gov (United States)

    Yan, Y; Xu, D; Wang, W

    1999-07-01

    To determine the role of placenta in hepatitis B virus (HBV) intrauterine transmission, and to trace the route of transplacental transmission and the timing of HBV infection in uterus. We collected 101 term placentas and newborn infants, 24 aborted first-trimester placentas, and 6 induced aborted fetuses and placentas from 131 HBsAg carrying pregnant women. Serologic HBV markers (HBsAg and HBV DNA) of pregnant women and newborns were detected by ELISA and PCR. The HBsAg, HBxAg, HBcAg and HBV DNA in placentas were determined by ABC immunohistochemical staining and in-situ hybridization. The HBV infection rates of placentas from first-trimester, second-trimester to term periods were 4.2%(1/24), 1/6, and 44.6%(45/101), respectively. In one induced aborted fetal liver tissue (19-week of pregnancy), the proteins and DNA of HBV were detected, and its placental villous capillary endothelial cells were also infected. The OR of HBV infection of villous capillary endothelial cells in intrauterine transmission was 18.46(95% CI = 2.83-152.78). HBV infection of placental capillary endothelial cell is a major risk factor of intrauterine transmission. HBV transplacental transmission route may be placental cell to cell transfer. The intrauterine infection may occur as early as on the 19th week of pregnancy, but the main timing is possibly in the third-trimester of pregnancy.

  18. Molecular characterization of the Neuronatin gene in the porcine placenta.

    Directory of Open Access Journals (Sweden)

    Ting Gu

    Full Text Available Imprinted genes play important roles in placental and embryonic development. Neuronatin (NNAT, first identified as an imprinted gene in human and mouse brains, played important roles in neuronal differentiation in the brain and in glucose-mediated insulin secretion in pancreatic β cells. In the pig, NNAT was reported to be imprinted in eleven tissues. Our previous microarray hybridization study showed that NNAT was differentially expressed in Yorkshire and Meishan pig placentas, but the imprinting status and function of NNAT in the placenta have not been investigated. We demonstrated for the first time that NNAT was monoallelically expressed in the placenta. Immunochemistry analysis showed that NNAT was located in the uterine luminal and glandular epithelium in placentas. We also confirmed the differential expression of NNAT in Meishan and Yorkshire pig placentas by qPCR. Using IPA software and the published literature, we created a model network of the possible relationships between NNAT and glucose transporter genes. A dual luciferase reporter assay demonstrated that the crucial promoter region of NNAT contained a CANNTG sequence in the +210 to +215 positions, which corresponded to the E-box. Our findings demonstrated important roles of NNAT in placenta function.

  19. Case with pyoderma gangrenosum abruptly emerging around the wound of cesarean section for placenta previa with placenta accrete.

    Science.gov (United States)

    Nonaka, Taro; Yoshida, Kunihiko; Yamaguchi, Masayuki; Aizawa, Atsuko; Fujiwara, Hiroshi; Enomoto, Takayuki; Takakuwa, Koichi

    2016-09-01

    A 39-year-old woman underwent emergency cesarean section (CS) due to placenta previa totalis with massive bleeding. Two major problems emerged in this patient after CS was carried out. One was partial retention of the placenta due to placenta accreta. Another major and more serious problem was pyoderma gangrenosum (PG) widely appearing at the skin of the abdomen around the CS wound. Conservative treatment was performed for the retained placenta, and it had completely disappeared by 76 days after the CS. The diagnosis of PG was promptly made in consultation with a plastic surgeon and a dermatologist when a wide ulcer emerged around the CS wound, and high-dose prednisolone was administered as treatment. At 90 days following the CS, near-complete epithelialization was achieved. This extremely rare case reflects the importance of rapid diagnosis and treatment of PG.

  20. Phthalate monoesters in perfusate from a dual placenta perfusion system, the placenta tissue and umbilical cord blood

    DEFF Research Database (Denmark)

    Mose, Tina; Mortensen, Gerda K; Hedegaard, Morten;

    2006-01-01

    Fetal exposure to phthalates may be associated with adverse reproductive effects, including cryptorchidism and decreased semen quality. Information about human placental transfer is needed to qualify the hypotheses. A dual recirculating placenta perfusion system to monitor concentrations of eight...... phthalate monoesters in fetal and maternal perfusates was established. In addition to perfusate background measures of phthalate monoesters, the concentrations in umbilical cord plasma and placenta tissue were measured. Monomethyl phthalate (mMP), monoethyl phthalate (mEP), monobutyl phthalate (m...

  1. The role of shear wave elastography in the assessment of placenta previa-accreta.

    Science.gov (United States)

    Alıcı Davutoglu, Ebru; Ariöz Habibi, Hatice; Ozel, Ayşegül; Yuksel, Mehmet Aytac; Adaletli, Ibrahim; Madazlı, Riza

    2017-05-09

    To evaluate the value of shear wave elastography (SWE) in the prediction of morbidly adherent placenta. Forty-three women with normal placental location and 26 women with anteriorly localized placenta previa were recruited for this case-control study. Placental elasticity values in both the groups were determined by SWE imaging. SWE values were higher in the placenta previa group in all regions than in normal localized placentas (p placenta previa with and without morbidly adherent placenta (p > .05). Placental stiffness is significantly higher in placenta previa than normal localized placentas. However, we could not demonstrate any statistically significant difference in the elasticity values between the placenta previa with and without accreta.

  2. Direct puncture embolization of the internal iliac artery during cesarean delivery for pernicious placenta previa coexisting with placenta accreta.

    Science.gov (United States)

    Chen, Zhenyu; Li, Ju; Shen, Jian; Jin, Jiaxi; Zhang, Wei; Zhong, Wan

    2016-12-01

    To evaluate direct puncture embolization of the internal iliac artery with hemostatic gelatin sponge particles to treat pernicious placenta previa coexisting with placenta accreta during cesarean delivery. A retrospective study was conducted of data from women with pernicious placenta previa and placenta accreta who underwent direct puncture embolization of the internal iliac artery during cesarean delivery at a center in China between September 1, 2013, and February 28, 2015. Information regarding surgical procedures, operative data, and outcomes during hospitalization were obtained from medical records. The procedure was successful in all 16 cases included. Mean operative time was 78 minutes (range 65-90) and mean estimated blood loss was 1550 mL (range 1000-2500). Complications such as fever, buttock pain, or acute limb ischemia were not observed. The procedure was performed after partial cystectomy for two patients with bladder invasion. Postoperative Doppler imaging indicated uterine recovery and normalized uterine blood flow in all patients. Direct puncture embolization of the internal iliac artery during cesarean delivery was a safe, effective, simple, and rapid method to control hemorrhage among women with pernicious placenta previa and placenta accreta. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Global DNA hypermethylation in down syndrome placenta.

    Directory of Open Access Journals (Sweden)

    Shengnan Jin

    2013-06-01

    Full Text Available Down syndrome (DS, commonly caused by an extra copy of chromosome 21 (chr21, occurs in approximately one out of 700 live births. Precisely how an extra chr21 causes over 80 clinically defined phenotypes is not yet clear. Reduced representation bisulfite sequencing (RRBS analysis at single base resolution revealed DNA hypermethylation in all autosomes in DS samples. We hypothesize that such global hypermethylation may be mediated by down-regulation of TET family genes involved in DNA demethylation, and down-regulation of REST/NRSF involved in transcriptional and epigenetic regulation. Genes located on chr21 were up-regulated by an average of 53% in DS compared to normal villi, while genes with promoter hypermethylation were modestly down-regulated. DNA methylation perturbation was conserved in DS placenta villi and in adult DS peripheral blood leukocytes, and enriched for genes known to be causally associated with DS phenotypes. Our data suggest that global epigenetic changes may occur early in development and contribute to DS phenotypes.

  4. Peripartal leukogram in cows with and without retained placenta

    Directory of Open Access Journals (Sweden)

    Lužajić Tijana

    2014-01-01

    Full Text Available The aim of this study was to investigate whether prepartal leukogram in cows with retained placenta could indicate the presence of subclinical systemic inflammatory response before the onset of disease. After calving, sixteen highly pregnant Holstein cows, aged 3 to 9 years, without clinical signs of the disease prior to calving were divided into two groups: the first group (n=9 were animals without retained placenta, or any visible inflammation after birth; the second group (n=7 were cows with retained placenta. Blood was sampled three times before parturition, at intervals of one week, and once 24 hours after birth. The number of total leukocytes, segmented and non segmented neutrophilic granulocytes (NG, lymphocytes and monocytes were determined by standard laboratory techniques. The results have shown that in the group of cows with retained placenta the number of mature neutrophils was slightly elevated in the third, second and last week before calving, and equal number of non segmented neutrophils in regard to the group with no retention. The results have also shown that, in both groups of cows, 24 hours after calving, the number of total leukocytes and the number of segmented neutrophils decreased, but the number of the non segmented neutrophils increased. Based on this, we can conclude that cows with retained placenta had no systemic inflammatory response during three weeks prepartal period, but 24 hours after calving, systemic inflammatory response was documented in all the cows. Moreover, the intensity of inflammatory response in cows with retained placenta was not more pronounced in comparison to cows without retained placenta. [Projekat Ministarstva nauke Republike Srbije, br. 175061

  5. The cervix as a natural tamponade in postpartum hemorrhage caused by placenta previa and placenta previa accreta: a prospective study.

    Science.gov (United States)

    El Gelany, Saad A A; Abdelraheim, Ahmed R; Mohammed, Mo'men M; Gad El-Rab, Mohammed T; Yousef, Ayman M; Ibrahim, Emad M; Khalifa, Eissa M

    2015-11-11

    Placenta previa and placenta accreta carry significant maternal and fetal morbidity and mortality. Several techniques have been described in the literature for controlling massive bleeding associated with placenta previa cesarean sections. The objective of this study was to evaluate the efficacy and safety of the use of the cervix as a natural tamponade in controlling postpartum hemorrhage caused by placenta previa and placenta previa accreta. This prospective study was conducted on 40 pregnant women admitted to our hospital between June 2012 and November 2014. All participating women had one or more previous cesarean deliveries and were diagnosed with placenta previa and/or placenta previa accreta. Significant bleeding from the placental bed during cesarean section was managed by inverting the cervix into the uterine cavity and suturing the anterior and/or the posterior cervical lips into the anterior and/or posterior walls of the lower uterine segment. The technique of cervical inversion described above was successful in stopping the bleeding in 38 out of 40 patients; yielding a success rate of 95%. We resorted to hysterectomy in only two cases (5%). The mean intra-operative blood loss was 1572.5 mL, and the mean number of blood units transfused was 3.1. The mean time needed to perform the technique was 5.4 ± 0.6 min. The complications encountered were as follows: bladder injury in the two patients who underwent hysterectomy and wound infection in one patient. Postoperative fever that responded to antibiotics occurred in 1 patient. The mean duration of the postoperative hospital stay was 3.5 days This technique of using the cervix as a natural tamponade appears to be safe, simple, time-saving and potentially effective method for controlling the severe postpartum hemorrhage (PPH) caused by placenta previa/placenta previa accreta. This technique deserves to be one of the tools in the hands of obstetricians who face the life-threatening hemorrhage of placenta

  6. Differential expression of GPR30 in preeclampsia placenta tissue and normal placenta tissue and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    Ben-Zhou Feng

    2016-01-01

    Objective: To study the differential expression of GPR30 in preeclampsia placenta tissue and normal placenta tissue and its clinical significance. Methods:Preeclampsia placenta tissue and normal placenta tissue were collected and GPR30 expression levels were detected;human umbilical vein endothelial cells were cultured and processed with GRP30 inhibitor and GRP30 agonist combined with hypoxia-reoxygenation respectively, and cell apoptosis as well as pro-angiogenesis molecule and apoptosis molecule contents were detected. Results:mRNA content and protein content of GRP30 in preeclampsia placenta tissue were significantly lower than those in normal placenta tissue;apoptosis rate of G15 group was significantly higher than that of control group, VEGF and bFGF contents in supernatant were significantly lower than those of control group, and mRNA contents of Bax, Caspase-3 and Caspase-9 in cells were significantly higher than those of control group;apoptosis rate of H/R group was significantly higher than that of control group, VEGF and bFGF contents in supernatant were significantly lower than those of control group, and mRNA contents of Bax, Caspase-3 and Caspase-9 in cells were significantly higher than those of control group;apoptosis rate of G1 group was significantly lower than that of H/R group, VEGF and bFGF contents in supernatant were significantly higher than those of H/R group, and mRNA contents of Bax, Caspase-3 and Caspase-9 in cells were significantly lower than those of H/R group. Conclusions:Low expression of GPR30 in placenta tissue is closely associated with the occurrence of preeclampsia, enhancing GPR function can reduce endothelial cell apoptosis and increase the contents of pro-angiogenesis factors, and it has endothelial protection effect.

  7. Is Grannum grading of the placenta reproducible?

    Science.gov (United States)

    Moran, Mary; Ryan, John; Brennan, Patrick C.; Higgins, Mary; McAuliffe, Fionnuala M.

    2009-02-01

    Current ultrasound assessment of placental calcification relies on Grannum grading. The aim of this study was to assess if this method is reproducible by measuring inter- and intra-observer variation in grading placental images, under strictly controlled viewing conditions. Thirty placental images were acquired and digitally saved. Five experienced sonographers independently graded the images on two separate occasions. In order to eliminate any technological factors which could affect data reliability and consistency all observers reviewed images at the same time. To optimise viewing conditions ambient lighting was maintained between 25-40 lux, with monitors calibrated to the GSDF standard to ensure consistent brightness and contrast. Kappa (κ) analysis of the grades assigned was used to measure inter- and intra-observer reliability. Intra-observer agreement had a moderate mean κ-value of 0.55, with individual comparisons ranging from 0.30 to 0.86. Two images saved from the same patient, during the same scan, were each graded as I, II and III by the same observer. A mean κ-value of 0.30 (range from 0.13 to 0.55) indicated fair inter-observer agreement over the two occasions and only one image was graded consistently the same by all five observers. The study findings confirmed the lack of reproducibility associated with Grannum grading of the placenta despite optimal viewing conditions and highlight the need for new methods of assessing placental health in order to improve neonatal outcomes. Alternative methods for quantifying placental calcification such as a software based technique and 3D ultrasound assessment need to be explored.

  8. RISK FACTORS OF PLACENTA PREVIA AMONG RURAL INDIAN WOMEN

    Directory of Open Access Journals (Sweden)

    Santu

    2014-11-01

    Full Text Available OBJECTIVE: The present study was to find out risk factors of placenta previa among rural Indian women. METHODS: This was a retrospective observational study conducted over two years. 220 women with placenta previa were taken as cases and 440 women without placenta previa were taken as control. RESULTS: Advanced maternal age (OR 2.7; 95% CI: 1.84-3.97, increased parity (OR 1.58; 95% CI: 1.13-2.22, previous abortions (OR 2.25; 95% CI: 1.5-3.35, previous uterine surgery (OR 5.91; 95% CI: 3.56-9.87, uterine anomalies (OR 4.64; 95% CI: 1.41-15.27 and tobacco chewing (OR 3.58; 95% CI: 1.04-12.37 are the potential risk factors. No significant associations have been found with socio economic status, religion, previous history of placenta previa, infertility treatment and sex of the newborn. CONCLUSION: Placenta previa have some identifiable risk factors. Tobacco chewing is a novel potential risk factor

  9. Three-dimensional ultrasound evaluation of the placenta.

    Science.gov (United States)

    Hata, T; Tanaka, H; Noguchi, J; Hata, K

    2011-02-01

    Conventional two-dimensional (2D) ultrasound has been widely used for the evaluation of the placenta during pregnancy. This 2D ultrasound evaluation includes the morphology, anatomy, location, implantation, anomaly, size, and color/power and pulsed Doppler sonographic assessment of the placenta. The introduction of three-dimensional (3D) ultrasound would facilitate the novel assessment of the placenta, such as surface-rendered imaging and volume measurement. With the recent advances in 3D power Doppler (3DPD) ultrasound as well as quantitative 3DPD histogram analysis, quantitative and qualitative assessments of the vascularization and blood flow of the placenta have become feasible. These novel techniques may assist in the evaluation of the feto-placental function, and offer potential advantages relative to conventional 2D sonographic assessments. 3D ultrasound may be an important modality in future placental research, in the evaluation of feto-placental insufficiency in clinical practice, and in the prediction of fetal growth restriction and pre-eclampsia, although some limitations regarding the assessment of the placenta employing 3D ultrasound still remain unresolved.

  10. A comprehensive analysis of the human placenta transcriptome.

    Science.gov (United States)

    Saben, J; Zhong, Y; McKelvey, S; Dajani, N K; Andres, A; Badger, T M; Gomez-Acevedo, H; Shankar, K

    2014-02-01

    As the conduit for nutrients and growth signals, the placenta is critical to establishing an environment sufficient for fetal growth and development. To better understand the mechanisms regulating placental development and gene expression, we characterized the transcriptome of term placenta from 20 healthy women with uncomplicated pregnancies using RNA-seq. To identify genes that were highly expressed and unique to the placenta we compared placental RNA-seq data to data from 7 other tissues (adipose, breast, hear, kidney, liver, lung, and smooth muscle) and identified several genes novel to placental biology (QSOX1, DLG5, and SEMA7A). Semi-quantitative RT-PCR confirmed the RNA-seq results and immunohistochemistry indicated these proteins were highly expressed in the placental syncytium. Additionally, we mined our RNA-seq data to map the relative expression of key developmental gene families (Fox, Sox, Gata, Tead, and Wnt) within the placenta. We identified FOXO4, GATA3, and WNT7A to be amongst the highest expressed members of these families. Overall, these findings provide a new reference for understanding of placental transcriptome and can aid in the identification of novel pathways regulating placenta physiology that may be dysregulated in placental disease.

  11. Placenta previa after prior abortion: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Manoochehr Karami

    2017-07-01

    Full Text Available There is controversy regarding the role of prior abortion on placenta previa in subsequent pregnancies. We conducted an updated, comprehensive meta-analysis of placenta previa after prior abortion. The search was conducted from PubMed, Web of Science and Scopus databases from the database inception to January 31, 2017. The heterogeneity across studies was evaluated by Q-test and I2 statistical test. Publication bias was assessed by Begg's test and Egger's test. Results of odds ratio (OR estimates with their corresponding 95% confidence intervals (CI were pooled using random-effects modeling. The literature search included 872 articles up until January 2017 with 2,134,529 participants. Based on OR estimates obtained from case-control and cohort studies, we found a significant association between prior spontaneous abortions and placenta previa (1.77; 95% CI: 1.60, 1.94 and between prior induced abortions and placenta previa (1.36; 95% CI: 1.02, 1.69. The meta-analysis study herein showed that prior abortion is a risk factor for placenta previa.

  12. Smoking and placenta previa: a meta-analysis.

    Science.gov (United States)

    Shobeiri, Fatemeh; Jenabi, Ensiyeh

    2017-01-04

    Previous studies found a positive association between placenta previa and smoking during pregnancy. However, the results of these studies are inconsistent. The aim was to perform meta-analysis of the association between smoking during pregnancy and placenta previa. Major electronic databases, including PubMed, Web of Science, and Scopus were searched until June 2015. The heterogeneity across studies was explored by Q-test and I(2) statistic. The possibility of publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) estimate with its 95% confidence intervals using a random-effects model. The literature search yielded 991 publications until October 2015 with 9,094,443 participants. Based on the random effect model, compared to nonsmoker women, the estimated OR and RR of placenta previa was 1.42 (95% CI: 1.30, 1.54) and 1.27 (95% CI: 1.18, 1.35), respectively. There is sufficient documents based on the observational studies that smoking during pregnancy is significantly associated with an increased risk of placenta previa. Therefore, smoking during pregnancy can be considered as a predictor of placenta previa.

  13. Ectopic Pregnancy after Conservative Management of Placenta Accreta: A Case Report

    Directory of Open Access Journals (Sweden)

    Chun-Kuang Yang

    2004-09-01

    Conclusion: There are few reports of successful pregnancy following conservative treatment for placenta accreta. Conservative treatment may increase the risk of secondary infertility, recurrent placenta accreta, and probably ectopic pregnancy.

  14. Trophoblast invasion and oxygenation of the placenta: measurements versus presumptions.

    Science.gov (United States)

    Huppertz, Berthold; Weiss, Gregor; Moser, Gerit

    2014-03-01

    Invasion of extravillous trophoblast into maternal tissues has a profound effect on the oxygenation of the placenta and hence the fetus. The main route of trophoblast invasion is interstitial invasion into the tissues of the decidua and myometrium. From this main route side branches reach the spiral arteries (endovascular trophoblast) as well as the uterine glands (endoglandular trophoblast) to open both structures toward the intervillous space. This enables histiotrophic nutrition in the first trimester and hemotrophic nutrition in the second and third trimesters of pregnancy. Failure of endovascular trophoblast invasion has profound effects on the oxygenation of the placenta. Interestingly, this does not lead to hypoxia as has long been presumed. Rather, all measurements available today point to increased oxygen levels within the placenta in patients with a failure of spiral artery transformation. This should lead to a rethink regarding pathological conditions such as intrauterine growth restriction and preeclampsia.

  15. [Maternal outcomes in pregnant women with pernicious placenta previa].

    Science.gov (United States)

    Zhu, Chang-kun; Wang, Fei; Zhou, Yu-mei; Ying, Jun; Chen, Dan-qing

    2015-05-01

    To analyze the maternal outcomes of pregnant women with pernicious placenta previa (PPP). Clinical data of 470 patients with placenta previa admitted in Women's Hospital Zhejiang University School of Medicine from August 2012 to August 2014 were collected and retrospectively analyzed. The patients were divided into pernicious group(n=101) and non-pernicious group(n=369) according to the history of cesarean section and location of placenta attached to the uterine. The general profiles, maternal outcomes of two groups were compared. The age, gravidity and rate of recurrent cavity surgery of pernicious group [(32.5 ± 4.1) y, 3.4 ± 1.2, 28.7%] were higher than those of non-pernicious group [(30.7 ± 4.5) y, 2.1 ± 1.4,13.6%] (Pplacenta accrete was significantly associated with postpartum massive hemorrhage in pernicious group (Pplacenta previa.

  16. A Case of Placenta Increta Mimicking Submucous Leiomyoma

    Directory of Open Access Journals (Sweden)

    Ali Ekiz

    2014-01-01

    Full Text Available In recent years with the increase in cesarean section rates, the frequency of placenta accreta cases rises. It causes 33–50% of all emergency peripartum hysterectomies. We present a 42-year-old case who was caught with early postpartum hemorrhage due to retained placental products. The ultrasonography showed a 65 × 84 mm mass in the uterine cavity after the delivery. Due to presence of early postpartum hemorrhage which needs transfusion, an intervention decision was made. The patient underwent curettage but the mass could not be removed so that placental retention was ruled out. Submucous leiomyoma was made as first-prediagnosis. Hysterectomy operation was performed as a curative treatment. Placenta increta diagnosis was made as a final diagnosis with pathological examination. As a result, placental attachment disorders may be overlooked if it is not a placenta previa case.

  17. Induced abortion and placenta complications in the subsequent pregnancy

    DEFF Research Database (Denmark)

    Zhou, Wei Jin; Nielsen, Gunnar Lauge; Larsen, Helle

    2001-01-01

    Background. To study the risk of placenta complications following an induced abortion as a function of the interpregnancy interval. Methods. This study is based on three Danish national registries; the Medical Birth Registry, the Hospital Discharge Registry, and the Induced Abortion Registry. All...... primigravida women from 1980 to 1982 were identified in these three registries. A total of 15,727 women who terminated the pregnancy with a first trimester induced abortion were selected to the abortion cohort, and 46,026 women who did not terminate the pregnancy with an induced abortion constituted...... or the Medical Birth Registry records. Results. A slightly higher risk of placenta complications following an abortion was found. Retained placenta occurred more frequently in women with one, two or more previous abortions, compared with women without any previous abortion of similar gravidity. Adjusting...

  18. Type and location of placenta previa affect preterm delivery risk related to antepartum hemorrhage.

    Science.gov (United States)

    Sekiguchi, Atsuko; Nakai, Akihito; Kawabata, Ikuno; Hayashi, Masako; Takeshita, Toshiyuki

    2013-01-01

    To evaluate whether type and location of placenta previa affect risk of antepartum hemorrhage-related preterm delivery. We retrospectively studied 162 women with singleton pregnancies presenting placenta previa. Through observation using transvaginal ultrasound the women were categorized into complete or incomplete placenta previa, and then assigned to anterior and posterior groups. Complete placenta previa was defined as a placenta that completely covered the internal cervical os, with the placental margin >2 cm from the os. Incomplete placenta previa comprised marginal placenta previa whose margin adjacent to the internal os and partial placenta previa which covered the os but the margin situated within 2 cm of the os. Maternal characteristics and perinatal outcomes in complete and incomplete placenta previa were compared, and the differences between the anterior and the posterior groups were evaluated. Antepartum hemorrhage was more prevalent in women with complete placenta previa than in those with incomplete placenta previa (59.1% versus 17.6%), resulting in the higher incidence of preterm delivery in women with complete than in those with incomplete placenta previa [45.1% versus 8.8%; odds ratio (OR) 8.51; 95% confidence interval (CI) 3.59-20.18; p placenta previa, incidence of antepartum hemorrhage did not significantly differ between the anterior and the posterior groups. However, gestational age at bleeding onset was lower in the anterior group than in the posterior group, and the incidence of preterm delivery was higher in the anterior group than in the posterior group (76.2% versus 32.0%; OR 6.8; 95% CI 2.12-21.84; p = 0.002). In incomplete placenta previa, gestational age at delivery did not significantly differ between the anterior and posterior groups. Obstetricians should be aware of the increased risk of preterm delivery related to antepartum hemorrhage in women with complete placenta previa, particularly when the placenta is located on the anterior

  19. More Than Clinical Waste? Placenta Rituals Among Australian Home-Birthing Women

    OpenAIRE

    Burns, Emily

    2014-01-01

    The discursive construction of the human placenta varies greatly between hospital and home-birthing contexts. The former, driven by medicolegal discourse, defines the placenta as clinical waste. Within this framework, the placenta is as much of an afterthought as it is considered the “afterbirth.” In home-birth practices, the placenta is constructed as a “special” and meaningful element of the childbirth experience. I demonstrate this using 51 in-depth interviews with women who were pregnant ...

  20. Dielectric properties of human placenta, umbilical cord and amniotic fluid

    Energy Technology Data Exchange (ETDEWEB)

    Peyman, A [Physical Dosimetry Department, Health Protection Agency, Chilton, Didcot OX11 0RQ (United Kingdom); Gabriel, C [MCL-P, Newbury RG14 5PY, Berkshire (United Kingdom); Benedickter, H R; Froehlich, J, E-mail: Azadeh.peyman@hpa.org.uk [Electromagnetic Fields and Microwave Electronics Laboratory, Swiss Federal Institute of Technology, Zurich (Switzerland)

    2011-04-07

    The dielectric properties of freshly delivered human placenta, umbilical cord and amniotic fluid have been acquired at 37 deg. C and in the frequency range of 200 MHz-10 GHz. The experimental data were fitted to a Cole-Cole expression. The results show that dielectric properties of the umbilical cord are significantly higher than placenta due to the presence of high water content Wharton's jelly. The results also demonstrate large differences in the dielectric properties of amniotic and cerebrospinal fluids. The data presented can be used in numerical simulations of the exposure of pregnant women to electromagnetic fields. (note)

  1. Dielectric properties of human placenta, umbilical cord and amniotic fluid

    Science.gov (United States)

    Peyman, A.; Gabriel, C.; Benedickter, H. R.; Fröhlich, J.

    2011-04-01

    The dielectric properties of freshly delivered human placenta, umbilical cord and amniotic fluid have been acquired at 37 °C and in the frequency range of 200 MHz-10 GHz. The experimental data were fitted to a Cole-Cole expression. The results show that dielectric properties of the umbilical cord are significantly higher than placenta due to the presence of high water content Wharton's jelly. The results also demonstrate large differences in the dielectric properties of amniotic and cerebrospinal fluids. The data presented can be used in numerical simulations of the exposure of pregnant women to electromagnetic fields.

  2. OBSERVATIONS ON VASCULAR PATTERN OF CHORIONIC BLOOD VESSELS OF PLACENTA

    Directory of Open Access Journals (Sweden)

    Yousuf Sarwar

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND: Placenta is a choriodecidual structure develops during pregnancy implanted on the uterine wall and car ries vital functions. It is connected to the foetus through umbilical cord. The branches of umbilical vessels that traverse along foetal surface of placenta are referred as chorionic vessels. There are two different patterns of chorionic vessels – Dispersa l and Magistral. In the dispersal type, the umbilical vessels undergo successive divisions with gradually diminishing caliber towards periphery while in magistral pattern the vessels traverse to the edge of placenta without appreciable decrease in diameter of vessels. The present study has been done for visualization of the pattern of chorionic vessels in placenta obtained from labour room of a tertiary care hospital in eastern Bihar, India. MATERIALS AND METHODS: A total of one hundred and fifty (150 fres h and intact placenta of full term pregnancies collected from Obstetrics & Gynaecology department were included in the study. After washing with distilled water, removal of blood clots were done with slight digital pressure applied over arteries and vein a nd later on by irrigation with saline. The cut end of the umbilical cord was carefully visualized to identify the umbilical arteries and vein. Dye was injected into umbilical vessels under normal physiological pressure and diameter of chorionic blood vesse ls were taken at the center and periphery. Ultimately each vessel was followed and examined to observe the dispersal and magistral pattern of chorionic blood vessels of placenta. RESULTS AND CONCLUSION: Out of the total of one hundred and fifty (150 full term placenta obtained and examined in the Anatomy department during the study period, 64% Dispersal type & 36 % of Magistral type of arterial pattern of branching of chorionic vessels were observed. Vein and its tributaries presented Dispersal pattern in 60% and Magistral pattern in 40%. There is a significant

  3. Clinical Analysis of Placenta Previa Complicated with Previous Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    Liang-kun Ma; Na Han; Jian-qiu Yang; Xu-ming Bian; Jun-tao Liu

    2012-01-01

    Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section.Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period.Results There was no difference in the mean age (28.9±3.6 vs.28.1±4.5 years) and the average gravidity (2.35 ± 1.48 vs.2.21 ± 1.53) between RCS group and FCS group (all P>0.05).The RCS group had more preterm births (24.1% vs.13.2%),complete placenta previa (55.2% vs.4.9%),placenta accreta (34.5% vs.2.5%),more blood loss during caesarean section (1412±602 vs.648 ±265 mL),blood transfusion (51.7% vs.4.9%),disseminated intravascular coagulation (13.8% vs.2.1%),and obstetric hysterectomy ( 13.8 % vs.0.8 %) than the F C S group (all P< 0.05).The preterm infant rate ( 30.0% vs.13.0%),neonatal asphyxia rate (10.0% vs.4.9%),and perinatal mortality rate (6.7% vs.0.4%) of the RCS group were higher than those of the FCS group (all P<0.05).Conclusions More patients had complete placenta previa and placenta accreta,postpartum hemorrhage,transfusion,uterine packing,obstetric hysterectomy,and perinatal morbidity in the placenta previa patients with previous caesarean section.The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.

  4. IFPA Meeting 2012 Workshop Report II: epigenetics and imprinting in the placenta, growth factors and villous trophoblast differentiation, role of the placenta in regulating fetal exposure to xenobiotics during pregnancy, infection and the placenta.

    Science.gov (United States)

    Ahmed, M S; Aleksunes, L M; Boeuf, P; Chung, M K; Daoud, G; Desoye, G; Díaz, P; Golos, T G; Illsley, N P; Kikuchi, K; Komatsu, R; Lao, T; Morales-Prieto, D M; Nanovskaya, T; Nobuzane, T; Roberts, C T; Saffery, R; Tamura, I; Tamura, K; Than, N G; Tomi, M; Umbers, A; Wang, B; Weedon-Fekjaer, M S; Yamada, S; Yamazaki, K; Yoshie, M; Lash, G E

    2013-03-01

    Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2012 there were twelve themed workshops, four of which are summarized in this report. These workshops related to various aspects of placental biology: 1) epigenetics and imprinting in the placenta; 2) growth factors and villous trophoblast differentiation; 3) role of the placenta in regulating fetal exposure to xenobiotics during pregnancy; 4) infection and the placenta.

  5. The effect of litter size, parity and farrowing duration on placenta expulsion and retention in sows

    NARCIS (Netherlands)

    Björkman, S.; Oliviero, C.; Rajala-Schultz, P.J.; Soede, N.M.; Peltoniemi, O.A.T.

    2017-01-01

    The hypothesis was that a prolonged parturition impairs placenta expulsion and can lead to retained placentas in sows. Furthermore, we hypothesized that application of oxytocin around the time of expulsion of the first placental part improves placenta expulsion. We recorded 142 parturitions of 10

  6. Retained placenta in Friesian mares : incidence, risk factors, therapy, and consequences

    NARCIS (Netherlands)

    Sevinga, M; Hesselink, JW; Barkema, H.W.

    2001-01-01

    This study concerns incidence, risk factors, therapy and consequences of retained placenta after normal foalings in Friesian mares. Retained placenta was defined as failure to expel all fetal membranes within 3 hours after the delivery of the foal. Incidence of retained placenta was studied in 495 p

  7. Frequency of placenta previa in women with history of previous caesarean and normal vaginal deliveries.

    Science.gov (United States)

    Bashir, Adeela; Jadoon, Humaira Naz; Abbasi, Aziz-un-Nisa

    2012-01-01

    Placenta previa is known to be associated with previous caesarean deliveries, advanced maternal age, increasing parity, smoking, curettage and myomectomy. This study was carried out to compare the frequency of placenta previa, in women with previous caesareans versus those with normal vaginal deliveries. It was one year study conducted at the Department of Obstetrics and Gynaecology Unit B, Ayub Teaching Hospital, Abbottabad. One hundred women were included in the study, 50 in Group A with previous caesarean deliveries, and 50 in Group B with previous normal vaginal deliveries. Frequency of placenta previa in both groups was analysed. Placenta previa was found in one (2%) woman in Group A, and in two women (4%) in Group B. It was not found in para 4 or less in both groups. One woman in Group A and two women in Group B with parity 4 or more had placenta previa (p placenta previa, while with previous 2 scars one had placenta previa (p placenta previa in Group A and both women with placenta previa in Group B were more than 25 years old. Placenta previa was not found in women below 25 years of age. Previous one caesarean section did not increase the frequency of placenta previa. Increasing number of scars, increasing maternal age beyond 25 years and increasing parity beyond 4 were associated with placenta previa.

  8. The evolving placenta: Convergent evolution of variations in the endotheliochorial relationship

    DEFF Research Database (Denmark)

    Enders, A C; Carter, Anthony Michael

    2012-01-01

    Endotheliochorial placentas occur in orders from all four major clades of eutherian mammal. Species with this type of placenta include one of the smallest (pygmy shrew) and largest (African elephant) land mammals. The endotheliochorial placenta as a definitive form has an interhemal area consisting...

  9. [Application of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa complicated with placenta accreta].

    Science.gov (United States)

    Cui, S H; Zhi, Y X; Zhang, K; Zhang, L D; Shen, L N; Gao, Y N

    2016-09-25

    Objective: To investigate the value of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa with placenta accreta. Methods: From January 2015 to February 2016, 24 cases of complete placenta previa with placenta accreta were treated with temporary balloon occlusion of the abdominal aorta(the study group)before cesarean, and 24 cases of complete placenta previa with placenta accreta did not receive balloon occlusion(the control group). The operation time, intraoperative blood loss, intraoperative blood transfusion volume, the perioperative hemoglobin level, the hysterectomy rate and the related complications were compared retrospectively.Also, the hospitalization time, the blood coagulation parameters after operation, including activated partial thromboplastin time(APTT), fibrinogen(FIB), D-Dimer and reperfusion injury parameters including creatine phosphokinase(CK), creatine phosphokinase isoenzyme(CK-MB), lactate dehydrogenase(LDH)and serum creatinine were compared between the 2 groups. Results: The blood loss[750 ml(400- 2 000 ml)vs 2 000 ml(1 500- 2 375 ml); Z=-3.214, P=0.001]and blood transfusion volume[200 ml(0-800 ml)vs 800 ml(0-1 200 ml); Z=- 2.173, P=0.030]in the study group were lower than in the control group. The hemoglobin difference between before and after operation in the study group was lower than the control group[(12.8±13.4)g/L vs(22.9±20.1)g/L; t=-2.041, P=0.047]. In the study group, there were still bleeding in 13 cases after releasing the balloon, 5 of them received uterine artery embolization, 5 cases received uterine artery ligation, and 3 cases received uterine packing. One case had venous thrombosis in the right lower limb. Two cases(8%,2/24)in the control group had hysterectomy, while none in the study group, there was no statistical significance(P= 0.489). Conclusions: Temporary balloon occlusion of the abdominal aorta can effectively reduce blood loss and blood transfusion in the treatment of

  10. [Risk factors of peripartum hysterectomy in placenta previa: a retrospective study of 3 840 cases].

    Science.gov (United States)

    Lyu, B; Chen, M; Liu, X X

    2016-07-25

    To investigate the risk factors of peripartum hysterectomy in placenta previa through retrospective study of 3 840 placenta previa cases. The clinical data of 3 840 patients with placenta previa who delivered in West China Second University Hospital between Jan 2005 and June 2014 were analyzed retrospectively. The relationship of certain factors and peripartum hysterectomy was analyzed, including maternal age, residence place, parity, prior curettage, prior cesarean section, twin or multiple pregnancy, antenatal vaginal bleeding, type of placenta previa, suspected placenta accreta, antenatal level of hemoglobin and gestational age at delivery. The prevalence of placenta previa was 4.84%(3 840/79 304)in West China Second University Hospital during the study period, and the incidence of preipartum hysterectomy in patients with placenta previa was 2.76%(106/3 840). One-factor analysis demonstrated that residence place, parity, times of prior curettage, prior cesarean section, prenatal vaginal bleeding, anterior placenta, type of placenta previa, placenta accreta, antenatal anemia and gestational age at delivery were potential risk factors for peripartum hysterectomy(Pplacenta(OR=4.8, 95%CI:2.1-10.7), complete placenta previa(OR=5.9, 95%CI: 1.8-42.5), placenta accreta(OR=11.2, 95%CI:6.8-18.6), antenatal hemoglobinplacenta previa(Pplacenta, complete placenta previa, placenta accreta, antenatal anemia and delivery before 34 gestational weeks are high risk factors of peripartum hysterectomy in placenta previa patients. Perinatal care and risk evaluation before cesarean section are important to improve perinatal outcomes and reduce peripartum hysterectomy.

  11. Invasive placenta previa: Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI - useful features for differentiating placenta percreta from placenta accreta.

    Science.gov (United States)

    Chen, Xin; Shan, Ruiqin; Zhao, Lianxin; Song, Qingxu; Zuo, Changting; Zhang, Xinjuan; Wang, Shanshan; Shi, Honglu; Gao, Fei; Qian, Tianyi; Wang, Guangbin; Limperopoulos, Catherine

    2017-08-02

    To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA). Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson's chi-squared or Fisher's two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA. Significant differences were found in nine MRI features between women with PP and those with PA (P <0.05). Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P < 0.001; odds ratio = 4.165, P = 0.018 respectively), and the combination of the two MRI features to distinguish PP from PA yielded an AUC of 0.92 for its predictive performance. Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA. • Placental bulge type-II demonstrated the strongest independent association with PP. • Uterine serosal hypervascularity is a useful feature for differentiating PP from PA. • MRI features associated with abnormal vessels increase the risk of massive haemorrhage.

  12. Placenta as a source of hematopoietic stem cells

    NARCIS (Netherlands)

    E.A. Dzierzak (Elaine); C. Robin (Catherine)

    2010-01-01

    textabstractThe placenta is a large, highly vascularised hematopoietic tissue that functions during the embryonic and foetal development of eutherian mammals. Although recognised as the interface tissue important in the exchange of oxygen, nutrients and waste products between the foetus and mother,

  13. Placenta previa: outcomes in scarred and unscarred uterus

    Directory of Open Access Journals (Sweden)

    Rajshree Dayanand Katke

    2016-08-01

    Conclusions: In conclusion, primary prevention in the form of reduction in the rate of primi cesearean section must be done in order to prevent likelihood of placenta previa in scarred uteri. Early diagnosis by Ultrasound and planned delivery should be the goal. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2728-2732

  14. Analytical theory of oxygen transport in the human placenta.

    Science.gov (United States)

    Serov, A S; Salafia, C M; Filoche, M; Grebenkov, D S

    2015-03-07

    We propose an analytical approach to solving the diffusion-convection equations governing oxygen transport in the human placenta. We show that only two geometrical characteristics of a placental cross-section, villi density and the effective villi radius, are needed to predict fetal oxygen uptake. We also identify two combinations of physiological parameters that determine oxygen uptake in a given placenta: (i) the maximal oxygen inflow of a placentone if there were no tissue blocking the flow and (ii) the ratio of transit time of maternal blood through the intervillous space to oxygen extraction time. We derive analytical formulas for fast and simple calculation of oxygen uptake and provide two diagrams of efficiency of oxygen transport in an arbitrary placental cross-section. We finally show that artificial perfusion experiments with no-hemoglobin blood tend to give a two-orders-of-magnitude underestimation of the in vivo oxygen uptake and that the optimal geometry for such setup alters significantly. The theory allows one to adjust the results of artificial placenta perfusion experiments to account for oxygen-hemoglobin dissociation. Combined with image analysis techniques, the presented model can give an easy-to-use tool for prediction of the human placenta efficiency.

  15. The human placenta--an alternative for studying foetal exposure

    DEFF Research Database (Denmark)

    Myren, Maja; Mose, Tina; Mathiesen, Line;

    2007-01-01

    , and though its main task is to act as a barrier and transport nutrients and oxygen to the foetus, many foreign compounds are transported across the placenta to some degree and may therefore influence the unborn child. Foetal exposures to environmental and medicinal products may have impact on the growth...

  16. Placenta as a source of hematopoietic stem cells

    NARCIS (Netherlands)

    E.A. Dzierzak (Elaine); C. Robin (Catherine)

    2010-01-01

    textabstractThe placenta is a large, highly vascularised hematopoietic tissue that functions during the embryonic and foetal development of eutherian mammals. Although recognised as the interface tissue important in the exchange of oxygen, nutrients and waste products between the foetus and mother,

  17. Oxygen diffusive conductance in placentae from control and diabetic women

    DEFF Research Database (Denmark)

    Mayhew, T M; Sørensen, Flemming Brandt; Klebe, J G

    1993-01-01

    Random tissue sections of placentae from control and diabetic deliveries were analysed stereologically. The aim was to test whether or not adaptations in oxygen diffusive conductances occur to help compensate for fetal hypoxic stress in utero. Organs were from 34 control and 55 diabetic deliveries...

  18. In situ measurements of magnetic nanoparticles after placenta perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Müller, Robert, E-mail: robert.mueller@ipht-jena.de [Leibniz-Institute of Photonic Technology (IPHT), Jena (Germany); Gläser, Marcus [Leibniz-Institute of Photonic Technology (IPHT), Jena (Germany); University of Applied Sciences, Jena (Germany); Göhner, Claudia; Seyfarth, Lydia; Schleussner, Ekkehard [Department of Obstetrics and Gynecology, Jena University Hospital (Germany); Hofmann, Andreas [HTS Systeme GmbH, Wallenfels (Germany); Fritzsche, Wolfgang [Leibniz-Institute of Photonic Technology (IPHT), Jena (Germany)

    2015-04-15

    Nanoparticles (NP) present promising tools for medical applications. However, the investigation of their spatial and temporal distribution is hampered by missing in-situ particle detection and quantification technologies. The placenta perfusion experiment represents an interesting model for the study of the particle distribution at a biological barrier. It allows the ex-vivo investigation of the permeability of the placenta for materials of interest. We introduce an approach based on a magnetic system for an in situ measurement of the concentration of magnetic NPs in such an experiment. A previously off-line utilized magnetic readout device (sensitivity of ≈10{sup −8} Am{sup 2}) was used for long term measurements of magnetic NP of 100–150 nm size range in a closed circuit of a placenta perfusion. It represents a semiquantitative approach. The behavior of particles in the placenta and in the measurement system was studied, as well as the influence of particle surface modifications. The results suggest a transfer of a low amount of particles from the maternal to the fetal blood circuit.

  19. Can we make the pig placenta work better?

    Science.gov (United States)

    The number of piglets born alive at each parity contributes to the efficiency of swine production. Moreover, piglet birth weights affect both survival to weaning and future growth rate. Litter size and birth weight are influenced by placental function. The pig placenta is classified as diffuse epith...

  20. Kinetics of gold nanoparticles in the human placenta.

    Science.gov (United States)

    Myllynen, Päivi K; Loughran, Michael J; Howard, C Vyvyan; Sormunen, Raija; Walsh, Adrian A; Vähäkangas, Kirsi H

    2008-10-01

    We studied the transfer of PEGylated gold nanoparticles through perfused human placenta. In 'once-through' perfusions using 15 and 30nm nanoparticles both maternal and fetal outflows were collected. Recirculating perfusions using 10 or 15nm nanoparticles lasted 6h. The gold concentration in samples was analysed on ICP-MS. The reference compound antipyrine crossed the placenta rapidly, as expected. In open perfusions nanoparticles were detected in maternal but not in fetal outflow, suggesting the lack of placental transfer. During 6h re-circulating perfusions, no particles were detected in fetal circulation. Using transmission electron microscopy (TEM) and silver enhancement, nanoparticles could be visualized in the placental tissue mainly in the trophoblastic cell layer. In in vitro experiments, nanoparticles were taken up by BeWo choriocarcinoma cells and retained inside the cells for an extended period of 48h. In conclusion, PEGylated gold nanoparticles of the size 10-30nm did not cross the perfused human placenta in detectable amounts into the fetal circulation within 6h. Whether PEGylated gold nanoparticles eventually are able to cross placenta and whether nanoparticles affect placental functions needs to be further studied.

  1. Epidemiology, Etiology, Diagnosis, and Management of Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Gali Garmi

    2012-01-01

    Full Text Available Placenta accreta is a severe pregnancy complication and is currently the most common indication for peripartum hysterectomy. It is becoming an increasingly common complication mainly due to the increasing rate of cesarean delivery. Main risk factor for placenta accreta is a previous cesarean delivery particularly when accompanied with a coexisting placenta previa. Antenatal diagnosis seems to be a key factor in optimizing maternal outcome. Diagnosis can be achieved by ultrasound in the majority of cases. Women with placenta accreta are usually delivered by a cesarean section. In order to avoid an emergency cesarean and to minimize complications of prematurity it is acceptable to schedule cesarean at 34 to 35 weeks. A multidisciplinary team approach and delivery at a center with adequate resources, including those for massive transfusion are both essential to reduce neonatal and maternal morbidity and mortality. The optimal management after delivery of the neonate is vague since randomized controlled trials and large cohort studies are lacking. Cesarean hysterectomy is probably the preferable treatment. In carefully selected cases, when fertility is desired, conservative management may be considered with caution. The current review discusses the epidemiology, predisposing factors, pathogenesis, diagnostic methods, clinical implications and management options of this condition.

  2. The metallome of the human placenta in gestational diabetes mellitus.

    Science.gov (United States)

    Roverso, Marco; Berté, Chiara; Di Marco, Valerio; Lapolla, Annunziata; Badocco, Denis; Pastore, Paolo; Visentin, Silvia; Cosmi, Erich

    2015-07-01

    Obtaining the knowledge of the "omics" and therefore of the metallomics of gestational diabetes mellitus (GDM) appears to be a necessary task to obtain information about the molecular causes of this disease. In this study, the metallome of GDM and of other types of diabetes mellitus was first reviewed. The comparative analysis of the published data revealed that no GDM elemental markers could be identified with sufficient reliability in blood or in the other considered samples, with the partial exception of selenium. The placenta was chosen as an alternative target organ for the analysis of the GDM metallome. The full elemental average composition of 19 healthy placentas was obtained by ICP-MS. Analyses were then performed on 28 placentas from women affected by GDM. The statistical tests and the principal component analysis evidenced that cadmium was found in lower concentrations and selenium was found in higher concentrations in GDM placentas than in those of the control group. These results were interpreted in light of literature data, and they attract attention on two key elements for understanding the molecular pathways of GDM.

  3. In situ measurements of magnetic nanoparticles after placenta perfusion

    Science.gov (United States)

    Müller, Robert; Gläser, Marcus; Göhner, Claudia; Seyfarth, Lydia; Schleussner, Ekkehard; Hofmann, Andreas; Fritzsche, Wolfgang

    2015-04-01

    Nanoparticles (NP) present promising tools for medical applications. However, the investigation of their spatial and temporal distribution is hampered by missing in-situ particle detection and quantification technologies. The placenta perfusion experiment represents an interesting model for the study of the particle distribution at a biological barrier. It allows the ex-vivo investigation of the permeability of the placenta for materials of interest. We introduce an approach based on a magnetic system for an in situ measurement of the concentration of magnetic NPs in such an experiment. A previously off-line utilized magnetic readout device (sensitivity of ≈10-8 Am2) was used for long term measurements of magnetic NP of 100-150 nm size range in a closed circuit of a placenta perfusion. It represents a semiquantitative approach. The behavior of particles in the placenta and in the measurement system was studied, as well as the influence of particle surface modifications. The results suggest a transfer of a low amount of particles from the maternal to the fetal blood circuit.

  4. Status of windowpane oyster Placuna placenta (Linnaeus) population in Goa

    Digital Repository Service at National Institute of Oceanography (India)

    Ingole, B.S.; Clemente, S.

    of medicines under the Indian system. The percentage of pearl formation in the natural population of P. placenta is higher in Goa (about 35%) compared to other regions in India. There is considerable scope of this important resource particularly for extracting...

  5. Nitrate Promotes Capsaicin Accumulation in Capsicum chinense Immobilized Placentas

    Directory of Open Access Journals (Sweden)

    Jeanny G. Aldana-Iuit

    2015-01-01

    Full Text Available In chili pepper’s pods, placental tissue is responsible for the synthesis of capsaicinoids (CAPs, the compounds behind their typical hot flavor or pungency, which are synthesized from phenylalanine and branched amino acids. Placental tissue sections from Habanero peppers (Capsicum chinense Jacq. were immobilized in a calcium alginate matrix and cultured in vitro, either continuously for 28 days or during two 14-day subculture periods. Immobilized placental tissue remained viable and metabolically active for up to 21 days, indicating its ability to interact with media components. CAPs contents abruptly decreased during the first 7 days in culture, probably due to structural damage to the placenta as revealed by scanning electron microcopy. CAPs levels remained low throughout the entire culture period, even though a slight recovery was noted in subcultured placentas. However, doubling the medium’s nitrate content (from 40 to 80 mM resulted in an important increment, reaching values similar to those of intact pod’s placentas. These data suggest that isolated pepper placentas cultured in vitro remain metabolically active and are capable of metabolizing inorganic nitrogen sources, first into amino acids and, then, channeling them to CAP synthesis.

  6. Placenta retention in the cow: Report of three cases

    African Journals Online (AJOL)

    ADEYEYE

    2016-06-17

    Jun 17, 2016 ... August, 2016. 73. ROP has a significant adverse impact on health, .... as well as many other metabolic or reproductive conditions ... in vitro study when placenta samples from human, equine and ... agents (Arthur & Bee, 1996). This however ... implication of eating such meat since that uterus was highly ...

  7. Purification and characterization of a soluble calnexin from human placenta

    DEFF Research Database (Denmark)

    Olsen, Dorthe T; Peng, Li; Træholt, Sofie D;

    2013-01-01

    Calreticulin (Crt) and calnexin (Cnx) are homologous endoplasmic reticulum (ER) chaperones involved in protein folding and quality control. Crt is a soluble ER luminal Mr 46 kDa protein and Cnx is a Mr 67kDa ER membrane protein. During purification of Crt from human placenta a soluble form of Cnx...

  8. The evolution of the mammal placenta — a computational approach to the identification and analysis of placenta-specific genes and microRNAs.

    OpenAIRE

    Walsh, Thomas A.

    2013-01-01

    The presence of a placenta is an important synapomorphy that defines the mammal clade. From the fossil record we know that the first placental mammal lived approximately 125 million years ago, with the chorioallantoic placenta evolving not long after. In this thesis a set of 22 complete genomes from Eutherian, non-Eutherian and outgroup species are compared, the aim being to identify protein-coding and regulatory alterations that are likely to be implicated in the emergence of mammal placenta...

  9. Natural killer cells and HLA-G expression in the basal decidua of human placenta adhesiva.

    Science.gov (United States)

    van Beekhuizen, H J; Joosten, I; Lotgering, F K; Bulten, J; van Kempen, L C

    2010-12-01

    Retained placenta is caused by abnormal adherence of the placenta to the uterine wall, leading to delayed expulsion of the placenta and causing postpartum haemorrhage. The mildest form of retained placenta is the placenta adhesiva (PA), of which the cause is unknown. The aim of our study was to explore possible differences in immune response in the basal decidua between PA and control placentas (CP). We performed a descriptive analysis of immunohistochemical differences in 17 PA and 10 CP. Our results show that in PA the amount of uterine natural killer (uNK) cells is significantly reduced (0.2 uNK cell/standardised area) as compared to CP (9.8 uNK cell/standardised area, p placenta.

  10. Complement inhibitory proteins expression in placentas of thrombophilic women Complement inhibitory proteins expression in placentas of thrombophilic women

    Directory of Open Access Journals (Sweden)

    Przemysław Krzysztof Wirstlein

    2012-10-01

    Full Text Available Factors controlling complement activation appear to exert a protective effect on pregnancy. This is
    particularly important in women with thrombophilia. The aim of this study was to determine the transcript and
    protein levels of complement decay-accelerating factor (DAF and membrane cofactor protein (MCP in the
    placentas of women with acquired and inherited thrombophilia. Also, we assessed immunohistochemistry staining
    of inhibitors of the complement cascade, DAF and MCP proteins, in the placentas of thrombophilic women.
    Placentas were collected from eight women with inherited thrombophilia and ten with acquired thrombophilia.
    The levels of DAF and MCP transcripts were evaluated by qPCR, the protein level was evaluated by Western
    blot. We observed a higher transcript (p < 0.05 and protein (p < 0.001 levels of DAF and MCP in the placentas
    of thrombophilic women than in the control group. DAF and MCP were localized on villous syncytiotrophoblast
    membranes, but the assessment of staining in all groups did not differ. The observed higher expression level of
    proteins that control activation of complement control proteins is only seemingly contradictory to the changes
    observed for example in the antiphospholipid syndrome. However, given the hitherto known biochemical changes
    associated with thrombophilia, a mechanism in which increased expression of DAF and MCP in the placentas is
    an effect of proinflammatory cytokines, which accompanies thrombophilia, is probable.Factors controlling complement activation appear to exert a protective effect on pregnancy. This is
    particularly important in women with thrombophilia. The aim of this study was to determine the transcript and
    protein levels of complement decay-accelerating factor (DAF and membrane cofactor protein (MCP in the
    placentas of women with acquired and inherited thrombophilia. Also, we assessed immunohistochemistry

  11. Antioxidative Defense Enzymes in Placenta Protect Placenta and Fetus in Inherited Thrombophilia from Hydrogen Peroxide

    Directory of Open Access Journals (Sweden)

    Jelena Bogdanovic Pristov

    2009-01-01

    Full Text Available Our aim was to investigate the activities of antioxidative defense enzymes in the placenta, fetal blood and amnion fluid in inherited thrombophilia. Thrombophilia was associated with nearly threefold increase of activity (p < 0.001 of the placental catalase (81.1 ± 20.6 U/mg of proteins in controls and 270.0 ± 69.9 U/mg in thrombophilic subjects, glutathione (GSH peroxidase (C: 20.2 ± 10.1 U/mg; T: 60.0 ± 15.5 U/mg, and GSH reductase (C: 28.9 ± 5.6 U/mg; T: 72.7 ± 23.0 U/mg. The placental activities of superoxide dismutating enzymes—MnSOD and CuZnSOD, did not differ in controls and thrombophilia. Likewise, the activities of catalase and SOD in the fetal blood, and the level of ascorbyl radical which represents a marker of oxidative status of amniotic fluid, were similar in controls and thrombophilic subjects. From this we concluded that in thrombophilia, placental tissue is exposed to H2O2-mediated oxidative stress, which could be initiated by pro-thrombic conditions in maternal blood. Increased activity of placental H2O2-removing enzymes protects fetus and mother during pregnancy, but may increase the risk of postpartum thrombosis.

  12. Expression of the Thomsen-Friedenreich (TF) tumor antigen in human abort placentas.

    Science.gov (United States)

    Richter, D U; Jeschke, U; Bergemann, C; Makovitzky, J; Lüthen, F; Karsten, U; Briese, V

    2005-01-01

    The Thomsen-Friedenreich antigen (TF), or more precisely epitope, has been known as a pancarcinoma antigen. It consists of galactose-beta1-3-N-acetylgalactose. We have already described the expression of TF in the normal placenta. TF is expressed by the syncytium and by extravillous trophoblast cells. In this study, we investigated the expression of TF in the abort placenta. Frozen samples of human abort placentas (12 placentas), obtained from the first and second trimesters of pregnancy and, for comparison, samples of normal placentas (17 placentas) from the first, second and third trimesters of pregnancy, were used. Expression of TF was investigated by immunohistochemical methods. For identification of TF-positive cells in abort placentas, immunofluorescence methods were used. Evaluation of simple and double immunofluorescence was performed on a laser scanning microscope. Furthermore, we isolated trophoblast cells from first and third trimester placentas and evaluated cytokeratin 7 and Muc1 expression by immunofluorescence methods. We observed expression of TF antigen in the syncytiotrophoblasts layer of the placenta in all three trimesters of pregnancy in normal and abort placentas evaluated by immunohistochemical methods. There was no expression of TF antigen in the decidua of abort placentas. Immunofluorescence double staining of TF antigen and cytokeratin 7 showed reduced expression of both antigens in the abort decidua and co-expression of both antigens in the syncytiotrophoblast layer of normal and abort placentas. TF expression in the syncytiotrophoblast was reduced in abort placentas. In the isolated trophoblast cells, no TF expression was found, however, Muc1 expression was visualized. Expression of TF antigen was reduced in the first and second trimester abort decidua compared to the normal decidua during the same time of pregnancy. TF antigen was restricted to the syncytiotrophoblast and extravillous trophoblast cells in the decidua. Abort placentas

  13. Placenta Maps: In Utero Placental Health Assessment of the Human Fetus.

    Science.gov (United States)

    Miao, Haichao; Mistelbauer, Gabriel; Karimov, Alexey; Alansary, Amir; Davidson, Alice; Lloyd, David; Damodaram, Mellisa; Story, Lisa; Hutter, Jana; Hajnal, Joseph; Rutherford, Mary; Preim, Bernhard; Kainz, Bernhard; Groller, M Eduard

    2017-02-24

    The human placenta is essential for the supply of the fetus. To monitor the fetal development, imaging data is acquired using ultrasound (US). Although it is currently the gold-standard in fetal imaging, it might not capture certain abnormalities of the placenta. Magnetic resonance imaging (MRI) is a safe alternative for the in utero examination while acquiring the fetus data in higher detail. Nevertheless, there is currently no established procedure for assessing the condition of the placenta and consequently the fetal health. Due to maternal respiration and inherent movements of the fetus during examination, a quantitative assessment of the placenta requires fetal motion compensation, precise placenta segmentation and a standardized visualization, which are challenging tasks. Utilizing advanced motion compensation and automatic segmentation methods to extract the highly versatile shape of the placenta, we introduce a novel visualization technique that presents the fetal and maternal side of the placenta in a standardized way. Our approach enables physicians to explore the placenta even in utero. This establishes the basis for a comparative assessment of multiple placentas to analyze possible pathologic arrangements and to support the research and understanding of this vital organ. Additionally, we propose a three-dimensional structure-aware surface slicing technique in order to explore relevant regions inside the placenta. Finally, to survey the applicability of our approach, we consulted clinical experts in prenatal diagnostics and imaging. We received mainly positive feedback, especially the applicability of our technique for research purposes was appreciated.

  14. The evolving placenta: convergent evolution of variations in the endotheliochorial relationship.

    Science.gov (United States)

    Enders, A C; Carter, A M

    2012-05-01

    Endotheliochorial placentas occur in orders from all four major clades of eutherian mammal. Species with this type of placenta include one of the smallest (pygmy shrew) and largest (African elephant) land mammals. The endotheliochorial placenta as a definitive form has an interhemal area consisting of maternal endothelium, interstitial lamina, trophoblast, individual or conjoint basal laminas, and fetal endothelium. We commonly think of such placentas as having hypertrophied maternal endothelium with abundant rough endoplasmic reticulum (rER), and as having hemophagous regions. Considering them as a whole, the trophoblast may be syncytial or cellular, fenestrated or nonfenestrated, and there may or may not be hemophagous regions. Variations also appear in the extent of hypertrophy of the maternal endothelium and in the abundance of rER in these cells. This combination of traits and a few other features produces many morphological variants. In addition to endotheliochorial as a definitive condition, a transitory endotheliochorial condition may appear in the course of forming a hemochorial placenta. In some emballonurid bats the early endotheliochorial placenta has two layers of trophoblast, but the definitive placenta lacks an outer syncytial trophoblast layer. In mollosid bats a well developed endotheliochorial placenta is present for a short time even after a definitive hemochorial placenta has developed in a different region. It is concluded that the endotheliochorial placenta is more widespread and diversified than originally thought, with the variant with cellular trophoblast in particular appearing in several species studied recently.

  15. Endothelial and lipoprotein lipases in human and mouse placenta

    DEFF Research Database (Denmark)

    Lindegaard, Marie L S; Olivecrona, Gunilla; Christoffersen, Christina;

    2005-01-01

    Placenta expresses various lipase activities. However, a detailed characterization of the involved genes and proteins is lacking. In this study, we compared the expression of endothelial lipase (EL) and LPL in human term placenta. When placental protein extracts were separated by heparin......-Sepharose affinity chromatography, the EL protein eluted as a single peak without detectable phospholipid or triglyceride (TG) lipase activity. The major portion of LPL protein eluted slightly after EL. This peak also had no lipase activity and most likely contained monomeric LPL. Fractions eluting at a higher Na......Cl concentration contained small amounts of LPL protein (most likely dimeric LPL) and had substantial TG lipase activity. In situ hybridization studies showed EL mRNA expression in syncytiotrophoblasts and endothelial cells and LPL mRNA in syncytiotrophoblasts. In contrast, immunohistochemistry showed EL and LPL...

  16. Sonographic features of placenta accreta after first-trimester abortion.

    Science.gov (United States)

    Li, Ping; Zheng, Qichao; Xiong, Bin; Cai, Hongbing

    2013-08-01

    We assessed 5 patients with histologically/clinically confirmed placenta accreta after first-trimester abortion. In 4 patients, sonography showed an unclear endometrium, absence of an endometrium-myometrium interface, a well-vascularized hyperechoic lesion in the uterine body with a low resistive index, and myometrial thinning near the lesion. In 2 patients, contrast-enhanced sonography showed rapid irregular lesion enhancement. Chemotherapy reduced the lesions in 3 patients, and a decreased blood supply increased the resistive index in all lesions. Two patients each underwent hysterectomy and uterine curettage. The fifth patient had a cervical pregnancy; sonography showed a well-vascularized hyperechoic lesion in an enlarged cervix. Methotrexate gradually reduced this lesion. Sonography, especially contrast-enhanced sonography, can detect placenta accreta and guide treatment.

  17. Infectious lesions of placenta as cause of miscarriage

    Directory of Open Access Journals (Sweden)

    A. V. Kolobov

    2015-01-01

    Full Text Available Analysis of the literature demonstratesimportant role played of infections in causes of miscarriage. The paper is based upon retrospective analysis of 12371 screening results of histological and selective immunohistochemical studies of placentas in 2009-12. Preterm births were in 706 cases (5.71%. Infection of the placenta was noted in early preterm labor in all cases (100%, and in premature labor at 28-36 weeks of gestation – in 97.35% of natural delivery cases and in 92.09% when cesarean delivery. Are described the typical structural changes that allow to suspect infections caused by Treponema pallidum, herpes viruses, human immunodeficiency virus, parvovirus with following verification by immunohistochemical study. 

  18. Abnormally invasive placenta-prevalence, risk factors and antenatal suspicion

    DEFF Research Database (Denmark)

    Thurn, L; Lindqvist, P G; Jakobsson, M;

    2016-01-01

    of women at high risk will likely strengthen antenatal suspicion. Prior PPH is a novel risk factor associated with an increased prevalence of AIP. TWEETABLE ABSTRACT: An ultrasound assessment in women with placenta praevia or prior CS may double the awareness for AIP.......OBJECTIVE: The objective was to investigate prevalence, estimate risk factors, and antenatal suspicion of abnormally invasive placenta (AIP) associated with laparotomy in women in the Nordic countries. DESIGN: Population-based cohort study. SETTING AND POPULATION: A 3-year Nordic collaboration...... National health registries. MAIN OUTCOME MEASURES: Prevalence, risk factors, antenatal suspicion, birth complications, and risk estimations using aggregated national data. RESULTS: A total of 205 cases of AIP in association with laparotomy were identified, representing 3.4 per 10 000 deliveries. The single...

  19. Gene expression profiling of placentas affected by pre-eclampsia

    DEFF Research Database (Denmark)

    Hoegh, Anne Mette; Borup, Rehannah; Nielsen, Finn Cilius;

    2010-01-01

    Several studies point to the placenta as the primary cause of pre-eclampsia. Our objective was to identify placental genes that may contribute to the development of pre-eclampsia. RNA was purified from tissue biopsies from eleven pre-eclamptic placentas and eighteen normal controls. Messenger RNA...... expression from pooled samples was analysed by microarrays. Verification of the expression of selected genes was performed using real-time PCR. A surprisingly low number of genes (21 out of 15,000) were identified as differentially expressed. Among these were genes not previously associated with pre-eclampsia...... as bradykinin B1 receptor and a 14-3-3 protein, but also genes that have already been connected with pre-eclampsia, for example, inhibin beta A subunit and leptin. A low number of genes were repeatedly identified as differentially expressed, because they may represent the endpoint of a cascade of events...

  20. Expression of RhoA in Placenta of Preeclampsia

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    In order to detect the expression of RhoA in placenta from normal pregnancy and preeclampsia and evaluate the role of RhoA in preeclampsia, the expression of RhoA in placenta collected from 40 preeclampsia patientsand 20 normotensive controls was determined by immunohistochemistry and RT-PCR. RhoA was found in syncytiotrophoblasts and cytotrophoblasts. The mean density of RhoA protein in placental tissues of mild and severe preeclampsia groups was significantly higher than that in normal pregnancy. The expression level of RhoA mRNA in mild and severe preeclampsia groups was significantly higher than that of normal pregnancy. Increased expression of RhoA in placental tissues might play an important role in the pathogenesis of preeclampsia.

  1. From Placenta to Polycystic Ovarian Syndrome: The Role of Adipokines

    Directory of Open Access Journals (Sweden)

    Chiara Sartori

    2016-01-01

    Full Text Available Adipokines are cytokines produced mainly by adipose tissue, besides many other tissues such as placenta, ovaries, peripheral-blood mononuclear cells, liver, muscle, kidney, heart, and bone marrow. Adipokines play a significant role in the metabolic syndrome and in cardiovascular diseases, have implications in regulating insulin sensitivity and inflammation, and have significant effects on growth and reproductive function. The objective of this review was to analyze the functions known today of adiponectin, leptin, resistin, and visfatin from placenta throughout childhood and adolescence. It is well known now that their serum concentrations during pregnancy and lactation have long-term effects beyond the fetus and newborn. With regard to puberty, adipokines are involved in the regulation of the relationship between nutritional status and normal physiology or disorders of puberty and altered gonadal function, as, for example, premature pubarche and polycystic ovarian syndrome (PCOS. Cytokines are involved in the maturation of oocytes and in the regular progression of puberty and pregnancy.

  2. Gene expression profiling of placentas affected by pre-eclampsia

    DEFF Research Database (Denmark)

    Hoegh, Anne Mette; Borup, Rehannah; Nielsen, Finn Cilius

    2010-01-01

    Several studies point to the placenta as the primary cause of pre-eclampsia. Our objective was to identify placental genes that may contribute to the development of pre-eclampsia. RNA was purified from tissue biopsies from eleven pre-eclamptic placentas and eighteen normal controls. Messenger RNA...... expression from pooled samples was analysed by microarrays. Verification of the expression of selected genes was performed using real-time PCR. A surprisingly low number of genes (21 out of 15,000) were identified as differentially expressed. Among these were genes not previously associated with pre-eclampsia...... as bradykinin B1 receptor and a 14-3-3 protein, but also genes that have already been connected with pre-eclampsia, for example, inhibin beta A subunit and leptin. A low number of genes were repeatedly identified as differentially expressed, because they may represent the endpoint of a cascade of events...

  3. MATERNAL AND PERINATAL OUTCOME IN PREGNANCIES COMPLICATED BY PLACENTA PREVIA

    Directory of Open Access Journals (Sweden)

    Rajendra

    2015-06-01

    Full Text Available AIMS AND OBJECTIVES: To evaluate the maternal and perinatal outcome of pregnancies complicated with placenta previa at tertiary care centre and to evaluate the potential risk factors involved in pregnancies complicated with placenta previa at tertiary care C ent re. METHOD: We carried out 2 year retrospective observational study during period from November 2009 to October 2011 Tertiary care hospital and medical college. ANC cases with history of bleeding per vaginum after 28 weeks attending ANC clinic and emergenc y ward were included in study with appropriate age parity matched controls with other complications like pregnancy induced hypertension, abruption placentae, multiple gestation were excluded. Demographic data, medical and surgical histories, all the events regarding maternal and perinatal mortality were recorded. Data was analysed by using appropriate software . RESULTS: 136 cases of placenta previa were analysed and found prevalence of placenta previa was 1.36%. During the present study 41.80% cases were bo oked and 58.20% cases were unbooked. Maximum number of cases in present study were in the age group of 18 - 24 years. Previous caesarean (57.49% and previous abortion (42.53% found important risk factors.41.04% cases were delivered at 33 - 36 weeks of gestat ion followed by 33.58% in 28 - 32 weeks of gestation. Expectant management was given to 37.32% of cases while 62.68% cases were managed on active basis. In present study maternal morbidity were postpartum hemorrhage (56.71%, sepsis (37.31%, urinary tract i nfection (5.22%, wound infection (5.22%,wound gape (4.47%, hysterectomy (2.23%, prolonged hospital stay >10 days (17.91%. There were two (1.49% maternal mortality in present study. Maximum number of infants i.e . 58.20% had bir th eight between 1.6 to 2.4kg. O ut of this 16.41% were of 1.6 - 2kg and 41.79% comprised of 2.1 - 2.4 kg. 39.55% infant required NICU admission and 60.45% of cases were with mother. Perinatal

  4. Sir William Turner and his studies on the mammalian placenta.

    Science.gov (United States)

    Magee, Reginald

    2003-06-01

    William Turner was appointed Professor of Anatomy at the University of Edinburgh in 1867, and from 1903 until his death in 1916, he was Principal and Vice-Chancellor. He was an outstanding teacher and many of those he taught went on to occupy chairs of anatomy. He published widely on anatomical subjects and one of his interests was comparative anatomy and physiology of the placenta. This paper takes a brief look at Turner's studies on the anatomical structure of the placenta, its comparative anatomy, his thoughts about its physiology and its place in the evolutionary process. At the time, these lectures constituted an anatomical and physiological classic. At the time Turner prepared his lectures, which were delivered in 1875 and 1876, little was known about the gestatory process in marsupials or monotremes. These mammals have a very brief period of intrauterine gestation and placentation and mention is made of studies that have been done in recent times on this subject.

  5. From Placenta to Polycystic Ovarian Syndrome: The Role of Adipokines

    Science.gov (United States)

    Sartori, Chiara; Lazzeroni, Pietro; Merli, Silvia; Patianna, Viviana Dora; Viaroli, Francesca; Cirillo, Francesca; Amarri, Sergio

    2016-01-01

    Adipokines are cytokines produced mainly by adipose tissue, besides many other tissues such as placenta, ovaries, peripheral-blood mononuclear cells, liver, muscle, kidney, heart, and bone marrow. Adipokines play a significant role in the metabolic syndrome and in cardiovascular diseases, have implications in regulating insulin sensitivity and inflammation, and have significant effects on growth and reproductive function. The objective of this review was to analyze the functions known today of adiponectin, leptin, resistin, and visfatin from placenta throughout childhood and adolescence. It is well known now that their serum concentrations during pregnancy and lactation have long-term effects beyond the fetus and newborn. With regard to puberty, adipokines are involved in the regulation of the relationship between nutritional status and normal physiology or disorders of puberty and altered gonadal function, as, for example, premature pubarche and polycystic ovarian syndrome (PCOS). Cytokines are involved in the maturation of oocytes and in the regular progression of puberty and pregnancy.

  6. The Effect of Hominis Placenta Herbal Acupuncture on Bell's palsy

    OpenAIRE

    2000-01-01

    This report was done to observe the effect of Hominis placenta herbal acupuncture on Bell's palsy. The study group comprised 16 patients who arrived at Woo-suk university oriental hospital from January, 1999 till January, 2000 for Bell's palsy. All patients were divided into two group. One was herbal acupunture group, and the other was control group. Acupunture group was done herbal acupuncture therapy on the facial acupuncture points. Followings are achievement and a term of each group. I...

  7. Differentially expressed miRNAs in trisomy 21 placentas.

    Science.gov (United States)

    Svobodová, Iveta; Korabečná, Marie; Calda, Pavel; Břešťák, Miroslav; Pazourková, Eva; Pospíšilová, Šárka; Krkavcová, Miroslava; Novotná, Michaela; Hořínek, Aleš

    2016-08-01

    Molecular pathogenesis of Down syndrome (DS) is still incompletely understood. Epigenetic mechanisms, including miRNAs gene expression regulation, belong to potential influencing factors. The aims of this study were to compare miRNAs expressions in placentas with normal and trisomic karyotype and to associate differentially expressed miRNAs with concrete biological pathways. A total of 80 CVS samples - 41 with trisomy 21 and 39 with normal karyotype - were included in our study. Results obtained in the pilot study using real-time PCR technology and TaqMan Human miRNA Array Cards were subsequently validated on different samples using individual TaqMan miRNA Assays. Seven miRNAs were verified as upregulated in DS placentas (miR-99a, miR-542-5p, miR-10b, miR-125b, miR-615, let-7c and miR-654); three of these miRNAs are located on chromosome 21 (miR-99a, miR-125b and let-7c). Many essential biological processes, transcriptional regulation or apoptosis, were identified as being potentially influenced by altered miRNA levels. Moreover, miRNAs overexpressed in DS placenta apparently regulate genes involved in placenta development (GJA1, CDH11, EGF, ERVW-1, ERVFRD-1, LEP or INHA). These findings suggest the possible participation of miRNAs in Down syndrome impaired placentation and connected pregnancy pathologies. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  8. A Marked Increase in Obstetric Hysterectomy for Placenta Accreta

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yu Pan; Yu-Ping Wang; Zheng Zheng; Yan Tian; Ying-Ying Hu; Su-Hui Han

    2015-01-01

    Background:Obstetric hysterectomy (OH) as a lifesaving measure to manage uncontrolled uterine hemorrhage appears to be increasing recently.The objective of this study was to determine the etiology and changing trends of OH and to identify those at particular risk of OH to enhance the early involvement of multidisciplinary intensive care.Methods:A retrospective study was carried out in patients who had OH in China-Japan Friendship Hospital from 2004 to 2014.Maternal characteristics,preoperative evaluation,operative reports,and prenatal outcomes were studied in detail.Results:There were 19 cases of OH among a total of 18,838 deliveries.Comparing the study periods between 2004-2010 and 2011-2014,OH increased from 0.8/1000 (10/12,890) to 1.5/1000 (9/5948).Indications for OH have changed significantly during this study period with uterine atony decreasing from 50.0% (5/10) to 11.1% (1/9) (P < 0.05),and placenta accreta as the indication for OH has increased significantly from 20.0% (2/10) to 77.8% (7/9) (P < 0.05).Ultrasonography and magnetic resonance imaging (MRI) have been used to make an exact antepartum diagnosis of placenta accreta.A multidisciplinary management led to improved outcomes for patients with placenta accreta.Conclusion:As the multiple cesarean delivery rates have risen,there has been a dramatic increase in OH for placenta accreta.An advance antenatal diagnosis of ultrasonography,and MRI,and a multidisciplinary teamwork can maximize patients' safety and outcome.

  9. 前置胎盘、胎盘粘连及胎盘植入与人工流产的关系研究%Relationship research of placenta previa,adherent placenta and placenta implantation

    Institute of Scientific and Technical Information of China (English)

    刘秀华

    2014-01-01

    目的:研究前置胎盘、胎盘粘连及胎盘植入与人工流产的相关性。方法对入我院进行分娩的3280例孕妇资料进行分析,选择其中342例发生胎盘异常孕妇进行研究,包括未经人工流产和人工流产的孕妇前置胎盘、胎盘粘连及胎盘植入的发生率;人工流产的次数与前置胎盘、胎盘粘连及胎盘植入的关系以及围产期感染相关因素的研究。结果未经人工流产孕妇胎盘总的异常率为3.7%,人工流产孕妇胎盘总的异常率为14.3%,两组胎盘异常总发生率比较显著差异(P<0.05);流产次数越多,胎盘异常发生率随着次数增高而增高;围产期感染与产前贫血、宫腔感染和产妇营养不良关系密切(P<0.05)。结论前置胎盘、胎盘粘连及胎盘植入与人工流产的关系密切,多次人工流产易导致胎盘异常情况的发生,又易由于胎盘异常导致产后出血,育龄女性应尽量避免人工流产。%Objective To study the correlation between placenta previa, adherent placenta and placenta implantation. Methods Data of 3280 pregnant women delivered in our hospital were analyzed, of which 342 pregnant women with abnormal placenta were selected for research, including the incidences of placenta previa, adherent placenta and placenta implantation of the pregnant women having gone and having not gone through induced abortion, relationship between the times of induced abortion and the placenta previa, adherent placenta and placenta implantation, and study on perinatal infection related factors. Results The total abnormal placenta rate of the pregnant women having not gone through induced abortion was 3.7%and that of those having gone through induced abortion was 14.3%, with significant difference between the total incidences of abnormal placenta(P < 0.05).The incidence of abnormal placenta went up as the times of induced abortion rose; Perinatal infection was closely related to

  10. Effects of twinning on gestation length, retained placenta, and dystocia.

    Science.gov (United States)

    Echternkamp, S E; Gregory, K E

    1999-01-01

    Constraints to maximal productivity from twinning in beef cattle include increased incidence of dystocia and retained placenta, longer postpartum interval, and lower conception rate. Incidence and cause(s) of the shorter gestation length and of the increased retained placenta and dystocia associated with twinning were evaluated for 3,370 single and 1,014 twin births produced in a population of cattle selected for natural twin births. Gestation length was shorter for twin than for single pregnancies (275.6 vs. 281.3 d, P.10) by parity with twin births. Because of the shorter gestation length and the increased incidence of retained placenta and(or) dystocia, achievement of increased productivity with twinning in cattle necessitates intensive management of twin-producing dams and their calves during the calving season. Management of the increased dystocia can be facilitated by preparturient diagnosis of twin pregnancies, enabling timely administration of obstetrical assistance to facilitate delivery of twin calves and to increase their neonatal survival.

  11. SUCCENTURIATE PLACENTA: AN INCIDENTAL FINDING DURING CESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Unmesh

    2015-12-01

    Full Text Available A 30 years, 4th Gravida with 3 abortions with history of 8 months amenorrhea was admitted to the hospital with chief complaints of leaking per vagina since 4 hours and was not associated with pain abdomen or bleeding per vaginum. Perceiving decreased fetal movements since 6 hours. She had 3 previous missed abortions followed by D and E. In the present pregnancy, gestational age was 32 weeks at the time of admission. Patient’s general condition was stable, all other investigation were found to be normal her pulse was 100 beats/min, tachycardia present, BP -100/70mmHg. On obstetric examination, uterus was 30 weeks size, 1-2 contraction lasting for 15- 20 seconds, Breech presentation, FHR was 124 per minute, regular, decreased liquor clinically. On vulvovaginal examination- Frank leaking per vagina present. Ultrasound showed single live intrauterine pregnancy of 29 weeks 3 days with breech presentation with oligohydramnios, Placenta was at fundal region, Biophysical profile was 6/8, FHR 124 bpm. After taking high risk consent in view of fetal prematurity, patient was posted for Emergency LSCS. And extracted a single live preterm female baby of weight of 1.45 kg by breech. During the cesarean section, on opening abdomen lower segment was found to be congested with torturous vessels. So we suspected missed diagnosis of placenta previa. After delivery of the baby, we found succenturiate lobe of the placenta occupying lower uterine segment with vessels running across the membrane.

  12. Management of Amniotic Sheet with a Hammock-like Placenta

    Directory of Open Access Journals (Sweden)

    Liangcheng Wang

    2016-09-01

    Full Text Available An amniotic sheet is a septation in the amniotic cavity with a perforation that allows amniotic fluid to pass through. Although the incidence of abnormal placental implantation is higher in such cases, the management recommendations remain unclear. We report a case of an amniotic sheet with a hammock-like placenta located in the center of the uterine cavity. A 25-year-old woman with a history of two dilation and curettage procedures was found to have an amniotic cavity separated by a septum that contained part of the placenta. At gestational Week 32, magnetic resonance images revealed that the placenta was attached from the anterior to posterior uterine walls and resembled a hammock hanging in the center of the uterus. Subsequently, continuous intravenous administration of ritodrine hydrochloride and magnesium sulfate were given. The pregnancy was extended to Week 36. Elective cesarean section was performed, and a 3212-g female infant was delivered. Thus, owing to the risk of umbilical cord complications and placental injury secondary to premature rupture of membranes, aggressive and careful perinatal management is required in such cases.

  13. [A retrospective analysis on the pernicious placenta previa from 2008 to 2014].

    Science.gov (United States)

    Yu, L; Hu, K J; Yang, H X

    2016-03-01

    To investigate the incidence changes, clinical characteristics and pregnant outcomes of pernicious placenta previa. A retrospective cohort analysis on 316 cases with placenta previa in the Peking University First Hospital from January 2008 to December 2014. The research group were 60 cases with the patients of placenta previa with the history of cesarean section, and the control group were placenta previa without the history of cesarean section. Compared with the incidence, intraoperative blood loss, the pregnancy outcomes and so on. (1) The average incidence rate of placenta previa during the past 7 years was 10.96 ‰ (316/28 837). And the cases of pernicious placenta previa was 60 (2.08‰, 60/28 837), the incidence of pernicious placenta previa was rising from 2008 to 2014 (0.91‰-3.08‰). (2) There were 145 cases of placenta privia had been translation from other hospitals in the past 7 years. The referral rate of pregnant women with placenta previa was 45.9% (145/316), and the referral rate of pernicious placenta previa (63.3%, 38/60) was significantly higher than that of non-pernicious placenta previa group (41.8%, 107/256; χ(2)=9.080, P=0.003). Referral the outcomes of these patients were good, and no maternal death occurred. (3) The placenta in the research group were mainly adhered in the front wall of the uterine, and the incidence was 38.5% (15/39), higher than that in the group of non-pernicious placenta previa (12.1%, 21/174; χ(2)=57.636, Pplacenta increased in research group was 53.3% (32/60), higher than that in the group of non-pernicious placenta previa, compared with the control group, there was significant difference (15.6%, 40/256; χ(2)= 39.041, Pplacenta previa were respectively 4.7% (12/256), 12.9% (33/256), 1.2% (3/256), 8.6% (22/256), compared those in other two groups, there were not significant difference (Pplacenta previa increased year by year, patients with placenta previa has a history of cesarean section often combined with

  14. Risk Factors and Consequent Outcomes of Placenta Previa: Report From a Referral Center.

    Science.gov (United States)

    Saleh Gargari, Soraya; Seify, Zahra; Haghighi, Ladan; Khoshnood Shariati, Maryam; Mirzamoradi, Masoumeh

    2016-11-01

     Because of an unknown factor, the frequency of complicated pregnancy with placenta previa has been raised during past decade. This study was designed to deepen our understanding of risk factors and outcomes of placenta previa in our country. This study investigated 694 cases of placenta previa comparing with 600 healthy pregnant women with not overlie placenta in two referral and tertiary Obstetrics and Gynecological Hospital in Iran on the basis of the clinical and para-clinical analysis, in order to find the probable risk factors for occurrence of placenta previa and its effect on maternal and neonatal complications. The most important risk factor for the occurrence of placenta previa was advanced maternal age (Pplacenta previa based on the type of risk factors which can provide the best possible management to decrease the morbidity and mortality of their related complications.

  15. A danish national cohort study on neonatal outcome in singleton pregnancies with placenta previa

    DEFF Research Database (Denmark)

    Nørgaard, Lone N; Pinborg, Anja; Lidegaard, Ojvind

    2012-01-01

    Objective. To describe the incidence of placenta previa and to assess neonatal morbidity and mortality in pregnancies with placenta previa after adjustment for previous cesarean section, smoking, multiparity, maternal age and in-vitro fertilization. Design. National cohort study. Setting. Danish ...... score, being transferred to neonatal intensive care and for death.......Objective. To describe the incidence of placenta previa and to assess neonatal morbidity and mortality in pregnancies with placenta previa after adjustment for previous cesarean section, smoking, multiparity, maternal age and in-vitro fertilization. Design. National cohort study. Setting. Danish....... Main outcome measures. Gestational age, birthweight, Apgar score after 5min, stillbirth, neonatal mortality and admittance to neonatal intensive care unit. Results. The incidence of placenta previa in Denmark was 0.54% in 2006. Neonates born after pregnancies with placenta previa had a higher risk...

  16. [Diagnosis of placenta previa accreta by two dimensional ultrasonography and color doppler in patients with cesarean section].

    Science.gov (United States)

    Shi, Huafang; Pi, Pixiang; Ding, Yiling

    2012-09-01

    To determine the accuracy of two dismensional sonography and color doppler in diagnosing placenta previa accreta in patients with previous cesarean section. Forty-one patients with previous cesarean sections were confirmed to have partial or total placenta previa in the current pregnancy and were given ultrasound examinations after the 28th week of gestation. Specific ultrasound features of the placenta and its interphase with the uterus and the bladder for placenta accreta were checked by two-dimensional ultrasonography and color Doppler. All the patients were traced until delivery. The golden standard in diagnosis was the intraoperative finding and the pathologic exam. Twenty-two patients had ultrasonographic evidence of placenta previa, 20 of which were later confirmed placenta previa accreta intraoperatively. Nineteen patients had no ultrasound evidence of placenta previa, and 1 of which was later confirmed placenta previa accreta. The sensitivity and specificity of antenatal ultrasound diagnosis of placenta previa accreta were 95.24% and 94.74% respectively. The most prominent feature to suggest placenta accreta in twodismensional sonography was the presence of multiple lakes that represented dilated vessels extending from the placenta through the myometrium. The most prominent color Doppler feature was the presence of interphase hypervascularity with abnormal vessels linking the placenta to the bladder, and the rate was 95.24%. Placenta previa accreta can be diagnosed made with a thorough two dimensional ultrasonographic and color Doppler examination in patients with previous cesarean scar and placenta previa.

  17. ClinicalAnalysisofDangerousPlacentaPreviaComplicatedwithPlacentaAccreta%凶险性前置胎盘并发胎盘植入的临床分析

    Institute of Scientific and Technical Information of China (English)

    王凌燕

    2013-01-01

    目的探讨凶险性前置胎盘并发胎盘植入的发病率、诊断方法、治疗及预防措施。方法对我院65例凶险性前置胎盘进行回顾性分析,其中并发胎盘植入29例。结果本研究凶险性前置胎盘并发胎盘植入发生率为44.62%(29/65),其产后出血量>2000mL发生率、弥漫性血管内凝血(DIC)发生率、产褥感染率及子宫切除率高于未并发胎盘植入者;早产率及新生儿预后情况两者无显著差异(P>0.05)。结论凶险性前置胎盘并发胎盘植入者,产后出血量大,易致失血性休克、DIC、产褥感染,增加子宫切除风险;降低剖宫产率,是减少凶险性前置胎盘并发胎盘植入的关键。%Objective To discuss the incidence, diagnostic methods ,treatment methods and prevention of dangerous placenta previa complicated with placenta accreta. Methods Retrospective analysis 65 cases of dangerous placenta previa admitted to our hospital in June 2007-2012, including 29 cases complicated with placenta accreta. Results In the present study the incidence rate of dangerous placenta previa complicated with placenta accreta was 44.62%(29/65). The postpartum incidence and hemorrhage, the incidence of disseminated intravascular coagulation (DIC), puerperal infection rate and the rate of hysterectomy of dangerous placenta praevia complicated with placenta accreta in patients was more than not complicated with placenta accreta in patients. The rate of preterm birth and neonatal prognosis has no signiifcant difference between them (P>0.05). Conclusion Dangerous placenta praevia complicated with placenta accreta in patients have a high incidence of postpartum hemorrhage, prone to cause hemorrhagic shock, DIC, puerperal infection, increase the risk of uterine resection. The key to reduce the dangerous placenta previa complicated with placenta accreta is reducing the rate of cesarean section.

  18. ORIGINAL ARTICLES

    African Journals Online (AJOL)

    small babies can only succeed once the causes are identified. We conducted this study ... for at least 60 minutes, or repeated late decelerations. 4. Antepartum ... Intrauterine death complicated the pregnancy in 19 patients. Abruptio placentae ...

  19. Assessment of total placenta previa by magnetic resonance imaging and ultrasonography to detect placenta accreta and its variants.

    Science.gov (United States)

    Peker, Nuri; Turan, Volkan; Ergenoglu, Mete; Yeniel, Ozgur; Sever, Ahmet; Kazandi, Mert; Zekioglu, Osman

    2013-03-01

    To evaluate the importance of ultrasonography (US) and magnetic resonance imaging (MRI) in detecting placental adherence defects. Patients diagnozed with total placenta previa (n = 40) in whom hysterectomy was performed due to placental adherence defects (n = 20) or in whom the placenta detached spontaneously after a Cesarean delivery (n = 20) were included into the study between June 2008 and January 2011, at the Department of Obstetrics and Gynecology Ege University (lzmir Turkey). Gray-scale US was used to check for any placental lacunae, sub-placental sonolucent spaces or a placental mass invading the vesicouterine plane and bladder Intra-placental lacunar turbulent blood flow and an increase in vascularization in the vesicouterine plane were evaluated with color Doppler mode. Subsequently all patients had MRI and the results were compared with the histopathologic examinations. The sensitivity of MRI for diagnosis of placental adherence defects before the operation was 95%, with a specificity of 95%. In the presence of at least one diagnostic criterion, the sensitivity and specificity of US were 87.5% and 100% respectively, while the sensitivity of color Doppler US was 62.5% with a specificity of 100%. Currently MRI appears to be the gold standard for the diagnosis of placenta accreta. None of the ultrasonographic criteria is solely sufficient to diagnose placental adherence defects, however they assist in the diagnostic process.

  20. Real increasing incidence of hysterectomy for placenta accreta following previous caesarean section.

    LENUS (Irish Health Repository)

    Higgins, Mary F

    2013-11-01

    Placenta accreta, morbid adherence to the uterus to the myometrium, is commonest in association with placenta previa in women previously delivered by caesarean section (CS). It has become proportionally a greater cause of major maternal morbidity and mortality as the frequency of other serious obstetric complications has declined. The aim of this study was to examine the incidence of placenta accreta in the context of a rising caesarean delivery rate.

  1. Clinical study of placenta previa and its effect on maternal health and fetal outcome

    Directory of Open Access Journals (Sweden)

    Sarojini

    2016-10-01

    Conclusions: Advancing maternal age, multiparity, prior cesarean section, and prior abortions are independent risk factors for placenta previa. Placenta praevia remains a risk factor for adverse maternal and perinatal outcome. The detection of placenta previa should encourage a careful evaluation with timely delivery to reduce the associated maternal and perinatal complications. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3496-3499

  2. Alternative management in a case of placenta accreta with previous caesarean

    Directory of Open Access Journals (Sweden)

    Rajani M. Parikh

    2012-12-01

    Full Text Available The rate of caesarean is increasing day by day, and with it the chance of repeat caesarean. This has led to a rise in the chance of occurrence of placenta accreta. Control of bleeding is the main goal in such cases, which usually necessitates hysterectomy. But alternative methods are useful when retaining fertility is important. We present this case of a 30 yr old female who was admitted as a case of central placenta previa with previous caesarean. Per operatively, placenta was attached along the incision and baby was delivered by separating the placenta attached above the upper margin of incision. On attempting to remove the placenta attached to lower part of incision, it was found to be adherent along the previous scar. So placenta was removed piece meal, some part was left behind. Box sutures were taken over that part and uterine packing was done to control the bleeding. Post operatively the patient was fine and given injection Methotrexate on 8th day following the regime of 1, 3, 5, 7 days. She failed to expulse the placenta by 6wks, so D&E was done and retained products were removed. Leaving the placenta in situ followed by Methotrexate and interval removal of placenta can thus be helpful in conserving the uterus and hence, the fertility. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 58-60

  3. Prophylactic Hypogastric Artery Ballooning in a Patient with Complete Placenta Previa and Increta

    Science.gov (United States)

    Yi, Kyong Wook; Seo, Tae-Seok; So, Kyeong A; Paek, Yu Chin; Kim, Hai-Joong

    2010-01-01

    Abnormal attachment of the placenta (Placenta accreta, increta, and percreta) is an uncommon but potentially lethal cause of maternal mortality from massive postpartum hemorrhage. A 33-yr-old woman, who had been diagnosed with a placenta previa, was referred at 30 weeks gestation. On ultrasound, a complete type of placenta previa and multiple intraplacental lacunae, suggestive of placenta accreta, were noted. For further evaluation of the placenta, pelvis MRI was performed and revealed findings suspicious of a placenta increta. An elective cesarean delivery and subsequent hysterectomy were planned for the patient at 38 weeks gestation. On the day of delivery, endovascular catheters for balloon occlusion were placed within the hypogastric arteries, prior to the cesarean section. In the operating room, immediately after the delivery of the baby, bilateral hypogastric arteries were occluded by inflation of the balloons in the catheters previously placed within. With the placenta retained within the uterus, a total hysterectomy was performed in the usual fashion. The occluding balloons were deflated after closure of the vaginal cuff with hemostasis. The patient had stable vital signs and normal laboratory findings during the recovery period; she was discharged six days after delivery without complications. The final pathology confirmed a placenta increta. PMID:20358016

  4. Antioxidants activities and concentration of selenium, zinc and copper in preterm and IUGR human placentas.

    Science.gov (United States)

    Zadrozna, Monika; Gawlik, Małgorzata; Nowak, Barbara; Marcinek, Antoni; Mrowiec, Halina; Walas, Stanisław; Wietecha-Posłuszny, Renata; Zagrodzki, Paweł

    2009-01-01

    The aim of this study was to examine changes in activities of cytochrome c oxidase (CCO), glucose-6-phosphate dehydrogenase (G6PDH), Cu-Zn superoxide dismutase (Cu-Zn SOD), glutathione peroxidase (GSH-Px), glutathione (GSH) levels and copper (Cu), zinc (Zn) and selenium (Se) concentrations, and to assess the possible differences between preterm placentas, placentas from term pregnancies complicated by intrauterine growth restriction (IUGR) and full-term control placentas. The enzyme activities and the level of GSH decreased in IUGR and preterm placentas in comparison with the control group. CCO activity and GSH level in preterm placentas were markedly lower compared with the IUGR (P<0.01; P<0.05) and control (P<0.01; P<0.05) placentas, respectively. In IUGR placentas the level of Cu was reduced by 23% (P<0.05) and Zn by 37%. In preterm placentas the level of Cu was reduced by 19% and Zn by 42%. Se level in IUGR and preterm placentas was higher (P<0.05) by 28% and 32% than in control group, respectively. The strong relation was observed between birth weight and CCO activity, birth weight and Cu-Zn SOD activity, and a low level of Zn and Cu influenced the birth weight especially in IUGR cases. Moreover, the strong inverse correlation between Se level and birth weight, Se level and placental weight and Se level and CCO activity are new findings.

  5. 前置胎盘与胎盘植入相关因素分析%Study on related factors for placenta praevia and placenta accreta

    Institute of Scientific and Technical Information of China (English)

    彭冬梅

    2012-01-01

    目的 总结前置胎盘与胎盘植入的相关因素及对母婴的影响.方法 对2007年10月至2010年4月间收治的96例前置胎盘和12例前置胎盘合并胎盘植入患者的孕周、胎盘位置、产妇年龄、妊娠次数、产后出血量及新生儿Apgar 评分等指标进行回顾性分析.结果 7 968产妇中,前置胎盘者发生率为1.20%(96/7 968).前置胎盘合并胎盘植入者12例,占前置胎盘的12.5%(12/96).胎盘植入的发生率与产妇孕产次、胎盘位置明显相关,而与其年龄、孕周关系无明显相关性.中央型胎盘胎盘植入的发生率明显高于边缘性胎盘,差异具有显著性(P<0.05).合并胎盘植入组产后出血、新生儿窒息和早产发生率均明显高于前置胎盘组,差异具有显著性(P<0.05).结论 胎盘植入与前置胎盘有相关关系,中央型前置胎盘及3次以上妊娠为胎盘植入的高危因素.胎盘植入严重危害母婴生命,针对胎盘植入的危险因素加以预防,对提高母婴生活质量有重要意义.%Objective To explore the related factors for placenta praevia and placenta aeereta and the impact on mother and child.Meth-ods The clinical data of ninety six patients with placenta praevia and 12 of them combined with placenta aeereta admitted in this hospital during JanumT 2007 to April 2010 were retrospectively analyzed for gestational age,placental location,maternal age,number of pregnancy,postpartum hemorrhage and Apgar scores of newborns.Results Among 7 968 pregnant wonlen,the incidence rate of placenta praevia was 1.20%(96/7 968).Twelve cases of placenta praevia combined with placenta aeereta accounted for 12.5%of patients with placenta praevia(12/96).The oc-currence of placenta accreta was related to tinms of gravid and delivery and location of placenta,and there was no significant relationship with their age and gestational age.The incidence of placenta accreta in central placenta was significantly higher than that oeeun'ed at

  6. Diagnosis of Placenta Previa and Placenta Implantation With MRI%前置胎盘及胎盘植入的MRI诊断

    Institute of Scientific and Technical Information of China (English)

    刘静; 罗莎

    2015-01-01

    ObjectiveTo explore the application value of MRI in the prenatal diagnosis of front disc and implantation of placenta previa. Methods Retrospective analysis of our hospital 16 cases of placental MRI examination conifrmed byoperation and pathology after cesarean section. Results8 cases of central placenta previa, 5 cases of partialplacenta previa, 2 cases of marginal placenta previa, low-lying placenta 1 cases, 2 cases of Placenta Adhesion, 2 cases of placenta implantation, including 1 cases of transmural implantation, placenta in the posterior inferior wall in 11 cases, 4 cases of anterior inferior wall, 2 cases of lateral wall.Conclusion MRI on placenta previa placenta implantation in the clinical diagnosis and timely and reasonable treatment plan have some certain signiifcance.%目的:探讨MRI在诊断产前前置前盘及植入性前置胎盘的应用价值。方法剖宫产后回顾性分析我院经手术及病理证实的16例胎盘MRI检查。结果中央性前置胎盘8例,部分性前置胎盘5例,边缘性前置胎盘2例,低置胎盘1例,胎盘粘连2例,胎盘植入2例,其中1例透壁植入,胎盘位于后下壁11例,前下壁4例,侧壁2例。结论 MRI对前置胎盘及胎盘植入诊断对临床及时合理制定治疗方案有一定意义。

  7. Can 3-dimensional power Doppler indices improve the prenatal diagnosis of a potentially morbidly adherent placenta in patients with placenta previa?

    Science.gov (United States)

    Haidar, Ziad A; Papanna, Ramesha; Sibai, Baha M; Tatevian, Nina; Viteri, Oscar A; Vowels, Patricia C; Blackwell, Sean C; Moise, Kenneth J

    2017-08-01

    Traditionally, 2-dimensional ultrasound parameters have been used for the diagnosis of a suspected morbidly adherent placenta previa. More objective techniques have not been well studied yet. The objective of the study was to determine the ability of prenatal 3-dimensional power Doppler analysis of flow and vascular indices to predict the morbidly adherent placenta objectively. A prospective cohort study was performed in women between 28 and 32 gestational weeks with known placenta previa. Patients underwent a two-dimensional gray-scale ultrasound that determined management decisions. 3-Dimensional power Doppler volumes were obtained during the same examination and vascular, flow, and vascular flow indices were calculated after manual tracing of the viewed placenta in the sweep; data were blinded to obstetricians. Morbidly adherent placenta was confirmed by histology. Severe morbidly adherent placenta was defined as increta/percreta on histology, blood loss >2000 mL, and >2 units of PRBC transfused. Sensitivities, specificities, predictive values, and likelihood ratios were calculated. Student t and χ(2) tests, logistic regression, receiver-operating characteristic curves, and intra- and interrater agreements using Kappa statistics were performed. The following results were found: (1) 50 women were studied: 23 had morbidly adherent placenta, of which 12 (52.2%) were severe morbidly adherent placenta; (2) 2-dimensional parameters diagnosed morbidly adherent placenta with a sensitivity of 82.6% (95% confidence interval, 60.4-94.2), a specificity of 88.9% (95% confidence interval, 69.7-97.1), a positive predictive value of 86.3% (95% confidence interval, 64.0-96.4), a negative predictive value of 85.7% (95% confidence interval, 66.4-95.3), a positive likelihood ratio of 7.4 (95% confidence interval, 2.5-21.9), and a negative likelihood ratio of 0.2 (95% confidence interval, 0.08-0.48); (3) mean values of the vascular index (32.8 ± 7.4) and the vascular flow index

  8. STUDY OF MORPHOLOGICAL VARIATIONS OF 50 PLACENTAE WITH UMBILICAL CORDS AND ITS DEVELOPMENTAL RELEVANCE

    Directory of Open Access Journals (Sweden)

    Asra Anjum

    2015-09-01

    Full Text Available Introduction: The word “Placenta” is a Latin word and the Greek equivalent word is “Plakons” which means “Flat cake on a plate”. The placenta is a complex multifunctional organ. It provides nutrition, gas exchange, waste removal, endocrine function and immune support. Placenta is a special circulating system to the developing foetus. Being an organ of vital importance for continuation of pregnancy and foetal nutrition it has evolved great interest among the anatomists, embryologists, pathologists and obstetricians. Materials and Methods: The study was done in 50 placentae which were collected from the department of Obstetrics and Gynaecology in collaboration with the department of Anatomy, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana, during the period of 2 years. The morphological variations of placenta, the size, shape, weight and attachment of umbilical cord with its blood vessels were observed, recorded and photographed. The prime objective of the study is to compare and evaluate the morphological alterations of placenta and umbilical cord in pregnancy. Results and Conclusion: In the current study, the majority of the placentae showed round shape, few placentae with oval and irregular and with an accessory lobe in single placenta. The current study also includes variations in insertion of umbilical cords was eccentric in majority, central, marginal and velamentous in a few. Pregnancy induced hypertension significantly affects the placenta by reducing weight and it does not have any significant effect on the shape of placenta, umbilical cord insertion and number of cotyledons on maternal surface. The placenta is the most accurate record of the infants prenatal experience.

  9. Placenta accreta: pathogenesis of a 20th century iatrogenic uterine disease.

    Science.gov (United States)

    Jauniaux, E; Jurkovic, D

    2012-04-01

    Placenta accreta refers to different grades of abnormal placental attachment to the uterine wall, which are characterised by invasion of trophoblast into the myometrium. Placenta accreta has only been described and studied by pathologists for less than a century. The fact that the first detailed description of a placenta accreta happened within a couple of decades of major changes in the caesarean surgical techniques is highly suggestive of a direct relationship between prior uterine surgery and abnormal placenta adherence. Several concepts have been proposed to explain the abnormal placentation in placenta accreta including a primary defect of the trophoblast function, a secondary basalis defect due to a failure of normal decidualization and more recently an abnormal vascularisation and tissue oxygenation of the scar area. The vast majority of placenta accreta are found in women presenting with a previous history of caesarean section and a placenta praevia. Recent epidemiological studies have also found that the strongest risk factor for placenta praevia is a prior caesarean section suggesting that a failure of decidualization in the area of a previous uterine scar can have an impact on both implantation and placentation. Ultrasound studies of uterine caesarean section scar have shown that large and deep myometrial defects are often associated with absence of re-epithelialisation of the scar area. These findings support the concept of a primary deciduo-myometrium defect in placenta accreta, exposing the myometrium and its vasculature below the junctional zone to the migrating trophoblast. The loss of this normal plane of cleavage and the excessive vascular remodelling of the radial and arcuate arteries can explain the in-vivo findings and the clinical consequence of placenta accreta. Overall these data support the concept that abnormal decidualization and trophoblastic changes of the placental bed in placenta accreta are secondary to the uterine scar and thus

  10. EFFECT OF GESTATIONAL DIABETES MELLITUS ON GROSS MORPHOLOGY OF PLACENTA: A COMPARATIVE STUDY

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    Pankaj Saini

    2015-03-01

    Full Text Available Background: The fetus, placenta and mother constitute a triad of contributors to pregnancy outcome. When pregnancy is complicated by a medical problem like, diabetes mellitus which affects maternal health, architecture and functions of the placenta may even jeopardize the fetal normalcy. The placenta being the bridge between maternal and fetal activities, considered as a window through which maternal dysfunctions and their impacts on fetal well being can be understood. Aim: The aim was to study gross morphology of placentae of women with gestational diabetes mellitus and to compare the results with normal pregnancies. Methods: It was an observational study. After due approval from institutional ethics committee, 40 placentae from pregnant women clinically diagnosed with gestational diabetes mellitus and 40 placentae from uncomplicated normal pregnant women were collected from labour room and operation theatre of department of obstetrics and gynaecology of government medical college hospital in Jaipur (Rajasthan. Confirmed gestational diabetic cases were selected purposively while controls were taken sequentially. Gross morphological features of each placenta were recorded. The statistical methods used were unpaired ‘t’ test and chi square test. Results: The results showed that weight, diameter, surface area, central thickness and number of cotyledons of placentae from diabetic mothers were significantly more than placentae from normal uncomplicated pregnancies, while no significant differences were observed in shape and site of umbilical cord insertion. Conclusion: The gross morphology of placentae with gestational diabetes mellitus significantly differs from normal pregnancies which may be associated with alteration in physiological functioning of placenta and ultimately fetal outcome.

  11. Transport of persistent organic pollutants across the human placenta.

    Science.gov (United States)

    Vizcaino, Esther; Grimalt, Joan O; Fernández-Somoano, Ana; Tardon, Adonina

    2014-04-01

    Prenatal life is the most sensitive stage of human development to environmental pollutants. Early exposure to persistent organic pollutants (POPs) may increase the risk of adverse health effects during childhood. The mechanisms of transference of POPs during pregnancy are still not well understood. The present study is aimed to investigate the transfer of POPs between mother and fetus. The concentrations of 14 organochlorine pesticides, 7 polychlorinated biphenyls (PCBs) and 14 polybromodiphenyl ether (PBDEs) congeners have been measured in 308 maternal serum samples, their respective umbilical cords and 50 placental tissues from a mother-infant cohort representative of Spanish general population. In general, the adjusted lipid-basis concentrations were higher in maternal serum than in cord serum and placenta. The concentrations of most pollutants between maternal serum and cord serum and between maternal serum and placenta were significantly correlated. These distributions were consistent with a predominant maternal source that transfers the pollutants into the placenta and the fetus. However, this distribution did not correspond to passive diffusion of these compounds between these tissues according to lipid content. The compounds more readily metabolized were higher in newborns, which suggest that differences in metabolic capabilities may be responsible of the observed variations in POP distributions between mother and newborns. Prenatal exposure to 4,4'-DDT and some PBDEs such as BDE 99 and BDE 209 is much higher than it could be anticipated from the composition of maternal serum. POP exposure assessment studies of newborns may overlook the effects of some of these pollutants if they only consider maternal determinations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Androgen receptor and histone lysine demethylases in ovine placenta.

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    Ellane R Cleys

    Full Text Available Sex steroid hormones regulate developmental programming in many tissues, including programming gene expression during prenatal development. While estradiol is known to regulate placentation, little is known about the role of testosterone and androgen signaling in placental development despite the fact that testosterone rises in maternal circulation during pregnancy and in placenta-induced pregnancy disorders. We investigated the role of testosterone in placental gene expression, and focused on androgen receptor (AR. Prenatal androgenization decreased global DNA methylation in gestational day 90 placentomes, and increased placental expression of AR as well as genes involved in epigenetic regulation, angiogenesis, and growth. As AR complexes with histone lysine demethylases (KDMs to regulate AR target genes in human cancers, we also investigated if the same mechanism is present in the ovine placenta. AR co-immunoprecipitated with KDM1A and KDM4D in sheep placentomes, and AR-KDM1A complexes were recruited to a half-site for androgen response element (ARE in the promoter region of VEGFA. Androgenized ewes also had increased cotyledonary VEGFA. Finally, in human first trimester placental samples KDM1A and KDM4D immunolocalized to the syncytiotrophoblast, with nuclear KDM1A and KDM4D immunostaining also present in the villous stroma. In conclusion, placental androgen signaling, possibly through AR-KDM complex recruitment to AREs, regulates placental VEGFA expression. AR and KDMs are also present in first trimester human placenta. Androgens appear to be an important regulator of trophoblast differentiation and placental development, and aberrant androgen signaling may contribute to the development of placental disorders.

  13. Mineral deficiency predisposes occurrence of retention of placenta in crossbred

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    S. K. Sheetal

    2014-12-01

    Full Text Available Aim: The present study was carried out to investigate the relationship between blood serum concentrations of macro and micro minerals and development of retention of placenta (ROP in crossbred cattle. Materials and Methods: The present study was carried out at Instructional Livestock Farm, Bihar Veterinary College and local Khatals in and around Patna. A total of 20 crossbred cattle (n=10 with normal expulsion of the placenta as control and n=10 with ROP were selected in the present study. Blood samples were collected from these animals and serum was separated and stored in the deep freezer at −20°C till further analysis. The estimation of serum macro-minerals (Ca, P, Ca/P ratio was done by Span diagnostic Kits (Surat, India and trace minerals or micro-minerals (Zn, Cu, and Fe were analyzed by atomic absorption spectrophotometer (Perkin Elmer AAS 220. Mean values were compared between both the groups at 0 h (at parturition and 12 h after parturition. Results: The mean values of serum calcium and zinc were found significantly lower in cattle having ROP than control at both 0 h and 12 h after parturition. The mean values of serum Ca and P ratio obtained at 0 hour were significantly lower in ROP groups as compared to control groups and non-significant at 12 h. The mean values of serum inorganic phosphorus, copper and iron was found non-significantly lower in ROP cases as compared to control. Conclusions: Macro and micro mineral deficiency such as calcium, iron, zinc and copper in blood serum may be predisposing factor for the occurrence of retention of placenta in crossbred cattle.

  14. Influence of placental position on obstetric morbidity in placenta previa

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    Shripad S. Hebbar

    2014-06-01

    Conclusions: It is difficult to assign a maternal or perinatal morbidity risk to a particular type of placental location. The need for specialized surgical intervention such as uterine / internal iliac artery ligation, peripartum hysterectomy can arise irrespective of placental location, whether underneath the surgical incision (anterior, proximity to main uterine trunks (lateral or encountered after the delivery of the baby (posterior. Pregnancies complicated by placenta previa must be delivered in the hospitals having expertise of senior and skilled surgeons and well equipped blood bank and good neonatal intensive care unit. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 585-591

  15. Anatomy and physiology of the embryo, fetus and placenta

    Energy Technology Data Exchange (ETDEWEB)

    Wegst, A.V. (Diagnostic Technology Consultants, Inc., Kansas City, MO (United States)); Davis, J.M. (Kansas Univ., Kansas City, KS (United States). Medical Center)

    1992-01-01

    Complexities of fetal and placental development introduce unique problems in quantitating a fetal radiation dose from internal radionuclide contamination. The paper briefly describes the many transitory stages in the development of the fetal organs and placenta from the time of the union of the egg and sperm. Descriptions of migration, differentiation and functional changes of cell lines will illustrate the difficulties in establishing a radiation history. The development of the cells responsible for hematopoiesis are reviewed, along with the thyroid gland and blood brain barrier, because of the importance of these tissues in radiation protection. (author).

  16. [Procedure for purifying RNA polymerase II from human placenta].

    Science.gov (United States)

    Kandyba, L V; Matsanova, V R; Shamovskiĭ, I V; Raĭt, V K

    1994-12-01

    DNA-dependent RNA polymerase IIB having a specific activity of 320 u./mg has been isolated from the term placenta homogenate using extraction performed at 4-6 degrees C in the presence of 75 mM ammonium sulfate and 1.5% nonidet P40, fractionation on DEAE-cellulose DE 23, desalting and heparin-agarose chromatography, resulting in 330-fold purification and a 18% yield. Technical details have been determined which are of crucial importance for reproducibility of affinity chromatography. The possibility of proteolysis of the IIc subunit during enzyme purification has been demonstrated.

  17. Gestational diabetes insipidus: a morphological study of the placenta.

    Science.gov (United States)

    Castiglione, F; Buccoliero, A M; Garbini, F; Gheri, C F; Moncini, D; Poggi, G; Saladino, V; Rossi Degl'Innocenti, D; Gheri, R G; Taddei, G L

    2009-12-01

    Gestational diabetes insipidus (GDI) refers to the state of excessive water intake and hypotonic polyuria. Those cases manifesting in pregnancy and referred to as GDI may persist thereafter or may be a transient latent form that resolves after delivery. Microscopic examination of affected subjects has not been previously reported. In the literature, there are various case reports and case series on diabetes insipidus in pregnancy. In this study, we present a case that had transient diabetes insipidus during pregnancy in which the placenta was examined.

  18. The placenta as a compensatory iodine storage organ.

    LENUS (Irish Health Repository)

    Burns, Robert

    2011-05-01

    The production of iodine-containing thyroid hormones necessary for brain development in the fetus depends not only on maternal dietary intake but also on placental iodine transport. The optimum level of iodine nutrition during pregnancy and the proportion of the pregnant population reaching this level have previously been evaluated. Little information exists on the ability of the placenta to either accumulate or store iodine. This study aims to investigate iodine uptake and tissue iodine content within placental tissue obtained from women delivering at term.

  19. Heritable and non-heritable genetic effects on retained placenta in Meuse-Rhine-Yssel cattle

    NARCIS (Netherlands)

    Benedictus, L.; Koets, A.P.; Kuijpers, F.H.J.; Joosten, I.; Eldik, van P.; Heuven, H.C.M.

    2013-01-01

    Failure of the timely expulsion of the fetal membranes, called retained placenta, leads to reduced fertility, increased veterinary costs and reduced milk yields. The objectives of this study were to concurrently look at the heritable and non-heritable genetic effects on retained placenta and test th

  20. Gray scale and Doppler ultrasound in placenta accreta: Optimization of ultrasound signs

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    Mohamed Shawky

    2016-09-01

    Conclusion: Ultrasound and Doppler examinations of placenta have signs highly suggestive of placenta accreta due to high sensitivity and specificity with placental lacunae of turbulent flow and retro-placental myometrial thickness ⩽1 mm are of the highest specificity.

  1. Placenta accreta and maternal morbidity in the Republic of Ireland, 2005-2010

    NARCIS (Netherlands)

    Upson, K.; Silver, R.M.; Greene, R.; Lutomski, J.E.; Holt, V.L.

    2014-01-01

    Abstract Objective: To describe the nationwide prevalence of placenta accreta and to quantify its impact on maternal morbidity. Methods: Using discharge data for public hospitals in Ireland, years 2005-2010, deliveries with placenta accreta were identified using ICD-10-AM code for morbidly adherent

  2. Tumorigenic Factor CRIPTO-1 Is Immunolocalized in Extravillous Cytotrophoblast in Placenta Creta

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    Carla Letícia Bandeira

    2014-01-01

    Full Text Available CRIPTO-(CR1 is a protein associated with tumorigenesis and metastasis. Here we demonstrate that CR-1 expression in normal and creta placentas is associated with various degrees of uterine invasion. Cytokeratin (CK and CR-1 protein expression was visualized by immunohistochemical staining of formalin-fixed, paraffin-embedded placental specimens (control placentas, n=9; accreta, n=6; increta, n=10; percreta, n=15. The pattern of extravillous trophoblast (EVT cell morphology was distinctive in creta placentas: densely-compacted cell columns and large star-shaped cells with a typically migratory phenotype, not common among third trimester control placentas. Quantification revealed higher CR-1 immunoreactivities in accreta (P=0.001, increta (P=0.0002, and percreta placentas (P=0.001 than in controls. In contrast to controls, there was a significant positive relationship between CR-1 and CK reactivity in all creta placentas (accreta, P=0.02; increta, P=0.0001, and percreta, P=0.025. This study demonstrated CR-1 expression in the placental bed, its increased expression in creta placentas, and EVT cells as the main CR-1-producing cell type. Morphological examination revealed an immature and invasive trophoblast profile in creta placentas, suggesting impairment of the trophoblast differentiation pathway. These findings provide important new insights into the pathophysiology of abnormal creta placentation and its gestational consequences.

  3. Comparative study of transperineal and transvaginal sonography for localization of placenta in antepartum haermorrhage

    Directory of Open Access Journals (Sweden)

    Pushpa Dahiya

    2016-01-01

    Conclusions: So, to conclude transperineal sonography is easy to perform, well tolerated accurate diagnostic tool with high sensitivity specificity, positive and negative predictive values for localisation of placenta cases of APH. TVS can be replaced by TPS in cases of APH for localisation of placenta. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 48-52

  4. GLUT12 expression in human placenta in first trimester and term

    NARCIS (Netherlands)

    Gude, NM; Stevenson, JL; Rogers, S; Best, JD; Kalionis, B; Erwich, JJHM; Timmer, A; King, RG

    2003-01-01

    The aim of this study was to characterize the expression of a novel glucose transporter protein GLUT12 in human placenta. GLUT12 mRNA expression was identified by RT-PCR in extracts from five normal term placentae and in extracts from cultured cells of the JAR, JEG-3 and HTR-8Svneo cell lines. In fu

  5. Placenta accreta and maternal morbidity in the Republic of Ireland, 2005-2010

    NARCIS (Netherlands)

    Upson, K.; Silver, R.M.; Greene, R.; Lutomski, J.E.; Holt, V.L.

    2014-01-01

    Abstract Objective: To describe the nationwide prevalence of placenta accreta and to quantify its impact on maternal morbidity. Methods: Using discharge data for public hospitals in Ireland, years 2005-2010, deliveries with placenta accreta were identified using ICD-10-AM code for morbidly adherent

  6. Persistence of placenta previa in twin gestations based on gestational age at sonographic detection.

    Science.gov (United States)

    Kohari, Katherine S; Roman, Ashley S; Fox, Nathan S; Feinberg, Jessica; Saltzman, Daniel H; Klauser, Chad K; Rebarber, Andrei

    2012-07-01

    The purpose of this study was to evaluate the gestational age at sonographic detection of placenta previa as a predictor of previa persistence until delivery in twin gestations. A retrospective cohort of twin pregnancies with placenta previa in a single ultrasound unit was analyzed from 2005 to 2010. Pregnancies were ascertained from a database. Diagnoses were confirmed by transvaginal imaging. Previa was categorized as complete if the placenta completely covered the internal os or marginal if the inferior placental edge reached within 2 cm. Gestational ages were grouped into intervals from 15 to 35 weeks. The study outcome was placenta previa at delivery. Only twin pregnancies at 25 weeks' gestation and later were analyzed using nonparametric statistics as appropriate, with P Placenta previa was detected in 120 twin pregnancies in the second trimester: 32 complete and 88 marginal. Of those with placenta previa at 15 to 19, 20 to 23, 24 to 27, 28 to 31, and 32 to 35 weeks, previa persisted until delivery in 8.3%, 19.2%, 50%, 75%, and 92.5%, respectively. Only at 15- to 19- and 20- to 23-week intervals was complete previa more likely to persist than marginal previa (P placenta previa persistence in twins is dependent on the gestational age at sonographic detection. Only at earlier gestations does the type of previa affect its persistence. As gestational age advances, the likelihood of resolution of placenta previa diminishes regardless of the type noted.

  7. Histopathological examination of the placenta : key issues for pathologists and obstetricians

    NARCIS (Netherlands)

    Gordijn, S. J.; Dahlstrom, J. E.; Khong, T. Y.; Ellwood, D. A.

    2008-01-01

    The placenta is often not submitted for histopathological examination and obstetricians may be sceptical of the value of the examination. This article looks at the reasons for histopathological assessment of the placenta, examines what clinical information should be provided to pathologists and

  8. The Mystery and Miracle of the Placenta | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Healthy Pregnancy The Mystery and Miracle of the Placenta Past Issues / Fall 2016 Table of Contents Understanding its role in health and disease The Human Placenta Project is a long-term research ...

  9. More than clinical waste? Placenta rituals among Australian home-birthing women.

    Science.gov (United States)

    Burns, Emily

    2014-01-01

    The discursive construction of the human placenta varies greatly between hospital and home-birthing contexts. The former, driven by medicolegal discourse, defines the placenta as clinical waste. Within this framework, the placenta is as much of an afterthought as it is considered the "afterbirth." In home-birth practices, the placenta is constructed as a "special" and meaningful element of the childbirth experience. I demonstrate this using 51 in-depth interviews with women who were pregnant and planning home births in Australia or had recently had home births in Australia. Analysis of these interviews indicates that the discursive shift taking place in home-birth practices from the medicalized model translates into a richer understanding and appreciation of the placenta as a spiritual component of the childbirth experience. The practices discussed in this article include the burial of the placenta beneath a specifically chosen plant, consuming the placenta, and having a lotus birth, which refers to not cutting the umbilical cord after the birth of the child but allowing it to dry naturally and break of its own accord. By shifting focus away from the medicalized frames of reference in relation to the third stage of labor, the home-birthing women in this study have used the placenta in various rituals and ceremonies to spiritualize an aspect of birth that is usually overlooked.

  10. Utility of ultrasound and magnetic resonance imaging in prenatal diagnosis of placenta accreta: A prospective study

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    Bhawna Satija

    2015-01-01

    Full Text Available Context: Placenta accreta is the abnormal adherence of the placenta to the uterine wall and the most common cause for emergency postpartum hysterectomy. Accurate prenatal diagnosis of affected pregnancies allows optimal obstetric management. Aims: To summarize our experience in the antenatal diagnosis of placenta accreta on imaging in a tertiary care setup. To compare the accuracy of ultrasound (USG with color Doppler (CDUS and magnetic resonance imaging (MRI in prenatal diagnosis of placenta accreta. Settings and Design: Prospective study in a tertiary care setup. Materials and Methods: A prospective study was conducted on pregnant females with high clinical risk of placenta accreta. Antenatal diagnosis was established based on CDUS and MRI. The imaging findings were compared with final diagnosis at the time of delivery and/or pathologic examination. Statistical Analysis Used: The sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV were calculated for both CDUS and MRI. The sensitivity and specificity values of USG and MRI were compared by the McNemar test. Results: Thirty patients at risk of placenta accreta underwent both CDUS and MRI. Eight cases of placenta accreta were identified (3 vera, 4 increta, and 1 percreta. All patients had history of previous cesarean section. Placenta previa was present in seven out of eight patients. USG correctly identified the presence of placenta accreta in seven out of eight patients (87.5% sensitivity and the absence of placenta accreta in 19 out of 22 patients (86.4% specificity. MRI correctly identified the presence of placenta accreta in 6 out of 8 patients (75.0% sensitivity and absence of placenta accreta in 17 out of 22 patients (77.3% specificity. There were no statistical differences in sensitivity (P = 1.00 and specificity (P = 0.687 between USG and MRI. Conclusions: Both USG and MRI have fairly good sensitivity for prenatal diagnosis of placenta accreta

  11. Utility of ultrasound and magnetic resonance imaging in prenatal diagnosis of placenta accreta: A prospective study

    Science.gov (United States)

    Satija, Bhawna; Kumar, Sanyal; Wadhwa, Leena; Gupta, Taru; Kohli, Supreethi; Chandoke, Rajkumar; Gupta, Pratibha

    2015-01-01

    Context: Placenta accreta is the abnormal adherence of the placenta to the uterine wall and the most common cause for emergency postpartum hysterectomy. Accurate prenatal diagnosis of affected pregnancies allows optimal obstetric management. Aims: To summarize our experience in the antenatal diagnosis of placenta accreta on imaging in a tertiary care setup. To compare the accuracy of ultrasound (USG) with color Doppler (CDUS) and magnetic resonance imaging (MRI) in prenatal diagnosis of placenta accreta. Settings and Design: Prospective study in a tertiary care setup. Materials and Methods: A prospective study was conducted on pregnant females with high clinical risk of placenta accreta. Antenatal diagnosis was established based on CDUS and MRI. The imaging findings were compared with final diagnosis at the time of delivery and/or pathologic examination. Statistical Analysis Used: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both CDUS and MRI. The sensitivity and specificity values of USG and MRI were compared by the McNemar test. Results: Thirty patients at risk of placenta accreta underwent both CDUS and MRI. Eight cases of placenta accreta were identified (3 vera, 4 increta, and 1 percreta). All patients had history of previous cesarean section. Placenta previa was present in seven out of eight patients. USG correctly identified the presence of placenta accreta in seven out of eight patients (87.5% sensitivity) and the absence of placenta accreta in 19 out of 22 patients (86.4% specificity). MRI correctly identified the presence of placenta accreta in 6 out of 8 patients (75.0% sensitivity) and absence of placenta accreta in 17 out of 22 patients (77.3% specificity). There were no statistical differences in sensitivity (P = 1.00) and specificity (P = 0.687) between USG and MRI. Conclusions: Both USG and MRI have fairly good sensitivity for prenatal diagnosis of placenta accreta; however

  12. Placenta Prévia: Fatores de risco para o Acretismo Placenta Previa: Risk Factors for Accretion

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    Maria Regina Torloni

    2001-08-01

    Full Text Available Objetivo: investigação dos fatores de risco associados ao acretismo em pacientes com placenta prévia (PP. Métodos: foi realizada uma análise retrospectiva caso-controle de todos os prontuários de pacientes com diagnóstico de PP que tiveram seus partos na Maternidade Escola Vila Nova Cachoeirinha (São Paulo entre 1986 e 1998. O grupo com acretismo foi comparado ao grupo sem acretismo quanto à idade, paridade, antecedentes de abortamentos, curetagens e cesarianas, o tipo de PP e a área predominante de inserção placentária. Para avaliar a associação entre a variável dependente (acretismo placentário e as variáveis independentes (características maternas e placentária foram utilizados o teste do chi², análise univariada e multivariada, considerando-se significantes os valores de p Purpose: to investigate risk factors associated with accretion in placenta previa (PP patients. Methods: this was a retrospective case-control study of all the records of patients who delivered between 1986-1998 at Maternidade Escola de Vila Nova Cachoeirinha (São Paulo with a diagnosis of placenta previa. The groups with and without accretion were compared regarding age, parity, previous history of miscarriage, curettage and cesarean section, type of PP and predominant area of placental attachment. Possible associations between the dependent (accretion and independent (maternal and placental characteristics variables were evaluated using the chi² test, univariate and multivariate analyses. Results: reviewing 245 cases of PP, two risk factors were significantly associated with accretion: central placenta previa (odds ratio (OR: 2.93 and two or more previous cesarean sections(OR: 2.54. Based on these data, a predictive model was constructed, according to which a patient with central PP and two more previous cesarean sections has a 44.4% risk for accretion. Conclusions: results of the current study may help obstetricians in the classification of their

  13. Prenatal Diagnosis and Perinatal Management of Placenta Previa Accreta: Past, Present and Future

    Directory of Open Access Journals (Sweden)

    Min-Min Chou

    2004-06-01

    Full Text Available The reported incidence of placenta accreta varies widely in the English literature, from 1:540 to 1:93,000 deliveries. In Taiwan, the quoted incidence ranges from 1:625 to 1:1,652 deliveries in tertiary medical centers. Massive obstetric hemorrhage is still the leading cause of pregnancy-related death, and placenta previa accreta remains one of the major predisposing factors. With the increasing rates of cesarean delivery and uterine curettage for abortion, both placenta previa and accreta are steadily increasing in frequency. Therefore, more cases of placenta previa accreta can be expected in obstetric practice. In several recent series, placenta accreta has emerged as the major indication for peripartum hysterectomy, accounting for 40% to 60% of cases. It has, therefore, become a challenging problem of increasing clinical significance in obstetrics.

  14. A Case of Vaginal Stillbirth in the Presence of Placenta Previa at 33 Weeks of Gestation.

    Science.gov (United States)

    Chinen, Yukiko; Kinjo, Tadatsugu; Nitta, Hayase; Kinjo, Yui; Masamoto, Hitoshi; Aoki, Yoichi

    2016-01-01

    It was demonstrated that second- and third-trimester therapeutic termination of pregnancy (TOP) is feasible in cases with placenta previa. We report a 34-year-old woman with complex fetal malformations associated with placenta previa. An ultrasound examination at 21 weeks of gestation revealed fetal growth restriction (FGR) and complex fetal malformations associated with a placenta previa. After extensive information, the parents opted for careful observation. Thereafter, FGR gradually progressed and we observed arrest of end-diastolic velocity of the umbilical artery. Finally, intrauterine fetal death (IUFD) was confirmed at 33 weeks of gestation. Two days after IUFD, the patient experienced labor pain. The placenta and dead fetus weighing 961 g were vaginally delivered, and total bleeding was 270 mL. Although further studies to confirm the dynamic change of the uteroplacental blood flow are necessary to avoid the risk of maternal hemorrhage, vaginal TOP with placenta previa after feticide or IUFD would be feasible.

  15. The Case Report of Trigger Finger Improved with Hominis Placenta Pharmacopuncture Treatment

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    Jeong-Won Kim

    2010-12-01

    Full Text Available Objectives : The Purpose of this study is to investigate and report the effectiveness of Hominis Placenta using Pharmacopuncture treatment for trigger finger. Methods : 3 Patients are admitted at Dept. of Oriental Rehabilitation, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as Trigger finger and treated with Hominis Placenta Pharmacopuncture. Each cases are measured and assessed by Quinnell's classification of triggering and VAS (Visual Analogue Scale scores. Results : 3 Patients of trigger finger have a different kind of cause and fingers lesion they have, but nodules are not significantly found up, so we could classify all of 3 patients to diffuse type. After treatment of Hominis placenta Pharmacopuncture, spontaneous pain and tenderness, grades of triggering are decreased significantly. We would expect that Hominis placenta Pharmacopuncture has a effect on degenerative diseases of diffuse type's tendon sheath. Conclusions : Trigger finger is generally divided into two stages, inflammatory and degenerative stage, and when degenerative stage, Hominis placenta pharmacopuncture appears to be effective.

  16. Participation in environmental health research by placenta donation - a perception study

    DEFF Research Database (Denmark)

    Lind, Uffe; Mose, Tina; Knudsen, Lisbeth E

    2007-01-01

    BACKGROUND: Much environmental health research depends on human volunteers participating with biological samples. The perception study explores why and how people participate in a placenta perfusion study in Copenhagen. The participation implies donation of the placenta after birth and some...... background information but no follow up. METHODS: Nineteen semi-structured qualitative interviews were conducted with participants in the placenta perfusion study after donation of placenta. Observation studies were made of recruitment sessions. RESULTS: The interviewed participants are generally in favour...... of medical research. They participated in the placenta perfusion study due to a belief that societal progress follows medical research. They also felt that participating was a way of giving something back to the Danish health care system. The participants have trust in medical science and scientists...

  17. Cervical varix complicated by placenta previa: A case report and literature review.

    Science.gov (United States)

    Tanaka, Mie; Matsuzaki, Shinya; Kumasawa, Keiichi; Suzuki, Yosuke; Endo, Masayuki; Kimura, Tadashi

    2016-07-01

    Uterine cervical varix is rare, and its clinical course is poorly understood. Therefore, we present a case report of cervical varix complicating placenta previa before describing our findings in the context of an electronic database search of relevant reports. In the case report, we describe the clinical course and imaging results of a 35-year-old woman who was diagnosed with cervical varix complicated by placenta previa. Investigation by magnetic resonance imaging, serial ultrasonography, and speculum confirmed the diagnosis, and a healthy baby was successfully delivered at 36 weeks of gestation by cesarean section. An electronic search identified nine previous cases of cervical varix complicated by placenta previa in the literature. Clinicians should be aware of cervical varices when managing placenta previa to avoid iatrogenic rupture or misdiagnosis of placenta accreta by magnetic resonance imaging. © 2016 Japan Society of Obstetrics and Gynecology.

  18. Uterine artery embolization, not cesarean section, as an option for termination of pregnancy in placenta previa.

    Science.gov (United States)

    Huang, Lingling; Awale, Reenu; Tang, Hui; Zeng, ZhiShan; Li, FuRong; Chen, Yue

    2015-04-01

    To summarize our experiences in the treatment of labor induction in placenta previa using uterine artery embolization. We retrospectively analyzed the clinical data of seven patients with placenta previa who underwent antepartum uterine artery embolization before vaginal delivery. After antepartum embolization, five patients with placenta previa had successful vaginal deliveries and two cases of placenta previa with accreta underwent emergency hysterectomy. Some complications were reported in this experience. The follow-up study showed that most patients resumed their normal menstruation and some of them were able to conceive. For the management of placenta previa, uterine artery embolization is a minimally invasive technique that helps to avoid cesarean section. The impact on menstruation and fertility is yet to be seen. Copyright © 2015. Published by Elsevier B.V.

  19. Successful outcome of placenta previa percreta with bladder invasion

    Directory of Open Access Journals (Sweden)

    Syeda Sayeeda

    2017-06-01

    Full Text Available A 41 year old multiparous lady, with previous history of one cesarean section presented at her 24 weeks of gestation with frank hematuria. The case was diagnosed as placenta previa percreta with the bladder involvement by ultrasound doppler and confirmed by MR urogram. So, peripartum hysterectomy was planned. On opening of the abdomen, a hugely distended bladder was found, which when retracted engorged blood vessels were found over the lower segment of uterus. Baby was delivered by giving a transverse incision in the upper segment. By keeping placenta in situ, total abdominal hysterectomy was done with quick successive clamping. Severe per-operative bleeding was occurred. Bladder irrigation started following total abdominal hysterectomy. Continuous small clots were coming out through catheter. A large old blood clot was removed by cystostomy done by an urologist. A sprouting vessel and a linear injury were noticed at the base of the bladder. The vessel was ligated and the injury was repaired. After proper hemostasis, the abdomen was closed in layers. The patient was shifted to ICU. Patient developed complications like MI, watery diarrhoea, low grade fever which was managed accordingly. She was discharged healthy on her 19th post-operative day.

  20. Glucose metabolism in cultured trophoblasts from human placenta

    Energy Technology Data Exchange (ETDEWEB)

    Moe, A.J.; Farmer, D.R.; Nelson, D.M.; Smith, C.H. (Washington Univ., St. Louis, MO (United States))

    1990-02-26

    The development of appropriate placental trophoblast isolation and culture techniques enables the study of pathways of glucose utilization by this important cell layer in vitro. Trophoblasts from normal term placentas were isolated and cultured 24 hours and 72 hours in uncoated polystyrene culture tubes or tubes previously coated with a fibrin matrix. Trophoblasts cultured on fibrin are morphologically distinct from those cultured on plastic or other matrices and generally resemble in vivo syncytium. Cells were incubated up to 3 hours with {sup 14}C-labeled glucose and reactions were stopped by addition of perchloric acid. {sup 14}CO{sub 2} production by trophoblasts increased linearly with time however the largest accumulation of label was in organic acids. Trophoblasts cultured in absence of fibrin utilized more glucose and accumulated more {sup 14}C in metabolic products compared to cells cultured on fibrin. Glucose oxidation to CO{sub 2} by the phosphogluconate (PG) pathway was estimated from specific yields of {sup 14}CO{sub 2} from (1-{sup 14}C)-D-glucose and (6-{sup 14}C)-D-glucose. Approximately 6% of glucose oxidation was by the PG pathway when cells were cultured on fibrin compared to approximately 1% by cells cultured in the absence of fibrin. The presence of a fibrin growth matrix appears to modulate the metabolism of glucose by trophoblast from human placenta in vitro.

  1. The Effect of Hominis Placenta Herbal Acupuncture on Bell's palsy

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    Yun Jeong-hun

    2000-07-01

    Full Text Available This report was done to observe the effect of Hominis placenta herbal acupuncture on Bell's palsy. The study group comprised 16 patients who arrived at Woo-suk university oriental hospital from January, 1999 till January, 2000 for Bell's palsy. All patients were divided into two group. One was herbal acupunture group, and the other was control group. Acupunture group was done herbal acupuncture therapy on the facial acupuncture points. Followings are achievement and a term of each group. In herbal acupuncture group, 100% motor recovery was 7 case, 75% was 1 case, and 25% motor recovery term was 7.38±5.21 days, 50% was 11.00±6.16 days, 75% was 15.13±9.55 days, 100% was 23.14±7.97 days. In control group, 100% motor recovery was 4 case, 75% was 2 case, 25% below was 2 case and 25% motor recovery term was 11.17±4.96days, 50% was 18.17±6.82 days, 75% was 29.50±6.95 days, 100% was 44.00±11.49 days. The above results indicate that Hominis placenta herbal acupuncture is a useful effect on Bell's palsy. thus, continuous herbal acupunture study will be needed for more clinical application on Bell' palsy.

  2. Drug interactions at the human placenta: what is the evidence?

    Directory of Open Access Journals (Sweden)

    Miriam eRubinchik-Stern

    2012-07-01

    Full Text Available Pregnant women (and their fetuses are treated with a significant number of prescription and nonprescription medications. Interactions among those drugs may affect their efficacy and toxicity in both mother and fetus. Whereas interactions that result in altered drug concentrations in maternal plasma are detectable, those involving modulation of placental transfer mechanisms are rarely reflected by altered drug concentrations in maternal plasma. Therefore, they are often overlooked. Placental-mediated interactions are possible because the placenta is not only a passive diffusional barrier, but also expresses a variety of influx and efflux transporters and drug metabolizing enzymes. Current data on placental-mediated drug interactions are limited. In rodents, pharmacological or genetic manipulations of placental transporters significantly affect fetal drug exposure. In contrast, studies in human placentae suggest that the magnitude of such interactions is modest in most cases. Nevertheless, under certain circumstances, such interactions may be of clinical significance. This review describes currently known mechanisms of placental-mediated drug interactions and the potential implications of such interactions in humans. Better understanding of those mechanisms is important for minimizing fetal toxicity from drugs while improving their efficacy when directed to treat the fetus.

  3. Suspected invasive placenta: evaluation with magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bour, Laurence; Place, Vinciane; Bendavid, Sandra; Fargeaudou, Yann [Hopital Lariboisiere-AP-HP, Department of Abdominal and Interventional Imaging, Paris cedex 10 (France); Portal, Jean-Jacques [Hopital Lariboisiere-AP-HP, Department of Biostatistics and Clinical Research, Paris cedex 10 (France); Ricbourg, Aude [Hopital Lariboisiere-AP-HP, Department of Obstetrics and Gynecology, Paris cedex 10 (France); Sebbag, Delphine; Dohan, Anthony; Soyer, Philippe [Hopital Lariboisiere-AP-HP, Department of Abdominal and Interventional Imaging, Paris cedex 10 (France); Diderot-Paris 7 University-Sorbonne Paris-Cite, Paris (France); Vicaut, Eric [Hopital Lariboisiere-AP-HP, Department of Biostatistics and Clinical Research, Paris cedex 10 (France); Diderot-Paris 7 University-Sorbonne Paris-Cite, Paris (France)

    2014-12-15

    To determine the utility of magnetic resonance imaging (MRI) in diagnosing invasive placenta (IP). MRI findings in 32 women with suspected IP were evaluated independently by four readers. Interobserver agreement was calculated with kappa (κ) statistics. Associations between MRI findings and IP were assessed by univariate and multivariate analyses. Sensitivity, specificity and accuracy of MRI for the diagnosis of IP were estimated. Sixteen women (16/32; 50 %) had confirmed IP. Interobserver correlation for the diagnosis of IP was fair (κ = 0.40). Univariate analysis revealed that thinning or focal defect of the uteroplacental interface (P < 0.0001) was the most discriminating MRI variable in the differentiation between normal and IP. Overall sensitivity and specificity of MRI for the diagnosis of IP were 84 % [95 % CI: 75-94 %] and 80 % [95 % CI: 66-93 %], respectively. Thinning or focal defect of the uteroplacental interface was the most accurate finding (88 %) in the diagnosis of IP. Multivariate analysis revealed that thinning or focal defect of the uteroplacental interface was the single independent predictor of IP (P = 0.0006; OR = 64.99). MR imaging has 84 % sensitivity [95 % CI: 75-94 %] and 80 % specificity [95 % CI: 66-93 %] for the diagnosis of IP. Thinning or focal defect of the uteroplacental interface is the most discriminating independent MR variable in differentiating between normal placenta and IP. (orig.)

  4. Optoacoustic measurements of human placenta and umbilical blood oxygenation

    Science.gov (United States)

    Nanovskaya, T. N.; Petrov, I. Y.; Petrov, Y.; Patrikeeva, S. L.; Ahmed, M. S.; Hankins, G. D. V.; Prough, D. S.; Esenaliev, R. O.

    2016-03-01

    Adequate oxygenation is essential for normal embryogenesis and fetal growth. Perturbations in the intrauterine oxidative environment during pregnancy are associated with several pathophysiological disorders such as pregnancy loss, preeclampsia, and intrauterine growth restriction. We proposed to use optoacoustic technology for monitoring placental and fetal umbilical blood oxygenation. In this work, we studied optoacoustic monitoring of oxygenation in placenta and umbilical cord blood ex vivo using technique of placenta perfusion. We used a medical grade, nearinfrared, tunable, optoacoustic system developed and built for oxygenation monitoring in blood vessels and in tissues. First, we calibrated the system for cord blood oxygenation measurements by using a CO-Oximeter (gold standard). Then we performed validation in cord blood circulating through the catheters localized on the fetal side of an isolated placental lobule. Finally, the oxygenation measurements were performed in the perfused placental tissue. To increase or decrease blood oxygenation, we used infusion of a gas mixture of 95% O2 + 5% CO2 and 95% N2 + 5% CO2, respectively. In placental tissue, up to four cycles of changes in oxygenation were performed. The optoacoustically measured oxygenation in circulating cord blood and in placental lobule closely correlated with the actual oxygenation data measured by CO-Oximeter. We plan to further test the placental and cord blood oxygenation monitoring with optoacoustics in animal and clinical studies.

  5. A RARE CASE OF PLACENTA PERCRETA AND ITS OBSTETRIC OUTCOME

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    Shobha

    2014-07-01

    Full Text Available A 24-year-old woman G2P1L1 with previous caesarean section presented at 39 weeks of gestation to CG Hospital attached to JJM medical college, Davangere. Ultrasound showed features suggestive of placenta accrete. The patient was taken for elective cesarean delivery with blood in hand. On table, there was massive hemorrhage with atonic Post-partum hemorrhage. The obstetricians immediately proceeded with an emergency hysterectomy, during which time the lower uterine segment was found to be densely adherent to the bladder wall and the placental tissue invading into the bladder wall. The adherent part of placenta was left behind. She developed reactionary hemorrhage after 9 hrs. Relaparotomy was done and bleeding was found from the placental tissue adherent to bladder. Ligation of the internal iliac artery was done. She was discharged home on postoperative day 9 after removal of the abdominal drain. Her USG after one month shows non vascular placental tissue of 17 ml and her beta HCG values were less than 1

  6. DNA flow cytometric analysis in variable types of hydropic placentas

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    Fatemeh Atabaki pasdar

    2015-05-01

    Full Text Available Background: Differential diagnosis between complete hydatidiform mole, partial hydatidiform mole and hydropic abortion, known as hydropic placentas is still a challenge for pathologists but it is very important for patient management. Objective: We analyzed the nuclear DNA content of various types of hydropic placentas by flowcytometry. Materials and Methods: DNA ploidy analysis was performed in 20 non-molar (hydropic and non-hydropic spontaneous abortions and 20 molar (complete and partial moles, formalin-fixed, paraffin-embedded tissue samples by flow cytometry. The criteria for selection were based on the histopathologic diagnosis. Results: Of 10 cases histologically diagnosed as complete hydatiform mole, 9 cases yielded diploid histograms, and 1 case was tetraploid. Of 10 partial hydatidiform moles, 8 were triploid and 2 were diploid. All of 20 cases diagnosed as spontaneous abortions (hydropic and non-hydropic yielded diploid histograms. Conclusion: These findings signify the importance of the combined use of conventional histology and ploidy analysis in the differential diagnosis of complete hydatidiform mole, partial hydatidiform mole and hydropic abortion.

  7. Identification and analysis of multi-protein complexes in placenta.

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    Fuqiang Wang

    Full Text Available Placental malfunction induces pregnancy disorders which contribute to life-threatening complications for both the mother and the fetus. Identification and characterization of placental multi-protein complexes is an important step to integratedly understand the protein-protein interaction networks in placenta which determine placental function. In this study, blue native/sodium dodecyl sulfate polyacrylamide gel electrophoresis (BN/SDS-PAGE and Liquid chromatography-tandem mass spectrometry (LC-MS/MS were used to screen the multi-protein complexes in placenta. 733 unique proteins and 34 known and novel heterooligomeric multi-protein complexes including mitochondrial respiratory chain complexes, integrin complexes, proteasome complexes, histone complex, and heat shock protein complexes were identified. A novel protein complex, which involves clathrin and small conductance calcium-activated potassium (SK channel protein 2, was identified and validated by antibody based gel shift assay, co-immunoprecipitation and immunofluorescence staining. These results suggest that BN/SDS-PAGE, when integrated with LC-MS/MS, is a very powerful and versatile tool for the investigation of placental protein complexes. This work paves the way for deeper functional characterization of the placental protein complexes associated with pregnancy disorders.

  8. Placenta accreta and the developing world--a review.

    Science.gov (United States)

    Umezurike, C C; Feyi-Waboso, P A

    2010-12-01

    The rising Caesarean section rate in the developing world implies that the incidence of placenta accreta might be on the increase and this might worsen the maternal mortality burden. To draw the attention of Obstetricians and other relevant professionals to this emerging but challenging trend. Original research findings and reviews published in the English literature. Additional information was obtained from texts and electronic books such as CD ROMS. Online searches of electronic database (Medline, Pubmed and Embase), requests for reprints from corresponding authors and institutional/private subscriptions. Information obtained was categorised accordingly. Optimal treatment of women with placenta accreta requires recognition of the clinical risk factors, accurate pre-operative diagnosis and meticulous planning to ensure safety at the time of delivery. In view of the rising incidence of this condition, and the absence of a highly reliable antenatal diagnostic method especially in developing countries, a high index of suspicion and advanced preparation is required to reduce its associated maternal morbidity and mortality.

  9. Impaired mitochondrial function in human placenta with increased maternal adiposity.

    Science.gov (United States)

    Mele, James; Muralimanoharan, Sribalasubashini; Maloyan, Alina; Myatt, Leslie

    2014-09-01

    The placenta plays a key role in regulation of fetal growth and development and in mediating in utero developmental programming. Obesity, which is associated with chronic inflammation and mitochondrial dysfunction in many tissues, exerts a programming effect in pregnancy. We determined the effect of increasing maternal adiposity and of fetal sex on placental ATP generation, mitochondrial biogenesis, expression of electron transport chain subunits, and mitochondrial function in isolated trophoblasts. Placental tissue was collected from women with prepregnancy BMI ranging from 18.5 to 45 following C-section at term with no labor. Increasing maternal adiposity was associated with excessive production of reactive oxygen species and a significant reduction in placental ATP levels in placentae with male and female fetuses. To explore the potential mechanism of placental mitochondrial dysfunction, levels of transcription factors regulating the expression of genes involved in electron transport and mitochondrial biogenesis were measured. Our in vitro studies showed significant reduction in mitochondrial respiration in cultured primary trophoblasts with increasing maternal obesity along with an abnormal metabolic flexibility of these cells. This reduction in placental mitochondrial respiration in pregnancies complicated by maternal obesity could compromise placental function and potentially underlie the increased susceptibility of these pregnancies to fetal demise in late gestation and to developmental programming.

  10. Evolution of the interhaemal barrier in the placenta of rodents

    DEFF Research Database (Denmark)

    Mess, A M; Carter, A M

    2009-01-01

    A recent phylogenetic analysis achieved good resolution between the 5 suborders of rodent. As a novel finding it suggested a basal split that gave rise to a monophyletic group comprising Hystricomorpha and Sciuromorpha. We asked whether the new tree could cast light on the evolution of the interh......A recent phylogenetic analysis achieved good resolution between the 5 suborders of rodent. As a novel finding it suggested a basal split that gave rise to a monophyletic group comprising Hystricomorpha and Sciuromorpha. We asked whether the new tree could cast light on the evolution...... of the interhaemal barrier in rodents where at least seven variants have been described. To supplement existing data we first examined the placenta of the common gundi, Ctenodactylus gundi. It was shown to be haemochorial with a single layer of syncytiotrophoblast in the interhaemal membrane but with nests...... of cytotrophoblast elsewhere. Next we used character mapping on the recent tree to determine the pattern of evolution of the placenta with respect to principal type (e.g. haemochorial) and the trophoblast found within the interhaemal barrier. This indicated that the common ancestor of living rodents had...

  11. Retained placenta in Friesian mares : reproductive performance after foal heat breeding versus breeding in a subsequent heat

    NARCIS (Netherlands)

    Sevinga, M; Hesselink, JW; Barkema, H.W.

    2001-01-01

    Postpartum reproductive performance was studied in 54 Friesian brood mares with and 50 without retained placenta. Retained placenta was defined as failure to expel all fetal membranes within 3 hours after the delivery of the foal. The group of mares with retained placenta was subdivided into mares i

  12. Treatment of retained placenta with misoprostol: A randomised controlled trial in a low-resource setting (Tanzania)

    NARCIS (Netherlands)

    H.J. van Beekhuizen (Heleen); A.B. Pembe (Andrea); H. Fauteck (Heiner); F.K. Lotgering (Fred)

    2009-01-01

    textabstractBackground: Retained placenta is one of the common causes of maternal mortality in developing countries where access to appropriate obstetrical care is limited. Current treatment of retained placenta is manual removal of the placenta under anaesthesia, which can only take place in larger

  13. Treatment of retained placenta with misoprostol: a randomised controlled trial in a low-resource setting (Tanzania).

    NARCIS (Netherlands)

    Beekhuizen, H.J. van; Pembe, A.B.; Fauteck, H.; Lotgering, F.K.

    2009-01-01

    BACKGROUND: Retained placenta is one of the common causes of maternal mortality in developing countries where access to appropriate obstetrical care is limited. Current treatment of retained placenta is manual removal of the placenta under anaesthesia, which can only take place in larger health care

  14. Early Developmental and Evolutionary Origins of Gene Body DNA Methylation Patterns in Mammalian Placentas.

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    Diane I Schroeder

    2015-08-01

    Full Text Available Over the last 20-80 million years the mammalian placenta has taken on a variety of morphologies through both divergent and convergent evolution. Recently we have shown that the human placenta genome has a unique epigenetic pattern of large partially methylated domains (PMDs and highly methylated domains (HMDs with gene body DNA methylation positively correlating with level of gene expression. In order to determine the evolutionary conservation of DNA methylation patterns and transcriptional regulatory programs in the placenta, we performed a genome-wide methylome (MethylC-seq analysis of human, rhesus macaque, squirrel monkey, mouse, dog, horse, and cow placentas as well as opossum extraembryonic membrane. We found that, similar to human placenta, mammalian placentas and opossum extraembryonic membrane have globally lower levels of methylation compared to somatic tissues. Higher relative gene body methylation was the conserved feature across all mammalian placentas, despite differences in PMD/HMDs and absolute methylation levels. Specifically, higher methylation over the bodies of genes involved in mitosis, vesicle-mediated transport, protein phosphorylation, and chromatin modification was observed compared with the rest of the genome. As in human placenta, higher methylation is associated with higher gene expression and is predictive of genic location across species. Analysis of DNA methylation in oocytes and preimplantation embryos shows a conserved pattern of gene body methylation similar to the placenta. Intriguingly, mouse and cow oocytes and mouse early embryos have PMD/HMDs but their placentas do not, suggesting that PMD/HMDs are a feature of early preimplantation methylation patterns that become lost during placental development in some species and following implantation of the embryo.

  15. Topical application of recombinant activated factor VII during cesarean delivery for placenta previa.

    Science.gov (United States)

    Schjoldager, Birgit T B G; Mikkelsen, Emmeli; Lykke, Malene R; Præst, Jørgen; Hvas, Anne-Mette; Heslet, Lars; Secher, Niels J; Salvig, Jannie D; Uldbjerg, Niels

    2017-06-01

    During cesarean delivery in patients with placenta previa, hemorrhaging after removal of the placenta is often challenging. In this condition, the extraordinarily high concentration of tissue factor at the placenta site may constitute a principle of treatment as it activates coagulation very effectively. The presumption, however, is that tissue factor is bound to activated factor VII. We hypothesized that topical application of recombinant activated factor VII at the placenta site reduces bleeding without affecting intravascular coagulation. We included 5 cases with planned cesarean delivery for placenta previa. After removal of the placenta, the surgeon applied a swab soaked in recombinant activated factor VII containing saline (1 mg in 246 mL) to the placenta site for 2 minutes; this treatment was repeated once if the bleeding did not decrease sufficiently. We documented the treatment on video recordings and measured blood loss. Furthermore, we determined hemoglobin concentration, platelet count, international normalized ratio, activated partial thrombin time, fibrinogen (functional), factor VII:clot, and thrombin generation in peripheral blood prior to and 15 minutes after removal of the placenta. We also tested these blood coagulation variables in 5 women with cesarean delivery planned for other reasons. Mann-Whitney test was used for unpaired data. In all 5 cases, the uterotomy was closed under practically dry conditions and the median blood loss was 490 (range 300-800) mL. There were no adverse effects of recombinant activated factor VII and we did not measure factor VII to enter the circulation. Neither did we observe changes in thrombin generation, fibrinogen, activated partial thrombin time, international normalized ratio, and platelet count in the peripheral circulation (all P values >.20). This study indicates that in patients with placenta previa, topical recombinant activated factor VII may diminish bleeding from the placenta site without initiation

  16. Placenta previa and the risk of delivering a small-for-gestational-age newborn.

    Science.gov (United States)

    Räisänen, Sari; Kancherla, Vijaya; Kramer, Michael R; Gissler, Mika; Heinonen, Seppo

    2014-08-01

    To evaluate whether there is an association between placenta previa and delivery of a small-for-gestational-age (SGA) newborn and to quantify the contribution of individual risk factors for SGA that are associated with placenta previa stratified by maternal parity. A cross-sectional study using the Finnish Medical Birth Register during 2000-2010. All singleton births (N=596,562) were included; major congenital anomalies were excluded. An association between SGA (less than 2 standard deviations below the mean) and placenta previa was modeled by parity-specific unadjusted and adjusted statistical models. Placenta previa complicated 625 of 249,476 singleton births among nulliparous women (2.50/1,000) and 915 of 347,086 singleton births among multiparous women (2.64/1,000). Among nulliparous women, the most common risk factor for placenta previa was in vitro fertilization; placenta previa was not associated with an increased prevalence of SGA controlling for maternal age, smoking, in vitro fertilization, socioeconomic status, and preeclampsia (adjusted odds ratio [OR] 0.81, 95% confidence interval [CI] 0.57-1.17). Among multiparous women, placenta previa was associated with a twofold increased risk of SGA controlling for maternal age, parity, prior preterm birth, prior caesarean delivery, prior SGA newborn, prior preeclampsia, smoking, in vitro fertilization, socioeconomic status, and preeclampsia (adjusted OR 2.08, 95% CI 1.50-2.89). Furthermore, only one-fourth of the association between SGA and placenta previa could be explained by controlling for risk factors clustering with placenta previa among multiparous women. Placenta previa is associated with impaired fetal growth in multiparous but not nulliparous women. II.

  17. Decreased placental and maternal serum TRAIL-R2 levels are associated with placenta accreta.

    Science.gov (United States)

    Oztas, Efser; Ozler, Sibel; Ersoy, Ali Ozgur; Ersoy, Ebru; Caglar, Ali Turhan; Uygur, Dilek; Yucel, Aykan; Ergin, Merve; Danisman, Nuri

    2016-03-01

    TNF-related apoptosis-inducing ligand receptor-2 (TRAIL-R2) is produced both by decidual and trophoblast cells during pregnancy and known to participate in apoptosis. In this study, we aimed to determine and to compare maternal serum and placental TRAIL-R2 levels in patients with placenta accreta, non-adherent placenta previa and in healthy pregnancies. We also aimed to analyze the association of placenta accreta with the occurrence of previous C-sections. A total of 82 pregnant women were enrolled in this case-control study (27 placenta accreta patients, 26 non-adherent placenta previa patients and 29 age-, and BMI-matched healthy, uncomplicated pregnant controls). TRAIL-R2 levels were studied in both maternal serum and placental tissue homogenates. Determining the best predictor(s) which discriminate placenta accreta was analyzed by multiple logistic regression analyses. Adjusted odds ratios and 95% confidence intervals were also calculated. Both placental and serum TRAIL-R2 levels were significantly lower in placenta accreta group (median 34.82 pg/mg and 19.85 pg/mL, respectively) when compared with both non-adherent placenta previa (median 39.24 pg/mg and 25.99 pg/mL, respectively) and the control groups (median 41.62 pg/mg and 25.87 pg/mL, respectively) (p placenta accreta (OR: 0.934 95% CI 0.883-0.987, p = 0.016 and OR:7.725 95% CI: 2.717-21.965, p placenta accreta, suggesting a possible role of apoptosis in abnormal trophoblast invasion. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Prenatal MRI diagnosis of placenta previa complicated with placenta accreta%前置胎盘合并胎盘植入的MRI产前诊断

    Institute of Scientific and Technical Information of China (English)

    钟华; 李丽红; 代海洋; 黎昕; 刘锦文

    2014-01-01

    目的:探讨前置胎盘合并胎盘植入的产前MRI诊断价值。材料与方法回顾性分析经手术病理证实的48例前置胎盘患者的临床及MRI资料,包括前置胎盘合并胎盘植入者12例,总结分析其MRI影像学特征。结果 MRI术前诊断前置胎盘43例,其中完全性前置胎盘31例,部分型前置胎盘9例,边缘型前置胎盘3例,总体诊断符合率为89.5%(43/48)。MRI术前正确诊断胎盘植入9例,诊断符合率为75.0%(9/12)。结论 MRI对前置胎盘及胎盘植入有较高的诊断价值,综合MR不同成像序列可提高术前诊断准确率。%Objective: To investigate the prenatal MRI imaging features of placenta previa complicated with placenta accreta.Materials and Methods:The clinical and MRI data of 48 cases of placenta previa including 12 placenta accreta conifrmed by clinic and surgery were retrospectively analyzed.Results: Forty-three cases of placenta previa were diagnosed by MRI pre-operation, including 31 cases of complete placenta previa, 9 cases of partial placenta previa and 3 cases of marginal placenta previa. The overall diagnose accordance rate was 89.5% (43/48). Nine cases of placenta accreta were diagnosed by MRI pre-operation, the diagnose accordance rate was 75.0% (9/12).Conclusions:MRI has a high accuracy for the diagnosis of placenta previa, the combination of different MR sequence can make accurate diagnosis possible.

  19. Increased levels of cell-free human placental lactogen mRNA at 28-32 gestational weeks in plasma of pregnant women with placenta previa and invasive placenta.

    Science.gov (United States)

    Kawashima, Akihiro; Sekizawa, Akihiko; Ventura, Walter; Koide, Keiko; Hori, Kyouko; Okai, Takashi; Masashi, Yoshida; Furuya, Kenichi; Mizumoto, Yoshifumi

    2014-02-01

    We compared the levels of cell-free human placental lactogen (hPL) messenger RNA (mRNA) in maternal plasma at 28 to 32 weeks of gestation between women with diagnosis of placenta previa or invasive placenta and women with an uneventful pregnancy. Sensitivity and specificity of hPL mRNA for the prediction of invasive placenta were further explored. Plasma hPL mRNA were quantified by real-time reverse-transcriptase polymerase chain reaction in women with placenta previa (n = 13), invasive placenta (n = 5), and normal pregnancies (n = 92). Median (range) hPL mRNA was significantly higher in women with placenta previa, 782 (10-2301) copies/mL of plasma, and in those with invasive placenta, 615 (522-2102) copies/mL of plasma, when compared to normal pregnancies, 90 (4-4407) copies/mL of plasma, P placenta among women with placenta previa. In conclusion, expression of hPL mRNA is increased in plasma of women with placenta previa and invasive placenta at 28 to 32 weeks of gestation.

  20. Clinical analysis of placenta previa complicated with placenta accreta%前置胎盘合并胎盘植入的临床分析

    Institute of Scientific and Technical Information of China (English)

    卢培玲; 辛崇敏; 徐宝兰

    2011-01-01

    目的 探讨前置胎盘合并胎盘植入的高危因素、临床特点、诊断及治疗.方法 对日照市中医医院4年间8 964例产妇中12例前置胎盘合并胎盘植入的患者资料进行分析.结果 在8 964例产妇中前置胎盘发生率为0.97%(87/8 964);87例前置胎盘患者均为多孕次产妇,经产妇占58.62%(51/87),高龄产妇占65.52%(57/87).前置胎盘合并胎盘植入的发生率为0.13%(12/8 964),占前置胎盘的13.79%(12/87),有前次剖宫产史者占83.33%(10/12),凶险型前置胎盘并胎盘植入至原子宫切口瘢痕处3例,占25.00%(3/12).植入组前次剖宫产史率明显高于对照组(χ2=17.789,P<0.01).结论 随着剖宫产率的提高,前置胎盘合并胎盘植入发生率也在不断升高,前置胎盘合并胎盘植入的发生与瘢痕子宫密切相关,因此要重视对其进行早期诊断及合理治疗,改善母婴结局.%Objective To investigate the risk factors, clinical features, diagnosis and treatment of placenta previa complicated with placenta accrete. Methods 12 cases of placenta previa complicated with placenta accreta diagnosed in Rizhao Hospital of Traditional Chinese Medicine in recent 4 years were analyzed. Results Among 8 964 deliveries, the incidence of placenta previa was 0.97% ( 87/8 964 ). All of 87 cases of placenta previa were multiple pregnancy women. Multipara occupied 58.62%( 51/87 ) and elder gravida occupied 65.52% ( 57/87 ). The incidence of placenta previa complicated with placenta accreta was 0.13%( 12/8 964 ), occupying 13.79%( 12/87 ) of the placenta previa. Patients with previous cesarean section histrory accounted for 83.33%( 10/12 ). There were 3 cases of dangerous placenta previa complicated with placenta accreta at original uterine incesion scar, occuping 25.00% ( 3/12 ). The rate of previous cesarean section histroy in the group with placenta accreta was obviously higher than that in control group ( X2 = 17. 789, P < 0.01 ). Conclusion The

  1. Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

    Directory of Open Access Journals (Sweden)

    Fiona Urner

    2014-01-01

    Full Text Available The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH, which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity.

  2. The placenta and neurologic and psychiatric outcomes in the child: study design matters.

    Science.gov (United States)

    Nelson, K B; Blair, E

    2011-09-01

    Much information exists about functions of the human placenta and about potential mechanisms by which the placenta may influence human health or disease, including developmental disorders of brain. Recent studies indicate a high frequency of placental pathology in infants with developmental brain disorders, or with risk factors for such disorders. However, most clinical studies of the association of placental features with adverse neurologic or psychiatric outcome have substantial methodologic limitations. We discuss issues of study design as they relate to studies of the placenta and human brain disorders. In addition to the need for further consensus on procedures and terminology for placental evaluation, there are a number of special features that make clinical studies of the association of placental features with neurologic and psychiatric disorders especially difficult: most such disorders are not diagnosed until months or years after the majority of placentas have been discarded; these disorders are individually uncommon, so that prospective studies - needed to provide denominator data to enable estimation of risks - will require very large sample sizes; the administrative structures required to relate features of the placenta with clinical outcome will be complicated and costly. We offer some suggestions concerning study design in the face of these practical difficulties. Systematic and methodologically rigorous exploration of the role of the placenta in human developmental brain disorders has scarcely begun. A new generation of studies, difficult but potentially enormously rewarding, will be needed for clinical investigations of the placenta and fetal brain development.

  3. Different characteristics of mesenchymal stem cells isolated from different layers of full term placenta

    Science.gov (United States)

    Ha, Chul-Won; Kim, Jin A; Heo, Jin-Chul; Han, Woo-Jung; Oh, Soo-Young; Choi, Suk-Joo

    2017-01-01

    Background The placenta is a very attractive source of mesenchymal stem cells (MSCs) for regenerative medicine due to readily availability, non-invasive acquisition, and avoidance of ethical issues. Isolating MSCs from parts of placenta tissue has obtained growing interest because they are assumed to exhibit different proliferation and differentiation potentials due to complex structures and functions of the placenta. The objective of this study was to isolate MSCs from different parts of the placenta and compare their characteristics. Methods Placenta was divided into amniotic epithelium (AE), amniotic membrane (AM), chorionic membrane (CM), chorionic villi (CV), chorionic trophoblast without villi (CT-V), decidua (DC), and whole placenta (Pla). Cells isolated from each layer were subjected to analyses for their morphology, proliferation ability, surface markers, and multi-lineage differentiation potential. MSCs were isolated from all placental layers and their characteristics were compared. Findings Surface antigen phenotype, morphology, and differentiation characteristics of cells from all layers indicated that they exhibited properties of MSCs. MSCs from different placental layers had different proliferation rates and differentiation potentials. MSCs from CM, CT-V, CV, and DC had better population doubling time and multi-lineage differentiation potentials compared to those from other layers. Conclusions Our results indicate that MSCs with different characteristics can be isolated from all layers of term placenta. These finding suggest that it is necessary to appropriately select MSCs from different placental layers for successful and consistent outcomes in clinical applications. PMID:28225815

  4. Expression of cystathionine beta-synthase and histopathological observations in placentas of patients with Down syndrome.

    Science.gov (United States)

    Pinilla, J Martínez; Ayala-Ramírez, P; García-Robles, R; Olaya-C, M; Bermúdez, M

    2015-01-01

    Down syndrome is the most frequent aneuploidy in live births, with an overall frequency of 1/600-700 births. The overexpression of cystathionine β-synthase is thought to participate in the presentation of some phenotypes observed in Down syndrome. The aim of this study was to compare the expression levels of cystathionine β-synthase and histopathological observations from placentas of infants with Down syndrome and healthy newborns. Six placentas of fetuses/infants with Down syndrome and sixteen placentas of healthy fetuses were studied. Cystathionine β-synthase mRNA and protein expression were performed by real-time PCR and immunohistochemistry, respectively. We observed an increase in cystathionine β-synthase mRNA expression (p = 0.0465) and protein levels (p = 0.009) in placentas of fetus/infants with Down syndrome compared with controls. Significantly more circinate edges (p = 0.0007) and trophoblast inclusions (p = 0.0037) were observed in the group with Down syndrome compared with control group. The results demonstrate overexpression of cystathionine β-synthase mRNA and protein in placentas of fetuses/infants with trisomy 21. Further histological abnormalities were found in placentas of patients with Down syndrome, suggesting an alteration in the development of placenta.

  5. Safety of cesarean delivery through placental incision in patients with anterior placenta previa.

    Science.gov (United States)

    Hong, Deok-Ho; Kim, Eugene; Kyeong, Kyu-Sang; Hong, Seung Hwa; Jeong, Eun-Hwan

    2016-03-01

    To demonstrate the safety of fetal delivery through placental incision in a placenta previa pregnancy. We examined the medical records of 80 women with singleton pregnancy diagnosed with placenta previa who underwent cesarean section between May 2010 and May 2015 at the Department of Obstetrics and Gynecology, Chungbuk National University Hospital. Among the women with placenta previa, those who did not have the placenta in the uterine incision site gave birth via conventional uterine incision, while those with anterior placenta previa or had placenta attached to the uterine incision site gave birth via uterine incision plus placental incision. We compared the postoperative hemoglobin level and duration of hospital stay for the mother and newborn of the two groups. There was no difference between the placental incision group and non-incision group in terms of preoperative and postoperative hemoglobin change, the amount of blood transfusions required by the mother, newborns with 1-min or 5-min Apgar scores below 7 points or showing signs of acidosis on umbilical cord blood gas analysis result of pH below 7.20. Moreover, neonatal hemoglobin levels did not differ between the two groups. Fetal delivery through placental incision during cesarean section for placenta previa pregnancy does not negatively influence the prognosis of the mother or the newborn, and therefore, is considered a safe surgical technique.

  6. Placenta previa: an outcome-based cohort study in a contemporary obstetric population.

    Science.gov (United States)

    Lal, Ann K; Hibbard, Judith U

    2015-08-01

    The objective of the study is to characterize the maternal and neonatal morbidities of women with placenta previa. This retrospective group study used the Consortium on Safe Labor electronic database, including 12 clinical centers, and 19 hospitals. Patients with placenta previa noted at the time of delivery were included. Maternal and neonatal variables were compared to a control group of women undergoing cesarean delivery with no previa. Logistic regression and general linear regression were used for the analysis, with p placenta previa group and 18,617 in the control group. Neonates born to mothers with placenta previa had lower gestational ages and birth weights. In univariate analysis only, these neonates were at increased risk of lower 5 min Apgar scores, neonatal intensive care unit admission, anemia, respiratory distress syndrome, mechanical ventilation, and intraventricular hemorrhage. There was no association of placenta previa with small for gestational age infants, congenital anomalies or death. As previously shown, women with placenta previa have significantly more maternal morbidities. Increased maternal morbidity was noted; however, only those neonatal morbidities associated with preterm delivery occurred in the placenta previa group.

  7. Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

    Science.gov (United States)

    Zimmermann, Roland

    2014-01-01

    The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity. PMID:24812585

  8. Risk Factors and Consequent Outcomes of Placenta Previa: Report From a Referral Center

    Directory of Open Access Journals (Sweden)

    Soraya Saleh Gargari

    2016-12-01

    Full Text Available  Because of an unknown factor, the frequency of complicated pregnancy with placenta previa has been raised during past decade. This study was designed to deepen our understanding of risk factors and outcomes of placenta previa in our country. This study investigated 694 cases of placenta previa comparing with 600 healthy pregnant women with not overlie placenta in two referral and tertiary Obstetrics and Gynecological Hospital in Iran on the basis of the clinical and para-clinical analysis, in order to find the probable risk factors for occurrence of placenta previa and its effect on maternal and neonatal complications. The most important risk factor for the occurrence of placenta previa was advanced maternal age (P<0.001 and history of stillbirth (OR=117.2, CI=58.3-236.0. In the other hand, the most substantial outcome of this disorder was a reduction of gestational age (P<0.001 and low birth weight neonatally (P<0.001. The conservative follow-up should be programmed for women with placenta previa based on the type of risk factors which can provide the best possible management to decrease the morbidity and mortality of their related complications.

  9. Changes in first trimester screening test parameters in pregnancies complicated by placenta previa and association with hyperemesis gravidarum.

    Science.gov (United States)

    Tülek, Fırat; Kahraman, Alper; Taşkın, Salih; Özkavukçu, Esra; Söylemez, Feride

    2014-01-01

    To assess the possible changes in first trimester screening test parameters in pregnancies complicated with placenta previa and to determine whether there is an association between hyperemesis gravidarum and placenta previa. A total of 131 singleton spontaneously conceived pregnancies that were complicated by placenta previa and delivered between May 2006 and May 2013 were evaluated from birth charts. Ninety patients without placenta previa were selected amongst patients who delivered within the same period of time as the control group. Cases of low lying placenta (n=52) within the study group were assessed as a separate group. The rest of the cases was considered to be in a different group. Beta human chorionic gonadotropin (BhCG) multiples of medians (MoMs) and nuchal translucency (NT) MoMs were significantly higher in the placenta previa group in comparison with the low lying placenta and control groups. Apgar scores at both the 1st and 5th minutes were significantly lower in the placenta previa group. Hyperemesis gravidarum was found to be significantly more frequent in the placenta previa group. The prevalence of hyperemesis gravidarum in the first trimester is higher in pregnancies complicated by placenta previa. Paying more attention to the development of placenta previa in the routine pregnancy follow-up of patients with hyperemesis gravidarum could be considered.

  10. Transabdominal ultrasonography as a screening test for second-trimester placenta previa.

    Science.gov (United States)

    Quant, Hayley S; Friedman, Alexander M; Wang, Eileen; Parry, Samuel; Schwartz, Nadav

    2014-03-01

    To determine the test characteristics of transabdominal ultrasonography as a screening test for second-trimester placenta previa. This secondary analysis of a prospective cohort study evaluated the distance from the placental edge to the internal os (placenta-cervix distance) through both transabdominal and transvaginal ultrasonography during the anatomic survey. Patients were recruited in the Maternal-Fetal Medicine Ultrasound Unit at the Hospital of the University of Pennsylvania, an urban tertiary care center. Transabdominal placenta-cervix distance cutoffs with high sensitivity for detection of previa and low-lying placenta were identified, and test characteristics were calculated. Follow-up ultrasound data, pregnancy, and delivery outcomes for those with second-trimester previa or low-lying placenta were obtained. One thousand two hundred fourteen women were included in the analysis. A transabdominal placenta-cervix distance cutoff of 4.2 cm was 93.3% sensitive and 76.7% specific for detection of previa with a 99.8% negative predictive value at a screen-positive rate of 25.0%. A cutoff of 2.8 cm was 86.7% sensitive and 90.5% specific with a 99.6% negative predictive value at a screen-positive rate of 11.4%. Only 9.8% (four of 41) of previas and low-lying placentas persisted through delivery. Transabdominal ultrasonography is an effective screening test for second-trimester placenta previa. At centers not performing universal transvaginal ultrasonography at the time of the anatomic survey, evidence-based transabdominal placenta-cervix distance cutoffs can optimize the identification of patients who require further surveillance for previa.

  11. Thrombophilia prevalence among women with placenta-mediated pregnancy complications

    DEFF Research Database (Denmark)

    Gils, Charlotte; Nybo, Mads

    2016-01-01

    OBJECTIVE: To evaluate the prevalence of thrombophilia in patients with placenta-mediated pregnancy complications (PMPC). METHODS: Patients referred for thrombophilia testing at Odense University Hospital, Denmark, owing to PMPC between January 1, 2010 and December 31, 2014, were included...... in the present retrospective study. Data collected from patient medical records included the type of PMPC, history of previous thrombosis, and arterial thrombosis risk factors. RESULTS: A total of 103 patients were included in the study; 25 (24.3%) were diagnosed with thrombophilia. Among the study population......, factor V Leiden was the most dominant thrombophilia and was diagnosed in 11 (10.7%) patients (compared with 7% prevalence in the general population). The prevalence of all thrombophilias (except prothrombin mutation) was significantly higher in patients with PMPC in comparison with the reported...

  12. Radical scavenging activity of ribonuclease inhibitor from cow placenta.

    Science.gov (United States)

    Wang, Shuo; Li, Haiping

    2006-05-01

    Cow placenta ribonuclease inhibitor (CPRI) has been purified 5062-fold by affinity chromatography, the product being homogeneous by sodium dodecyl sulfate-gel electrophoresis. The chemiluminescence technique was used to determine the radical scavenging activities of CPRI toward different reactive oxygen species (ROS) including superoxide anion (O2-*), hydroxyl radical (OH*), lipid-derived radicals (R*), and singlet oxygen (1O2). CPRI could effectively scavenge O2-*, OH*, R*, and 1O2 at EC50 of 0.12, 0.008, 0.009, and 0.006 mg/ml, respectively. In addition, the radical scavenging activities of CPRI were higher than those of tea polyphenols, indicating that CPRI is a powerful antioxidant.

  13. Purification and characterization of a soluble calnexin from human placenta.

    Science.gov (United States)

    Olsen, Dorthe T; Peng, Li; Træholt, Sofie D; Duus, Karen; Højrup, Peter; Houen, Gunnar

    2013-11-01

    Calreticulin (Crt) and calnexin (Cnx) are homologous endoplasmic reticulum (ER) chaperones involved in protein folding and quality control. Crt is a soluble ER luminal Mr 46 kDa protein and Cnx is a Mr 67kDa ER membrane protein. During purification of Crt from human placenta a soluble form of Cnx (sCnx) was consistently identified in a separate ion exchange chromatography peak. The sCnx was further purified and characterised. This showed that the protein had been cleaved after residue 472 (between Gln and Met), thus liberating it from the transmembrane and cytoplasmic parts of Cnx. The extraction and initial purification steps were carried out in the presence of protease inhibitors, thus ruling out that the cleavage was an artefact of the isolation procedure. This indicates that sCnx may have a physiological chaperone function similar to that of Crt.

  14. [HISTOLOGYCAL AND HISTOCHEMICAL CHARACTERISTICS OF AREOLAE IN THE PIG PLACENTA].

    Science.gov (United States)

    Siraziev, R Z

    2015-01-01

    Rounded white lustreless dome-shaped wheels are detected by visually from allantochorion side in the in fetal areas epiteliochorial pig's placenta on day 30 of pregnancy. These structures are located over the opening of the uterine glands. Areolaes consist from maternal and foetal parts. Areola include glandular epithelium, chorial and endometrial stroma at the mouth of the uterine glands, areolar cavity-enhanced formed by endometrial and chorial invaginations. Chorion gives in cavity radial folds lining differences high epithelium. Glycogen, neutral and acid sulfated glycoproteins, proteoglycans, glycosaminoglycans, hyaluronates, total and cationic protein, RNA, arginine, gistidine, lysin were founded in structural components of areoles during gestation period. Numerous areolas serve as specialized sites for absorption the secrets of uterine glands; they are form a powerful functional system of histotrophic nutrition.

  15. PREMATURE BIRTH, MORPHOLOGY OF PLACENTA AND INTRAUTERINE GROWTH RETARDATION

    Directory of Open Access Journals (Sweden)

    L.V. Vasilenko

    2007-09-01

    Full Text Available Retrospectively studied following and outcome of pregnancy, women with non carrying of pregnancy, women that give birth to children with development delay (1 group and women that give birth in proper time (2 group. Premature birth arranged 4,4% of 2962 delivery. Fetus development delay was established by 38,1% of premature babies and by 10,5% of borne in proper time. Non carrying of pregnancy stipulated by motherґs urogenital infection, high expressed gestosis and others obsterical and extra genital complications. Each third of women that give birth to premature babies with development delay, have inflammatory overpatching in placenta, each fifth have morphological proved FPI. Realized researches allowed to conclude, that for decreasing frequencies of premature births and fetus development delay is necessary doing opportunely urogenital tract sonation, pre-clinical diagnostics of gestosis Noncarryng of pregnancy and treat this disease preventive.

  16. Inhibition of placenta growth factor with TB-403

    DEFF Research Database (Denmark)

    Nielsen, Dorte Lisbet; Sengeløv, Lisa

    2012-01-01

    targeting angiogenesis. AREAS COVERED: The data are obtained by searching in the PubMed database. The search terms used included antiangiogenic therapy, TB-403 (RO5323441), placenta growth factor (PlGF) and VEGFR-1 (Flt-1). We review preclinical data concerning the function and inhibition of Pl......GF and summarize data on expression of PlGF in cancer patients. Data from early-phase clinical trials of TB-403 (RO5323441), a monoclonal antibody inhibiting PlGF, are discussed. Future development strategies, therapeutic potentials and limitations of TB-403 are further evaluated. EXPERT OPINION: There are some...... conflicting data on the function of PlGF and the importance of its role in primary tumor growth. Data from some preclinical models of PlGF inhibition and early-phase clinical trials with TB-403 are, however, promising, although the true potential of the drug is yet to be determined. Further clinical...

  17. Barrier Capacity of Human Placenta for Nanosized Materials

    Science.gov (United States)

    Wick, Peter; Malek, Antoine; Manser, Pius; Meili, Danielle; Maeder-Althaus, Xenia; Diener, Liliane; Diener, Pierre-Andre; Zisch, Andreas; Krug, Harald F.; von Mandach, Ursula

    2010-01-01

    Background Humans have been exposed to fine and ultrafine particles throughout their history. Since the Industrial Revolution, sources, doses, and types of nanoparticles have changed dramatically. In the last decade, the rapidly developing field of nanotechnology has led to an increase of engineered nanoparticles with novel physical and chemical properties. Regardless of whether this exposure is unintended or not, a careful assessment of possible adverse effects is needed. A large number of projects have been carried out to assess the consequences of combustion-derived or engineered nanoparticle exposure on human health. In recent years there has been a growing concern about the possible health influence of exposure to air pollutants during pregnancy, hence an implicit concern about potential risk for nanoparticle exposure in utero. Previous work has not addressed the question of whether nanoparticles may cross the placenta. Objective In this study we investigated whether particles can cross the placental barrier and affect the fetus. Methods We used the ex vivo human placental perfusion model to investigate whether nanoparticles can cross this barrier and whether this process is size dependent. Fluorescently labeled polystyrene beads with diameters of 50, 80, 240, and 500 nm were chosen as model particles. Results We showed that fluorescent polystyrene particles with diameter up to 240 nm were taken up by the placenta and were able to cross the placental barrier without affecting the viability of the placental explant. Conclusions The findings suggest that nanomaterials have the potential for transplacental transfer and underscore the need for further nanotoxicologic studies on this important organ system. PMID:20064770

  18. Intraoperative bleeding control during cesarean delivery of complete placenta previa with transient occlusion of uterine arteries.

    Science.gov (United States)

    Kim, Ju Hyun; Joung, Eun-Ju; Lee, Soo-Jung; Kwack, Jae Young; Kwon, Yong Soon

    2015-11-01

    There are few methods to control heavy intra-operative bleeding during cesarean delivery of placenta previa. Transient occlusion of uterine arteries (TOUA) during operation has previously been reported as a quick and safe method to control intra-operative uterine bleeding. We reported 2 cases of cesarean delivery with complete placenta previa in which TOUA was performed to safely reduce intra-operative complication, especially heavy intra-operative bleeding. In the 2 cases, cesarean deliveries were safe and without any complications under the TOUA method. TOUA can be a good method to control heavy intra-operative bleeding during cesarean delivery of complete placenta previa with risk of heavy bleeding.

  19. Placenta previa percreta left in situ - management by delayed hysterectomy: a case report

    Directory of Open Access Journals (Sweden)

    Stefanovic Vedran

    2011-08-01

    Full Text Available Abstract Introduction Placenta percreta is an obstetric emergency often associated with massive hemorrhage and emergency hysterectomy. Case presentation We present the case of a 30-year-old African woman, gravida 7, para 5, with placenta percreta managed by an alternative approach: the placenta was left in situ, methotrexate was administered, and a delayed hysterectomy was successfully performed. Conclusions Further studies are needed to develop the most appropriate management option for the most severe cases of abnormal placentation. Delayed hysterectomy may be a reasonable strategy in the most severe cases.

  20. [Perioperative management of abdominal aortic balloon occlusion in patients complicated with placenta percteta: a case report].

    Science.gov (United States)

    Zeng, Hong; Wang, Yan; Wang, Yang; Guo, Xiang-yang

    2015-12-18

    When placenta previa complicated with placenta percreta, the exposure of operative field is difficult and the routine methods are difficult to effectively control the bleeding, even causing life-threatening results. A 31-year-old woman, who had been diagnosed with a complete type of placenta previa and placenta percreta with bladder invasion at 34 weeks gestation. Her ultrasound results showed a complete type of placenta previa and there was a loss of the decidual interface between the placenta and the myometrium on the lower part of the uterus, suggestive of placenta increta. For further evaluation of the placenta, pelvis magnetic resonance imaging was performed, which revealed findings suspicious of a placenta percreta. She underwent elective cecarean section at 36 weeks of gestation. Firstly, two ureteral stents were placed into the bilateral ureter through the cystoscope. After the infrarenal abdominal aorta catheter was inserted via the femoral artery (9 F sheath ), subarachnoid anesthesia had been established. A healthy 2 510 g infant was delivered, with Apgar scores of 10 at 1 min and 10 at 5 min. Immediately after the baby was delivered, following which there was massive haemorrhage and general anaesthesia was induced. The balloon catheter was immediately inflated until the wave of dorsal artery disappeared. With the placenta retained within the uterus, a total hysterectomy was performed. The occluding time was 30 min. The intraoperative blood loss was 2 500 mL. The occluding balloon was deflated at the end of the operation. The patient had stable vital signs and normal laboratory findings during the recovery period and the hemoglobin was 116 g/L. She was discharged six days after delivery without intervention-related complications. This case illustrates that temporary occlusion of the infrarenal abdominal aorta using balloon might be a safe and effective treatment option for patients with placenta previa complicated with placenta percreta, who were at high

  1. A 3D co-culture microtissue model of the human placenta for nanotoxicity assessment

    DEFF Research Database (Denmark)

    Muoth, Carina; Wichser, Adrian; Monopoli, Marco;

    2016-01-01

    and functionality of the placental tissue. The effects of NPs on the human placenta are not well studied or understood, and predictive in vitro placenta models to achieve mechanistic insights on NP-placenta interactions are essentially lacking. Using the scaffold-free hanging drop technology, we developed a well-organized...... and highly reproducible 3D co-culture microtissue (MT) model consisting of a core of placental fibroblasts surrounded by a trophoblast cell layer, which resembles the structure of the in vivo placental tissue. We could show that secretion levels of human chorionic gonadotropin (hCG) were significantly higher...

  2. Predictors of foeto-maternal outcome of patients with abruptio ...

    African Journals Online (AJOL)

    maternal mortality rates due to AP worldwide was 2.1% and foetal perinatal mortality rate was 15% while its ... was 65-139 mmol/L. All laboratory values, clinical evaluations and ... Data analysis was done using STATA 11 (College ..... artificial rupture of membrane and augmentation of labour (Ozumba, 1989; Hossain et al.

  3. Recent advances in the study of active endogenous retrovirus envelope glycoproteins in the mammalian placenta

    Institute of Scientific and Technical Information of China (English)

    Yufei; Zhang; Jing; Shi; Shuying; Liu

    2015-01-01

    Endogenous retroviruses(ERVs) are a component of the vertebrate genome and originate from exogenous infections of retroviruses in the germline of the host. ERVs have coevolved with their hosts over millions of years. Envelope glycoproteins of endogenous retroviruses are often expressed in the mammalian placenta, and their potential function has aroused considerable research interest, including the manipulation of maternal physiology to benefit the fetus. In most mammalian species, trophoblast fusion in the placenta is an important event, involving the formation of a multinucleated syncytiotrophoblast layer to fulfill essential fetomaternal exchange functions. The key function in this process derives from the envelope genes of endogenous retroviruses, namely syncytins, which show fusogenic properties and placenta-specific expression. This review discusses the important role of the recognized endogenous retrovirus envelope glycoproteins in the mammalian placenta.

  4. Maternal Death Due to Placenta Percreta with Bladder Involvement: A Case Report

    Directory of Open Access Journals (Sweden)

    Sedigheh Ayati M.D.

    2011-06-01

    Full Text Available Background: Placenta accreta is a life-threatening complication after previous cesarean delivery. The aim of this case report is to present a case of placenta percreta with bladder involvement and subsequent maternal death.Case presentation: The patient was a 37-year old who had an unwanted pregnancy due to tubectomy failure two years afterwards. She was hospitalized at 26th and 30th week of gestation because of gross hematuria. Sonography reported placenta previa. Cesarean section was performed at 34th gestational week. Due to severe hemorrhage, hysterectomy with resection of some part of the bladder was done. Died at the operating room after four hours of severe uncontrollable hemorrhage. Conclusion: The increasing prevalence of different forms of placenta accreta is the result of the ever-increasing rate of cesarean deliveries. One of the strategies to prevent this catastrophic obstetric complication is decreasing the number of cesarean deliveries without appropriate indications.

  5. Role of Doppler US and MRI in diagnosis of placenta accreta

    Directory of Open Access Journals (Sweden)

    Manal Hamisa

    2015-09-01

    Conclusion: In conclusion, data of the present study show that the use of transabdominal color Doppler ultrasonography complemented by MRI in suspected cases improves the diagnostic accuracy in prediction of placenta accreta in patients with previous cesarean delivery.

  6. Expression of Androgen Receptor in Human Placentas from Normal and Preeclamptic Pregnancies

    Directory of Open Access Journals (Sweden)

    Te-Yao Hsu

    2009-09-01

    Conclusion: These data suggest that the increased AR expression may alter AR-mediated function on syncytiotrophoblasts and stromal cells in PE placentas, and be a possible mechanism for its association with preeclampsia.

  7. The Triple-P procedure as a conservative surgical alternative to peripartum hysterectomy for placenta percreta.

    Science.gov (United States)

    Chandraharan, Edwin; Rao, Sridevi; Belli, Anna-Maria; Arulkumaran, Sabaratnam

    2012-05-01

    The reported maternal mortality for morbidly adherent placenta ranges from 7% to 10% worldwide. Current treatment modalities for this potentially life-threatening condition include radical approaches such as elective peripartum hysterectomy with or without bowel/bladder resection or ureteric re-implantation (for placenta percreta infiltrating these organs), and conservative measures such as compression sutures with balloon tamponade and the placenta remaining in situ. However, both conservative and radical measures are associated with significant maternal morbidity and mortality. The present article describes the Triple-P procedure-which involves perioperative placental localization and delivery of the fetus via transverse uterine incision above the upper border of the placenta; pelvic devascularization; and placental non-separation with myometrial excision and reconstruction of the uterine wall-as a safe and effective alternative to conservative management or peripartum hysterectomy. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  8. Teratogenic effects of the Zika virus and the role of the placenta.

    Science.gov (United States)

    Adibi, Jennifer J; Marques, Ernesto T A; Cartus, Abigail; Beigi, Richard H

    2016-04-09

    The mechanism by which the Zika virus can cause fetal microcephaly is not known. Reports indicate that Zika is able to evade the normal immunoprotective responses of the placenta. Microcephaly has genetic causes, some associated with maternal exposures including radiation, tobacco smoke, alcohol, and viruses. Two hypotheses regarding the role of the placenta are possible: one is that the placenta directly conveys the Zika virus to the early embryo or fetus. Alternatively, the placenta itself might be mounting a response to the exposure; this response might be contributing to or causing the brain defect. This distinction is crucial to the diagnosis of fetuses at risk and the design of therapeutic strategies to prevent Zika-induced teratogenesis.

  9. Ki-67 proliferation index in patients with placenta previa percreta in the third trimester.

    Science.gov (United States)

    Hilali, Nese; Kocarslan, Sezen; Vural, Mehmet; Incebiyik, Adnan; Camuzcuoglu, Aysun; Camuzcuoglu, Hakan

    2015-02-01

    The purpose of this study was to investigate proliferative capacity of placenta previa percreta in the third trimester via evaluating Ki-67 proliferating index. The paraffin blocks of placental tissues, which were obtained from the patients who underwent hysterectomy for placenta previa percreta (n = 12, gestational age > 28 weeks), from legal abortions (n = 12, gestational age  38 weeks), between January 2011 and April 2013, were included into the study. The paraffin blocks of the patients were stained with Ki-67 (proliferating cell marker) immunohistochemically, and Ki-67 proliferation index levels were calculated. Ki-67 proliferation index levels were higher in patients with legal abortions than patients with placenta percreta or noncomplicated cesarean delivery group. However, any statistically significant difference was not detected between the percreta and noncomplicated groups (p > 0.05). The tissue samples of the patients with placenta previa percreta exhibited low proliferative capacity similar to the samples of normal placentation group.

  10. Thomas Huxley and the rat placenta in the early debates on evolution.

    Science.gov (United States)

    Pijnenborg, R; Vercruysse, L

    2004-01-01

    The 19th century debates on mammalian classification in the light of the new evolutionary thinking led to controversies between Thomas Huxley and Richard Owen concerning the value of the placenta as a representative key organ. As a main point in his argument, Huxley provided a detailed description of a sectioned rat placenta, highlighting the importance of decidualization of the uterus as an argument supporting an evolutionary relationship between rodents, insectivores and primates, an idea hotly contested by Owen. In addition, he illustrated and correctly interpreted the maternal blood supply from uterus to placenta in striking detail. During the succeeding decades the key role of trophoblast in placenta formation was discovered, and the decidua became neglected in later comparative studies. Nevertheless, at the present time trophoblast-decidual interaction is regarded as an extremely important feature of placental development in both primates and rodents, and Huxley can therefore rightfully be considered as an early pioneer in placental research.

  11. Longitudinal parallel compression suture to control postopartum hemorrhage due to placenta previa and accrete

    Directory of Open Access Journals (Sweden)

    Guang-Tai Li

    2016-04-01

    Conclusion: Longitudinal parallel compression suture is a safe, easy, effective, practical, and conservative surgical technique to stop intractable PPH from the lower uterine segment, particularly in women who have a cesarean scar and placenta previa/accreta.

  12. Apoptotic and stress signaling markers are augmented in preeclamptic placenta and umbilical cord

    Directory of Open Access Journals (Sweden)

    Syeda H. Afroze

    2016-12-01

    Conclusions: Apoptotic and stress signaling are augmented in preE placenta and cord tissue that alter the intrauterine environment and activates the detrimental signaling that is transported to fetus.

  13. Uterine and placenta characteristics during early vascular development in the pig from day 22 to 42 of gestation.

    Science.gov (United States)

    Wright, Elane C; Miles, Jeremy R; Lents, Clay A; Rempel, Lea A

    2016-01-01

    Insufficient placenta development is one of the primary causes of fetal death and reduced fetal growth after 35 days of gestation. Between day 22 and 42 the placenta consists of a central highly vascular placenta (HVP), adjacent to the fetus, a less vascular placenta (LVP), on either side of the fetus, and necrotic tips (NT). The objective of this study was to comprehensively evaluate uterine-placenta characteristics during early gestation in the gilt and determine time points and physiological changes. Gilts (n=25) were artificially inseminated at first detection of estrus (day 0) and 24h later, and harvested at 22, 27, 32, 37 or 42 days of gestation. Litter size, 12.1±3.4, was similar for all days of gestation. Fetal and placenta weight increased with day of gestation. The greatest increase in placenta weight occurred between 37 and 42 days of gestation. The LVP zones had no measurable fold formation until day 27. Necrotic tips became apparent after 27 days of gestation. Unoccupied areas of the uterus developed folds with changes in endometrial cell size and morphology from day 32 to 42 of gestation. Limited changes occurred in either fetal growth or placenta weight from day 27 through 32 of gestation; however, significant morphological changes occur at the maternal-fetal interface, demonstrating the dynamic architecture of the developing porcine placenta during early gestation. This work establishes fundamental time points in placenta development corresponding to fetal growth and microfold formation that may influence fetal growth and impact fetal survival.

  14. STUDY OF MORPHOLOGICAL VARIATIONS OF 50 PLACENTAE WITH UMBILICAL CORDS AND ITS DEVELOPMENTAL RELEVANCE

    OpenAIRE

    Asra Anjum; D.Suseelamma; S. Saritha; T V Ramani; D. Nagajyothi

    2015-01-01

    Introduction: The word “Placenta” is a Latin word and the Greek equivalent word is “Plakons” which means “Flat cake on a plate”. The placenta is a complex multifunctional organ. It provides nutrition, gas exchange, waste removal, endocrine function and immune support. Placenta is a special circulating system to the developing foetus. Being an organ of vital importance for continuation of pregnancy and foetal nutrition it has evolved great interest among the anatomists, embryologists, patholog...

  15. Asymptomatic "placental prolapse" with cervical funneling in a patient with complete placenta previa.

    Science.gov (United States)

    Adekola, Henry; Lam-Rachlin, Jennifer; Bronshtein, Elena; Abramowicz, Jacques S

    2015-02-01

    We describe the transvaginal sonographic findings in a patient with complete placenta previa and increased risk of preterm birth owing to a prior history of mid-trimester pregnancy loss in whom we observed a short cervix and prolapse of the placenta and fetal membranes into the endocervical canal. We believe that this could lead to antepartum hemorrhage and mandate close observation when diagnosed. We introduced the term "placental prolapse" to describe our finding.

  16. Creation of plastinated placentas as a novel teaching resource for medical education in obstetrics and gynaecology.

    Science.gov (United States)

    McRae, Karalyn E; Davies, Gregory A L; Easteal, Ronald A; Smith, Graeme N

    2015-09-01

    Knowledge of the gross anatomy of the placenta is fundamental in order to help identify potential complications during pregnancy. The placenta is difficult to study without a three-dimensional appreciation of its structure. The aim of this study was to develop a collection of plastinated placenta specimens and accompanying clinical educational materials to provide learning resources for placental abnormalities and their associated pregnancy outcomes. These plastinates and educational modules were used as teaching resources for both undergraduate and post-graduate medical trainees in Obstetrics and Gynaecology. Placentas were plastinated by S10 silicone plastination. Clinical education materials were created that included ultrasound images, photographs and information on the associated pregnancy outcomes. Utility of the plastinates was assessed using questionnaires completed by 70 medical students and 33 attendees at the 8th and 9th Annual International Human Placenta Workshop held at Queen's University, Kingston, ON. Attendees included graduate students, post-doctoral fellows, medical residents, research investigators and clinicians. Data collected demonstrated that 76.7% of medical student (n = 60) and 78.1% of Placenta Workshop attendees (n = 32) preferred plastinates as a supplemental learning resource compared to textbooks and images alone (36.7% and 37.5% respectively). All respondents also expressed the desire to have plastinated placentas available for future learning opportunities. Plastinated placentas are a valuable addition as teaching resources for many demographic groups with an interest in placental anatomy and pathology. Medical trainees and residents in Obstetrics and Gynaecology would benefit from the availability of plastinates as educational tools. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Comprehensive investigation of DNA methylation and gene expression in trisomy 21 placenta.

    Science.gov (United States)

    Lim, Ji Hyae; Kim, Shin Young; Han, Jung Yeol; Kim, Moon Young; Park, So Yeon; Ryu, Hyun Mee

    2016-06-01

    Trisomy 21 (T21) is the most common aneuploidy affecting humans and is caused by an extra copy of all or part of chromosome 21 (chr21). DNA methylation is an epigenetic event that plays an important role in human diseases via regulation of gene expression. However, the integrative association between DNA methylation and gene expression in T21 fetal placenta has yet to be determined. We profiled expression of 207 genes on chr21 and their DNA methylation patterns in placenta samples from normal and DS fetuses using microarray analysis and predicted the functions of differentially expressed genes using bioinformatics tools. We found 47 genes with significantly increased expression in the T21 placenta compared to the normal placenta. Hypomethylation of the 47 genes was observed in the T21 placenta. Most of hypomethylated DNA positions were intragenic regions, i.e. regions inside a gene. Moreover, gene expression and hypomethylated DNA position showed significantly positive associations. By analyzing the properties of the gene-disease network, we found that increased genes in the T21 placenta were significantly associated with T21 and T21 complications such as mental retardation, neurobehavioral manifestations, and congenital abnormalities. To our knowledge, this is the first study to comprehensively survey the association between gene expression and DNA methylation in chr21 of the T21 fetal placenta. Our findings provide a broad overview of the relationships between gene expression and DNA methylation in the placentas of fetuses with T21 and could contribute to future research efforts concerning genes involvement in disease pathogenesis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Paraoxonase 2 protein is spatially expressed in the human placenta and selectively reduced in labour

    OpenAIRE

    Alwarfaly, Samy; Abdulsid, Akrem; Hanretty, Kevin; Lyall, Fiona

    2014-01-01

    Humans parturition involves interaction of hormonal, neurological, mechanical stretch and inflammatory pathways and the placenta plays a crucial role. The paraoxonases (PONs 1–3) protect against oxidative damage and lipid peroxidation, modulation of endoplasmic reticulum stress and regulation of apoptosis. Nothing is known about the role of PON2 in the placenta and labour. Since PON2 plays a role in oxidative stress and inflammation, both features of labour, we hypothesised that placental PON...

  19. A comparative study of neonatal outcomes in placenta previa versus cesarean for other indication at term.

    Science.gov (United States)

    Schneiderman, Megan; Balayla, Jacques

    2013-07-01

    Currently, no ACOG guidelines address the issue of the optimal timing of delivery in placenta previa. Though there is an increased risk of neonatal morbidity and mortality when electively delivered preterm, it is unclear whether adverse neonatal outcomes exist when these pregnancies make it beyond term. By comparing neonatal outcomes amongst pregnancies with placenta previa versus those from cesarean for another indication at term, the objective of this study was to determine whether placenta previa is an independent risk factor for adverse neonatal outcomes at term. We conducted a population-based cohort-study using the CDC's Linked Birth-Infant Death data from the United States. The effect of placenta previa on the risk of adverse neonatal outcomes was estimated using unconditional logistic regression analysis, adjusting for relevant confounders. Our cohort consisted of 3,550,842 deliveries meeting inclusion criteria. The incidence of placenta previa at term was 1.3/1000 (n = 4,492), accounting for 40.6% of all previa cases. Relative to cesareans for other indications, pregnancies with placenta previa had an increased risk of IUGR 3.20 [2.50-4.10], SGA 2.70 [2.45-2.97], respiratory distress 3.82 [2.91-5.00], prolonged ventilation 3.41 [2.70-4.32] and neonatal anemia 6.87 [4.43-10.65]. Rates of meconium aspiration syndrome, seizures, birth injury and overall infant mortality do not appear to be affected by this condition. Relative to cesareans for other indications, placenta previa is associated with increased morbidity, but not mortality, at term. This information might be helpful in the development of future guidelines, which are currently needed to guide and standardize clinical practice regarding the optimal timing of delivery in placenta previa.

  20. Placenta previa and risk of major congenital malformations among singleton births in Finland.

    Science.gov (United States)

    Kancherla, Vijaya; Räisänen, Sari; Gissler, Mika; Kramer, Michael R; Heinonen, Seppo

    2015-06-01

    Placenta previa has been associated with adverse birth outcomes, but its association with congenital malformations is inconclusive. We examined the association between placenta previa and major congenital malformations among singleton births in Finland. We performed a retrospective population register-based study on all singletons born at or after 22+0 weeks of gestation in Finland during 2000 to 2010. We linked three national health registers: the Finnish Medical Birth Register, the Hospital Discharge Register, and the Register of Congenital Malformations, and examined several demographic and clinical characteristics among women with and without placenta previa, in association with major congenital malformations. We estimated adjusted odds ratios and 95% confidence intervals using multivariable logistic regression models. The prevalence of placenta previa was estimated as 2.65 per 1000 singleton births in Finland (95% confidence interval, 2.53-2.79). Overall, 6.2% of women with placenta previa delivered a singleton infant with a major congenital malformation, compared with 3.8% of unaffected women (p ≤ 0.001). Placenta previa was positively associated with almost 1.6-fold increased risk of major congenital malformations in the offspring, after controlling for maternal age, parity, fetal sex, smoking, socio-economic status, chorionic villus biopsy, In vitro fertilization, pre-existing diabetes, depression, preeclampsia, and prior caesarean section (adjusted odds ratio = 1.55; 95% confidence interval, 1.27-1.90). Using a large population-based study, we found that placenta previa was weakly, but significantly associated with an increased risk of major congenital malformations in singleton births. Future studies should examine the association between placenta previa and individual types of congenital malformations, specifically in high-risk pregnancies. © 2015 Wiley Periodicals, Inc.

  1. [The Application of Internal Iliac Artery Balloon Occlusion in Pernicious Placenta Previa].

    Science.gov (United States)

    Qi, Xiao-Rong; Liu, Xing-Hui; You, Yong; Wang, Xiao-Dong; Zhou, Rong; Xing, Ai-Yun; Zhang, Li; Ning, Gang; Zhao, Fu-Min; Li, Kai-Ming

    2016-07-01

    To evaluate the clinical application value of internal iliac artery balloon occlusion in pernicious placenta previa. We retrospectively reviewed the medical records of the patients of pernicious placenta previa in a single center from Jan, 2010 to Jan, 2015. The patients were divided into two groups, internal iliac artery balloon occlusion group and the control group without endovascular intervention. Blood loss in operation, volume of transfused blood products, caesarean hysterectomy, operating time, hospital days after operation and postoperative morbidity were compared between the two groups. The balloon occlusion group had significantly less blood loss, the volume of transfused blood products, caesarean hysterectomy, hospital day after operation than the control group had. There was no statistical difference in operating time, intensive care units (ICU), hypotension, infection, hypoxemia, bladder injury, bowel obstruction, neonatal asphyxia between the two groups. The balloon occlusion group had significantly higher rate in coagulopathy, hypoalbuminemia, electrolyte imbalance. Among the patients whose uterus were preserved, the blood loss was not significantly difference between the two groups. Among the patients with the complication of placenta accreta, caesarean hysterectomy was less in balloon group, and blood loss between the two groups was not significantly different. Among the patients without placenta accrete, the blood loss was less in balloon group, and caesarean hysterectomy between the two groups was not significantly different. The risk of hysterectomy in balloon group was related to placenta accreta, uterine arteries engorgement, placental invasive serosa, taking placenta by hand, placental invasive bladder, barrel-shaped thickening of lower uterine segment, unable to remove placenta. Internal iliac artery balloon occlusion is an effective treatment for pernicious placenta previa.

  2. Morphological study of human heart and placenta in the first trimester of prenatal period of ontogenesis

    OpenAIRE

    Abdul-Ogly L.V.

    2008-01-01

    Probability of abnormal development is high in certain periods when the increased sensitiveness of embryo and fetus takes place. Influence of damaging factors as maternal infection and, consequently, fetal infection is a reason of abnormal development. Morphological characteristics of heart and placenta were studied during the first trimester of prenatal period of ontogenesis. 17 embryos, fetuses and placenta of 4-12 weeks were used. Abortions were made according to medical statements or mate...

  3. High glucose levels reduce fatty acid oxidation and increase triglyceride accumulation in human placenta

    OpenAIRE

    Visiedo, Francisco; Bugatto, Fernando; Sánchez, Viviana; Cózar-Castellano, Irene; Bartha, Jose L.; Perdomo, Germán

    2013-01-01

    Placentas of women with gestational diabetes mellitus (GDM) exhibit an altered lipid metabolism. The mechanism by which GDM is linked to alterations in placental lipid metabolism remains obscure. We hypothesized that high glucose levels reduce mitochondrial fatty acid oxidation (FAO) and increase triglyceride accumulation in human placenta. To test this hypothesis, we measured FAO, fatty acid esterification, de novo fatty acid synthesis, triglyceride levels, and carnitine palmitoyltransferase...

  4. Monocarboxylate transporter 8 expression in the human placenta: the effects of severe intrauterine growth restriction.

    Science.gov (United States)

    Chan, S-Y; Franklyn, J A; Pemberton, H N; Bulmer, J N; Visser, T J; McCabe, C J; Kilby, M D

    2006-06-01

    Thyroid hormones (THs) are essential for normal fetal development, with even mild perturbation in maternal thyroid status in early pregnancy being associated with neurodevelopmental delay in children. Transplacental transfer of maternal THs is critical, with increasing evidence suggesting a role for 3,3',5-tri-iodothyronine (T3) in development and function of the placenta itself, as well as in development of the central nervous and other organ systems. Intrauterine growth restriction (IUGR) is associated with fetal hypothyroxinaemia, a factor that may contribute to neurodevelopmental delay. The recent description of monocarboxylate transporter 8 (MCT8) as a powerful and specific TH membrane transporter, and the association of MCT8 mutations with profound neurodevelopmental delay, led us to explore MCT8 expression in placenta. We describe the expression of MCT8 in normal human placenta throughout gestation, and in normal third-trimester placenta compared with that associated with IUGR using quantitative reverse transcriptase PCR. MCT8 mRNA was detected in placenta from early first trimester, with a significant increase with advancing gestation (P=0.007). In the early third trimester, MCT8 mRNA was increased in IUGR placenta compared with normal samples matched for gestational age (PMCT8 immunostaining was demonstrated in villous cytotrophoblast and syncytiotrophoblast as well as extravillous trophoblast cells from the first trimester onwards with increasingly widespread immunoreactivity seen with advancing gestation. In conclusion, expression of MCT8 in placenta from early gestation is compatible with an important role in TH transport during fetal development and a specific role in placental development. Altered expression in placenta associated with IUGR may reflect a compensatory mechanism attempting to increase T3 uptake by trophoblast cells.

  5. Ultrasonographic diagnosis of placenta previa: comparison between transabdominal and transperineal ultrasonography

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    Lee, Jin Wook; Byun, Woo Mok; Hwang, Mi Soo; Chang, Jae Chun; Park, Bok Hwan; Cho, Kil Ho; Lee, Tae Hyeung [Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    1994-12-15

    Sometimes, the diagnosis of placenta previa by transabdominal ultrasonography may be difficult, especially in the third trimester of pregnancy, because of obscuration of internal os of the cervix by overlying placenta as advancing pregnancy. In such situations, however, the transperineal ultrasonography may offer an additional view of internal os of the cervix without obscuration by overlying fetal parts or placenta. We evaluated forty pregnant women in whom placenta previa were suspected clinically, with both transabdominal and transperineal ultrasonography. The menstrual age at the time of ultrasonography, ranged from 27 to 36 weeks. We compared the diagnostic accuracy of each procedure with the final diagnosis at the time of delivery. Transabdominalul trasonography provided to correct diagnosis in 25 cases. In remaining 15 cases, the confident diagnosis could not be made because of poor visualization of internal os of the cervix. However, transperineal ultrasonography provided the correct diagnosis in all 40 cases. We conclude that the transperineal ultrasonography is relatively easy and convenient technique and valuable for detection of placenta previa, especially when the diagnosis of placenta previa is difficult by transabdominal ultrasonography

  6. Selenoprotein P expression in liver, uterus and placenta during late pregnancy.

    Science.gov (United States)

    Kasik, J W; Rice, E J

    1995-01-01

    To identify genes that exhibit increased expression in the placenta during late pregnancy, the technique of differential cDNA library screening was used to isolate a clone subsequently identified as the 3' untranslated region of the mouse selenoprotein p gene. Random primed radiolabelled cDNA probes were constructed from this clone and these probes were used to conduct Northern hybridizations against total RNA purified from mouse placenta, liver (maternal and fetal) and uterus collected sequentially during the latter third of pregnancy. Signal is present in the placenta and beginning 4 days before birth, the level of message increases, reaching maximal levels at term. The level of expression in the placenta at maximum is approximately 25 per cent of that observed in adult liver. In liver obtained from pregnant females, the level of message is increased compared to nonpregnant adults, but returns to normal shortly after birth. Message is also found in the fetal liver beginning at 4 days before birth and exhibits a pattern of expression similar to the placenta. The similarity of expression observed in fetal liver and placenta suggests a coordinated regulation of expression of this gene in these tissues. There is a minimal amount of signal present in the uterus and the expression does not appear to vary. We speculate that selenoprotein p may play a role in the transplacental transport of selenium to the fetus during late pregnancy.

  7. Prototype and Chimera-Type Galectins in Placentas with Spontaneous and Recurrent Miscarriages

    Directory of Open Access Journals (Sweden)

    Laura Unverdorben

    2016-04-01

    Full Text Available Galectins are galactose binding proteins and, in addition, factors for a wide range of pathologies in pregnancy. We have analyzed the expression of prototype (gal-1, -2, -7, -10 and chimera-type (gal-3 galectins in the placenta in cases of spontaneous abortions (SPA and recurrent abortions (RA in the first trimester. Fifteen placental samples from healthy pregnancies were used as a control group. Nine placentas were examined for spontaneous abortions, and 12 placentas for recurrent abortions. For differentiation and evaluation of different cell types of galectin-expression in the decidua, immunofluorescence was used. For all investigated prototype galectins (gal-1, -2, -7, -10 in SPA and RA placenta trophoblast cells the expression is significantly decreased. In the decidua/extravillous trophoblast only gal-2 expression was significantly lowered, which could be connected to its role in angiogenesis. In trophoblasts in first-trimester placentas and in cases of SPA and RA, prototype galectins are altered in the same way. We suspect prototype galectins have a similar function in placental tissue because of their common biochemical structure. Expression of galectin 3 as a chimera type galectin was not found to be significantly altered in abortive placentas.

  8. The placentation of eulipotyphla-reconstructing a morphotype of the Mammalian placenta.

    Science.gov (United States)

    Ferner, Kirsten; Siniza, Swetlana; Zeller, Ulrich

    2014-10-01

    Placentation determines the developmental status of the neonate, which can be considered as the most vulnerable stage in the mammalian life cycle. In this respect, the different evolutionary and ecological adaptations of marsupial and placental mammals have most likely been associated with the different reproductive strategies of the two therian clades. The morphotypes of marsupial and placental neonates, as well as the placental stem species pattern of Marsupialia, have already been reconstructed. To contribute to a better understanding of the evolution of Placentalia, a histological and ultrastructural investigation of the placenta in three representatives of Eulipotyphla, that is, core insectivores, has been carried out in this study. We studied the Musk shrew (Suncus murinus), the four-toed hedgehog (Atelerix albiventris), and the Iberian mole (Talpa occidentalis). As a result, a eulipotyphlan placental morphotype consisting of a compact and invasive placenta was reconstructed. This supports the widely accepted hypothesis that the stem lineage of Placentalia is characterized by an invasive, either endothelio- or hemochorial placenta. Evolutionary transformations toward a diffuse, noninvasive placenta occurred in the stem lineages of lower primates and cetartiodactyles and were associated with prolonged gestation and the production of few and highly precocial neonates. Compared to the choriovitelline placenta of Marsupialia, the chorioallantoic placenta of Placentalia allows for a more intimate contact and is associated with more advanced neonates.

  9. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Science.gov (United States)

    Cho, Hee Young; Park, Yong Won; Kim, Young Han; Jung, Inkyung; Kwon, Ja-Young

    2015-01-01

    The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation. We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL. Sixty-four patients (46.7%) required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1%) had placenta previa totalis. The overall success rate was 75% (48/64) for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all pcesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  10. Placenta previa. A 13 years experience at a tertiary care center in Western Saudi Arabia.

    Science.gov (United States)

    Abduljabbar, Hassan S; Bahkali, Nedaa M; Al-Basri, Samera F; Al Hachim, Estabrq; Shoudary, Ibrahim H; Dause, Wesam R; Mira, Mohammed Y; Khojah, Mohammed

    2016-07-01

    To review cases of placenta previa in the last 13 years in a tertiary teaching hospital to identify risk factors for maternal morbidity.  A retrospective analysis of all cases of placenta previa managed at King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia from January 2001 to December 2013.    The total number of deliveries was 55,862 deliveries, and 11,412 (20.3%) delivered by cesarean section (C/S). The charts of 230 cases diagnosed with placenta previa was reviewed, and different variables were collected and analyzed. Diagnoses were achieved in 94% of them using ultrasound. The prevalence rate of placenta previa was 4.1 per 1000 births. Cesarean section was carried out as an emergency procedure in 130 (56.5%) women and as elective in 100 (43.5%) women. Of them, 26 patients were admitted to the intensive care unit (ICU) (11.3%), all of which received blood transfusion >6 units and 22 patients had a hysterectomy for uncontrollable bleeding.   Placenta previa is one of the leading causes of maternal morbidity and mortality. Every hospital must have a protocol, or algorithm for the management of placenta previa. Risk factors for maternal morbidity included complete previa, history of previous C/S, emergency C/S at a gestational age of less than 36 weeks, and estimated blood loss more than 2000 ml.

  11. Efficacy and Safety of Prophylactic Uterine Artery Embolization in Pregnancy Termination with Placenta Previa.

    Science.gov (United States)

    Pei, Renguang; Wang, Guoxiang; Wang, Heping; Huang, Xinyu; Yan, Xiaoxing; Yang, Xiaohua

    2017-03-01

    To appraise the efficacy and safety of prophylactic uterine artery embolization in pregnancy termination with placenta previa. A cohort of 54 consecutive patients with placenta previa underwent prophylactic uterine artery embolization before vaginal delivery from February 2012 to March 2015. Vaginal delivery was attempted in all patients. Cesarean section or hysterectomy was introduced when vaginal delivery failed. Vaginal delivery succeeded in 50 patients (93.6%) and failed in 4 patients (6.4%), thereupon converted to cesarean delivery. No patients resorted to hysterectomy. Six patients (11.1%) underwent blood transfusion. None of clinical characteristics, including maternal age, gestational age, history of abortion, history of cesarean delivery, and volume of vaginal bleeding, was significantly associated with complete placenta previa (P > 0.05). However, patients with complete placenta previa had a significantly lower successful rate of vaginal delivery than did patients without complete placenta previa (81 vs 100%, P = 0.038). The rate of complications was 3.7%. No major complications were observed. Uterine artery embolization is an effective and safe technique to assist pregnancy termination with placenta previa, which may lower the risk of cesarean section, hysterectomy, and blood transfusion.

  12. 经腹彩色多普勒超声在前置胎盘并发胎盘植入诊断中的价值%Value of abdominal color Doppler ultrasonography in the diagnosis of placenta placenta complicated with pla-centa implantation

    Institute of Scientific and Technical Information of China (English)

    邢艳芳; 江艳丽

    2016-01-01

    目的:探讨经腹彩色多普勒超声在前置胎盘并发胎盘植入诊断中的价值。方法:收治前置胎盘并发胎盘植入的患者82例,所有患者均选用彩色多普勒超声进行检查,对胎盘位置、胎盘后间隙、胎盘回声、胎盘周围组织以及胎盘的血流情况进行观察。结果:产前彩色多普勒超声诊断前置胎盘并发胎盘植入阳性44例,阳性检出率53.7%。结论:经腹彩色多普勒超声在诊断前置胎盘并发胎盘植入方面有着较高的临床价值。%Objective:To explore the value of abdominal color Doppler ultrasonography in the diagnosis of placenta placenta complicated with placenta implantation.Methods:82 patients with placenta placenta complicated with placenta implantation were selected.All the patients were examined by color Doppler.The location of the placenta,the clearance of the placenta,the echo of the placenta,the blood flow of the surrounding tissues and the placenta were observed.Results:The positive rate of 44 cases was positive,and the positive rate was 53.7%.Conclusion:The abdominal color Doppler ultrasound in the diagnosis of placenta placenta complicated with placenta implantation has a high clinical value.

  13. Human endogenous retrovirus-FRD envelope protein (syncytin 2 expression in normal and trisomy 21-affected placenta

    Directory of Open Access Journals (Sweden)

    Handschuh Karen

    2008-01-01

    Full Text Available Abstract Human trophoblast expresses two fusogenic retroviral envelope proteins, the widely studied syncytin 1, encoded by HERV-W and the recently characterized syncytin 2 encoded by HERV-FRD. Here we studied syncytin 2 in normal and Trisomy 21-affected placenta associated with abnormal trophoblast differentiation. Syncytin 2 immunolocalization was restricted throughout normal pregnancy to some villous cytotrophoblastic cells (CT. During the second trimester of pregnancy, syncytin 2 was immunolocalized in some cuboidal CT in T21 placentas, whereas in normal placentas it was observed in flat CT, extending into their cytoplasmic processes. In vitro, CT isolated from normal placenta fuse and differentiate into syncytiotrophoblast. At the same time, syncytin 2 transcript levels decreased significantly with syncytiotrophoblast formation. In contrast, CT isolated from T21-affected placentas fused and differentiated poorly and no variation in syncytin 2 transcript levels was observed. Syncytin 2 expression illustrates the abnormal trophoblast differentiation observed in placenta of fetal T21-affected pregnancies.

  14. Human endogenous retrovirus-FRD envelope protein (syncytin 2) expression in normal and trisomy 21-affected placenta

    Science.gov (United States)

    Malassiné, André; Frendo, Jean-Louis; Blaise, Sandra; Handschuh, Karen; Gerbaud, Pascale; Tsatsaris, Vassilis; Heidmann, Thierry; Evain-Brion, Danièle

    2008-01-01

    Human trophoblast expresses two fusogenic retroviral envelope proteins, the widely studied syncytin 1, encoded by HERV-W and the recently characterized syncytin 2 encoded by HERV-FRD. Here we studied syncytin 2 in normal and Trisomy 21-affected placenta associated with abnormal trophoblast differentiation. Syncytin 2 immunolocalization was restricted throughout normal pregnancy to some villous cytotrophoblastic cells (CT). During the second trimester of pregnancy, syncytin 2 was immunolocalized in some cuboidal CT in T21 placentas, whereas in normal placentas it was observed in flat CT, extending into their cytoplasmic processes. In vitro, CT isolated from normal placenta fuse and differentiate into syncytiotrophoblast. At the same time, syncytin 2 transcript levels decreased significantly with syncytiotrophoblast formation. In contrast, CT isolated from T21-affected placentas fused and differentiated poorly and no variation in syncytin 2 transcript levels was observed. Syncytin 2 expression illustrates the abnormal trophoblast differentiation observed in placenta of fetal T21-affected pregnancies. PMID:18215254

  15. Pathologic examination of the placenta and its clinical utility: a survey of obstetrics and gynecology providers.

    Science.gov (United States)

    Odibo, Imelda; Gehlot, Ashita; Ounpraseuth, Songthip T; Magann, Everett F

    2016-01-01

    To determine provider awareness of the College of American Pathologists (CAP) recommended guidelines for examination of placenta and evaluate the Obstetrician -Gynecologist's perception of the clinical utility of placenta pathology reports. An anonymous survey of Obstetrician Gynecologists who attended the national conference of The Central Association of Obstetricians and Gynecologists (CAOG) in 2013 assessing their knowledge of the CAP guidelines and utilization of information obtained from pathology reports. Chi-square or Fisher's exact test were used to evaluate association between specialists and non-specialist providers as related to survey questions and multivariable logistic regression used to explore factors associated with utilization and awareness of the guidelines. A total of 218 providers attended the conference and 111 surveys were completed. Only 36% of participants were aware of the CAP guidelines for pathologic examination of the placenta. The odds that a physician with more than 15 years of experience will send a placenta for examination was 0.210 times that of physicians with less than 15 years of experience (CI 0.084, 0.521). The odds for awareness of the CAP guideline among subspecialists who participated in the study were 3.630 times the odds for non-specialist (CI 1.44, 9.147). In addition, the odds of sending a placenta for those physicians in a community hospital are 0.300 times that of physicians in a University hospital (CI 0.110, 0.820). The presence of a pathologist skilled in obstetrics and gynecology did not seem to affect awareness of the CAP guidelines, perception of the usefulness of the guidelines and likelihood of sending a placenta for examination. Only 21% of participants reported understanding the nomenclature used in pathology reports "all the time". Participants ranked the explanation of adverse pregnancy outcome as the most useful clinical application of placenta pathologic examination and most advocated for continued

  16. Poor agreement between operators on grading of the placenta.

    LENUS (Irish Health Repository)

    Moran, M

    2011-01-01

    Abnormal placental grading is associated with poor pregnancy outcome. The aim of this study was to measure intra- and interobserver variability in placental grading. Five expert sonographers independently graded 90 images on two occasions, each viewing separated by 1 week. A number of measures were employed to standardise assessment and minimise potential for variation: prior agreement was established between observers on the classifications for placental grading; a controlled viewing laboratory was used for all viewings; ambient lighting was optimal and monitors were calibrated to the GSDF standard. Kappa (κ) analysis was used to measure observer agreement. Substantial variations between individuals\\' scores were observed. A mean κ-value of 0.34 (range from 0.19 to 0.50) indicated fair interobserver agreement over the two occasions and only nine of the 90 images were graded the same by all five observers. Intraobserver agreement had a moderate mean κ-value of 0.52, with individual comparisons ranging from 0.45 to 0.66. This study demonstrates that, despite standardised viewing conditions, Grannum grading of the placenta is not a reliable technique even among expert observers. The need for new methods to assess placental health is required and work is ongoing to develop 2D and 3D software-based methods.

  17. Discovery of eight novel divergent homologs expressed in cattle placenta.

    Science.gov (United States)

    Larson, Joshua H; Kumar, Charu G; Everts, Robin E; Green, Cheryl A; Everts-van der Wind, Annelie; Band, Mark R; Lewin, Harris A

    2006-05-16

    Ten divergent homologs were identified using a subtractive bioinformatic analysis of 12,614 cattle placenta expressed sequence tags followed by comparative, evolutionary, and gene expression studies. Among the 10 divergent homologs, 8 have not been identified previously. These were named as follows: cattle cerebrum and skeletal muscle-specific transcript 1 (CSSMST1), cattle intestine-specific transcript 1 (CIST1), hepatitis A virus cellular receptor 1 amino-terminal domain-containing protein (HAVCRNDP), prolactin-related proteins 8, 9, and 11 (PRP8, PRP9, and PRP11, respectively) and secreted and transmembrane protein 1A and 1B (SECTM1A and SECTM1B, respectively). In addition, two previously known divergent genes were identified, trophoblast Kunitz domain protein 1 (TKDP1) and a new splice variant of TKDP4. Nucleotide substitution analysis provided evidence for positive selection in members of the PRP gene family, SECTM1A and SECTM1B. Gene expression profiles, motif predictions, and annotations of homologous sequences indicate immunological and reproductive functions of the divergent homologs. The genes identified in this study are thus of evolutionary and physiological importance and may have a role in placental adaptations.

  18. Poor agreement between operators on grading of the placenta.

    Science.gov (United States)

    Moran, M; Ryan, J; Higgins, M; Brennan, P C; McAuliffe, F M

    2011-01-01

    Abnormal placental grading is associated with poor pregnancy outcome. The aim of this study was to measure intra- and interobserver variability in placental grading. Five expert sonographers independently graded 90 images on two occasions, each viewing separated by 1 week. A number of measures were employed to standardise assessment and minimise potential for variation: prior agreement was established between observers on the classifications for placental grading; a controlled viewing laboratory was used for all viewings; ambient lighting was optimal and monitors were calibrated to the GSDF standard. Kappa (κ) analysis was used to measure observer agreement. Substantial variations between individuals' scores were observed. A mean κ-value of 0.34 (range from 0.19 to 0.50) indicated fair interobserver agreement over the two occasions and only nine of the 90 images were graded the same by all five observers. Intraobserver agreement had a moderate mean κ-value of 0.52, with individual comparisons ranging from 0.45 to 0.66. This study demonstrates that, despite standardised viewing conditions, Grannum grading of the placenta is not a reliable technique even among expert observers. The need for new methods to assess placental health is required and work is ongoing to develop 2D and 3D software-based methods.

  19. Morphometric Evaluation of Preeclamptic Placenta Using Light Microscopic Images

    Directory of Open Access Journals (Sweden)

    Rashmi Mukherjee

    2014-01-01

    Full Text Available Deficient trophoblast invasion and anomalies in placental development generally lead to preeclampsia (PE but the inter-relationship between placental function and morphology in PE still remains unknown. The aim of this study was to evaluate the morphometric features of placental villi and capillaries in preeclamptic and normal placentae. The study included light microscopic images of placental tissue sections of 40 preeclamptic and 35 normotensive pregnant women. Preprocessing and segmentation of these images were performed to characterize the villi and capillaries. Fisher’s linear discriminant analysis (FLDA, hierarchical cluster analysis (HCA, and principal component analysis (PCA were applied to identify the most significant placental (morphometric features from microscopic images. A total of 10 morphometric features were extracted, of which the villous parameters were significantly altered in PE. FLDA identified 5 highly significant morphometric features (>90% overall discrimination accuracy. Two large subclusters were clearly visible in HCA based dendrogram. PCA returned three most significant principal components cumulatively explaining 98.4% of the total variance based on these 5 significant features. Hence, quantitative microscopic evaluation revealed that placental morphometry plays an important role in characterizing PE, where the villous is the major component that is affected.

  20. Altered gene expression in human placenta after suspected preterm labour.

    Science.gov (United States)

    Oros, D; Strunk, M; Breton, P; Paules, C; Benito, R; Moreno, E; Garcés, M; Godino, J; Schoorlemmer, J

    2017-07-01

    Suspected preterm labour occurs in around 9% of pregnancies. However, almost two-thirds of women admitted for threatened preterm labour ultimately deliver at term and are considered risk-free for fetal development. We examined placental and umbilical cord blood samples from preterm or term deliveries after threatened preterm labour as well as term deliveries without threatened preterm labour. We quantitatively analysed the mRNA expression of inflammatory markers (IL6, IFNγ, and TNFα) and modulators of angiogenesis (FGF2, PGF, VEGFA, VEGFB, and VEGFR1). A total of 132 deliveries were analysed. Preterm delivery and term delivery after suspected preterm labour groups showed similar increases in TNFα expression compared with the term delivery control group in umbilical cord blood samples. Placental samples from preterm and term deliveries after suspected preterm labour exhibited significantly increased expression of TNFα and IL6 and decreased expression of IFNγ. Suspected preterm labour was also associated with altered expression of angiogenic factors, although not all differences reached statistical significance. We found gene expression patterns indicative of inflammation in human placentas after suspected preterm labour regardless of whether the deliveries occurred preterm or at term. Similarly, a trend towards altered expression of angiogeneic factors was not limited to preterm birth. These findings suggest that the biological mechanisms underlying threatened preterm labour affect pregnancies independently of gestational age at birth. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. mRNA related to insulin family in human placenta

    Energy Technology Data Exchange (ETDEWEB)

    Younes, M.A.; D' Agostino, J.B.; Frazier, M.L.; Besch, P.K.

    1986-03-01

    The authors have previously reported that human term placenta contains mRNA displaying sequence homology to a rat preproinsulin I cDNA clone (p119). When placental poly(A/sup +/) RNA was analyzed for homology to p119 by RNA/DNA blot hybridization, prominent hybridization was observed which was found by densitometric analysis to be three-fold higher than control. To further characterize this insulin-like message, a cDNA library was generated (approx.7000 transformants) using normal term cesarean-sectioned tissue to prepare placental poly(A/sup +/) RNA templates. Five hundred transformants were initially screened by colony hybridization using a /sup 32/P-labeled rat preproinsulin I cDNA as probe. Of the ten initial positives obtained, three were found to be true positives based on Southern hybridization analyses of the recombinant plasmids. Using Taq I digested pBr322 as a size marker, the cDNAs were found to be approximately 300 bp in length. Preliminary DNA sequencing using the Sanger dideoxy chain termination method has revealed that one of these clones displays significant homology to the 5' region of human insulin-like growth factors I and II.

  2. Transposable element recruitments in the mammalian placenta: impacts and mechanisms.

    Science.gov (United States)

    Emera, Deena; Wagner, Günter P

    2012-07-01

    Transposable elements (TEs) are mobile DNA elements found at high frequency in mammalian genomes. Although these elements are generally perceived as genomic parasites, they have the potential to influence host genome function in many beneficial ways. This article discusses the role TEs have played in the evolution of the placenta and pregnancy in viviparous mammals. Using examples from our own research and the literature, we argue that frequent recruitment of TEs, in particular of retroelements, has facilitated the extreme diversification of tissues at the maternal-fetal interface. We also discuss the mechanisms by which TEs have been recruited for functions during pregnancy. We argue that retroelements are pre-adapted to becoming cis-regulatory elements for host genomes because they need to utilize host regulatory signals for their own life cycle. However, although TEs contain some of the signals necessary for host functions upon insertion, they often require modification before acquiring a biological role in a host tissue. We discuss the process by which one TE was transformed into a promoter for prolactin expression in the endometrium, describing a model for TE domestication called 'epistatic capture'.

  3. Increased Levels of Cell-Free Human Placental Lactogen mRNA at 28-32 Gestational Weeks in Plasma of Pregnant Women With Placenta Previa and Invasive Placenta

    OpenAIRE

    2014-01-01

    We compared the levels of cell-free human placental lactogen (hPL) messenger RNA (mRNA) in maternal plasma at 28 to 32 weeks of gestation between women with diagnosis of placenta previa or invasive placenta and women with an uneventful pregnancy. Sensitivity and specificity of hPL mRNA for the prediction of invasive placenta were further explored. Plasma hPL mRNA were quantified by real-time reverse-transcriptase polymerase chain reaction in women with placenta previa (n = 13), invasive place...

  4. Prevalence of placenta previa among deliveries in Mainland China: A PRISMA-compliant systematic review and meta-analysis.

    Science.gov (United States)

    Fan, Dazhi; Wu, Song; Wang, Wen; Xin, Lihong; Tian, Guo; Liu, Li; Feng, Jinping; Guo, Xiaoling; Liu, Zhengping

    2016-10-01

    Placenta previa is characterized by the abnormal placenta overlying the endocervical os, and it is known as one of the most feared adverse maternal and fetal-neonatal complications in obstetrics. We aimed to obtain overall and regional estimates of placenta previa prevalence among deliveries in Mainland China. The research was performed a systematic review, following the Meta-analysis of observational studies in epidemiology (MOOSE) guidelines for systematic reviews of observational studies, and the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement for reporting systematic reviews and meta-analysis. Electronic databases were searched and included hospital-based studies that reported placenta previa prevalence in Mainland China. Random-effects meta-analyses were used to pool prevalence estimates of placenta previa. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. For exploring the geographical distributions of placenta previa, the ArcGIS software (Esri) was used to construct the map of prevalence. A total of 80 articles and 86 datasets (including 1,298,548 subjects and 14,199 placenta previa cases) from 1965 through 2015 were included. The pooled overall prevalence of placenta previa among deliveries was 1.24% (95% confidence interval [CI], 1.12-1.36) in Mainland China during 1965 to 2015. And, the trend in the prevalence of placenta previa was steady. The occurrence rate of placenta previa in the region groups Northeast, North, Northwest, Central China, East, South, and Southwest was 1.20%, 1.01%, 1.10%, 1.15%, 0.93%, 1.42%, and 2.01%, respectively. The prevalence map based on a geographic information system showed an unequal geographic distribution. The results showed that placenta previa is currently a high-burden disease in Mainland China. This review would be useful for the design of placenta previa planning and implementation adequate health care systems and treatment

  5. 凶险性前置胎盘伴胎盘植入处理体会%Treatment experience of dangerous placenta previa complicated with placenta accrete

    Institute of Scientific and Technical Information of China (English)

    周庆红; 周晓红

    2015-01-01

    目的:研究凶险性前置胎盘伴胎盘植入的诊断及治疗。方法:收治凶险性前置胎盘并胎盘植入孕妇18例,对其具体情况进行回顾分析。结果:产前彩超胎盘植入时检出率55.55%(10/18),10例行MRI检查,检出率100%(10/10),8例行“8”缝扎剥离面及结扎双侧子宫血管。7例行“8”缝扎剥离面及结扎双侧子宫血管后效果不佳,急行子宫动脉栓塞治疗,保留子宫成功。3例直接行子宫切除。结论:凶险性前置胎盘伴胎盘植入易产后出血,充分术前准备,个体化,多方式治疗,降低并发症。%Objective:To explore the diagnosis and treatment of dangerous placenta previa complicated with placenta accreta. Methods:18 cases of pregnant women with dangerous placenta previa complicated with placenta accreta were selected,the clinical data were retrospectively analyzed.Results:The detection rate of prenatal ultrasound placenta implantation was 55.55%(10/18),10 patients were given MRI examination,the detection rate was 100% (10/10),8 cases were given "8" suture wound surface and bilateral uterine vessel ligation.The effect of "8" suture wound surface and bilateral uterine vessel ligation in 7 cases was poor, they were given emergency uterine artery embolization treatment,uterus was successfully retained.3 patients were given hysterectomy.Conclusion:Postpartum hemorrhage in dangerous placenta previa complicated with placenta accreta was easy to occur,we should have adequate preoperative preparation and individualized treatment in many ways,so as to reduce the complications.

  6. Review: A high capacity of the human placenta for genetic and epigenetic variation: implications for assessing pregnancy outcome.

    Science.gov (United States)

    Yuen, R K C; Robinson, W P

    2011-03-01

    Genetic and epigenetic studies of the human placenta can help to clarify the underlying mechanisms of placenta-associated diseases. However, such studies have also revealed a considerable degree of within- and between-placenta variability, which can be attributed to a variety of influences. We illustrate the inherent heterogeneity in the placenta using examples from two types of studies: 1) chromosomal mosaicism and 2) DNA methylation variation. We discuss the factors that may influence the distribution of variation and how, understanding the source of this variation is important for interpreting data used to investigate and predict clinical outcomes.

  7. Effects of netrin-1 and netrin-1 knockdown on human umbilical vein endothelial cells and angiogenesis of rat placenta.

    Science.gov (United States)

    Xie, H; Zou, L; Zhu, J; Yang, Y

    2011-08-01

    Angiogenesis is an important process essential for the development of placenta. Netrin-1 was first discovered in nervous system and was later found to play roles in angiogenesis. In order to better understand the functional relevance of netrin-1 in placental angiogenesis, we investigated the effect of netrin-1 on human umbilical vein endothelial cells (HUVECs) and rat placenta by employing up-regulation and down-regulation strategies. HUVECs and rat placenta were treated with recombinant netrin-1, and netrin-1 expression in the cells and placenta was reduced by short hairpin RNA (shRNA) in vitro and in vivo. The inhibition efficiency was determined by real-time quantitative polymerase chain reaction (RT-PCR) and Western blotting. The expression of netrin-1 was immunohistochemically located. The results demonstrated that netrin-1 promoted viability, proliferation, migration and tube formation of HUVECs. A strong reduction in cell capability was observed in vitro after netrin-1 expression was inhibited with shRNA. Netrin-1 accelerated neovascularization of placenta in pregnant rats. Suppression of netrin-1 expression in placenta resulted in reduced vascular sprouting in vivo. These findings suggest that netrin-1 is essential for the proper functioning of HUVECs and angiogenesis of rat placenta, and it is involved in the development of placenta and fetus. The proangiogenic effect of netrin-1 might offer an alternative therapeutic approach for the treatment of vascular disease of placenta.

  8. Effect of placenta previa on neonatal respiratory disorders and amniotic lamellar body counts at 36-38weeks of gestation.

    Science.gov (United States)

    Tsuda, Hiroyuki; Kotani, Tomomi; Sumigama, Seiji; Mano, Yukio; Hua, Li; Hayakawa, Hiromi; Hayakawa, Masahiro; Sato, Yoshiaki; Kikkawa, Fumitaka

    2014-01-01

    Pregnancies with placenta previa are significantly associated with preterm delivery and cesarean section. Therefore particular attention should be paid to the incidence of neonatal respiratory disorders in pregnancies with placenta previa. The purpose of this study is to examine the relationship between placenta previa and neonatal respiratory disorders, including respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN), and to evaluate the impact of placenta previa on the amniotic lamellar body count (LBC) values. We analyzed the data from 186 registered elective cesarean cases without fetal or maternal complications at 36-38weeks of gestation. Amniotic fluid samples were analyzed immediately without centrifugation, and the LBC was measured using a platelet channel on the Sysmex XE-2100. RDS was present in four neonates (2.2%) and TTN in 12 neonates (6.5%). The rate of TTN was significantly higher and the LBC values were significantly lower in the placenta previa group than in the control group (P=0.002 and P=0.024). The adjusted odds ratio for neonatal TTN was 7.20 (95% confidence interval: 6.58-7.88) among females with placenta previa. In placenta previa, warning bleeding was a significant factor protecting against neonatal respiratory disorders (P=0.046). Placenta previa in itself is a risk factor for neonatal TTN. When an elective cesarean section is performed in cases with uncomplicated placenta previa, special care should be taken to monitor for neonatal TTN even at 36-38weeks of gestation. © 2013.

  9. Placenta Increta after First-Trimester Dilatation and Curettage Manifesting as an Unusual Uterine Mass: Magnetic Resonance Findings

    Energy Technology Data Exchange (ETDEWEB)

    Ju, W.; Kim, S.C. [Dept. of Obstetrics and Gynecology, and Medical Research Inst., School of Medicine, Ewha Womens Univ., Seoul (Korea)

    2007-10-15

    Placenta increta during the first trimester of pregnancy is extremely rare. Only a few cases of placenta accreta during the latter half of pregnancy manifesting as a uterine mass have been published. This report describes a case of placenta increta that caused prolonged bleeding after a first-trimester abortion, and was identified by magnetic resonance imaging (MRI) as a heterogeneous mass in the myometrium. This is the first report of a placenta increta detected as a uterine mass after first-trimester dilatation and curettage, and its MRI findings.

  10. Ultrasonic detection and developmental changes in calcification of the placenta during normal pregnancy in mice.

    Science.gov (United States)

    Akirav, C; Lu, Y; Mu, J; Qu, D W; Zhou, Y Q; Slevin, J; Holmyard, D; Foster, F S; Adamson, S L

    2005-01-01

    High resolution ultrasound imaging of the mouse placenta during development revealed highly echogenic foci localized near the materno-placental interface in early gestation and, near term, in the placental labyrinth (the exchange region of the placenta). Echogenic foci and calcium deposits identified in histological sections using Alizarin red staining showed similar localization and changes with gestation. Calcium deposits caused the echogenic foci because incubating uteri in a decalcifying solution eliminated both the deposits and echogenic foci. Transmission electron microscopy, X-ray microanalysis, and electron diffraction were used to show that deposits were calcium hydroxyapatite crystals. Calcium deposits were extensive and densely packed at days 7.5-9.5 of gestation at the border between the maternal decidua and the fetal trophoblast giant cells of ectoplacental cone. After the formation of the chorio-allantoic placenta (approximately day 10.5), calcification deposits appeared larger and more rarefied but were still localized at the border between the maternal decidua and the fetal trophoblast giant cells of the placenta. Calcification deposits were not observed in the labyrinthine region of the mouse placenta until > or = day 15.5 (day 18.5 is full term). We conclude that deposits of calcium hydroxyapatite crystals in the mouse placenta are detectable by high resolution ultrasound imaging. These deposits provide an ultrasound detectable marker of the maternal-placental interface that is particularly prominent during the establishment of the chorio-allantoic placenta between days 7.5 and 9.5 of gestation. (c) Elsevier Ltd. All rights reserved.

  11. Evaluation of glycosaminoglycans and heparanase in placentas of women with preeclampsia.

    Science.gov (United States)

    Famá, Eduardo Augusto Brosco; Souza, Renan Salvioni; Melo, Carina Mucciolo; Melo Pompei, Luciano; Pinhal, Maria Aparecida Silva

    2014-11-01

    Preeclampsia is a multisystem disorder whose etiology remains unclear. It is already known that circulation of soluble fms-like tyrosine kinase-1 (sFlt-1) is directly involved in pre-eclampsia development. However, the molecular mechanisms involved with sFlt-1 shedding are still unidentified. We identified, quantified glycosaminoglycans and determined the enzymatic activity of heparanase in placentas of women with preeclampsia, in order to possibly explain if these compounds could be related to cellular processes involved with preeclampsia. A total of 45 samples collected from placentas, 15 samples from placentas of preeclampsia women and 30 samples from non-affected women. Heparan sulfate and dermatan sulfate were identified and quantified by agarose gel electrophoresis, whilst hyaluronic acid was quantified by an ELISA like assay. Heparanase activity was determined using biotynilated heparan sulfate as substrate. The results showed that dermatan sulfate (P=0.019), heparan sulfate levels (P=0.015) and heparanase activity (P=0.006) in preeclampsia were significantly higher than in the control group. There was no significant difference between the groups for hyaluronic acid expression in placentas (P=0.110). The present study is the first to demonstrate directly the increase of heparan sulfate in human placentas from patients with preeclampsia, suggesting that endogenous heparan sulfate could be involved in the release of sFlt-1 from placenta, increasing the level of circulating sFlt-1. Alterations of extracellular matrix components in placentas with preeclampsia raise the possibility that heparan sulfate released by heparanase is involved in mechanisms of preeclampsia development. Published by Elsevier B.V.

  12. Stereological Changes of Human Placenta in Systemic Lupus Erythematosus Compared with Healthy Controls

    Directory of Open Access Journals (Sweden)

    Zahra Heidari

    2013-07-01

    Full Text Available Background: Systemic lupus erythematosus (SLE is a chronic autoimmune disease that can cause changes in the placenta. In this study, quantitative changes of placenta were investigated using stereological methods.Materials and Methods: In this case-control study, 10 placentas from systemic lupus erythematosus pregnancy (antinuclear antibody>10, and 10 placentas from normal uncomplicated pregnancy were obtained from Imam Ali Hospital. Volume of placentas was estimated using Cavalieri's principle. 3 full-thickness columns of each placenta were taken using systematic uniform random sampling (SURS. After fixation in modified Lillie's solution, they were cut into 5 mm slices. 5-7 sections selected from each slice using SURS and stained by Masson’s trichrome. Then stereological analyses were done on 8-10 SURS fields of each section. Placental volume, absolute volume and volume density of chorionic villi, intervillous space, syncytiotrophoblast, fibrin and blood vessels in chorionic villi were estimated in both groups. The Mann Whitney-U test was employed to determine statistically significant differences between the means. Significant level was set at p<0.05.Results: Total volume and volume density of fibrin and total volume and volume density of blood vessels significantly increased in SLE group in comparison with control group (p<0.01. Volume density of syncytiotrophoblast increased 50% in SLE group in comparison with control group, this increase was statistically significant (p<0.01.Conclusion: Results showed that systemic lupus erythematosus disease can cause significant changes in the structure of placenta that may be influential on the evolution and survival of fetus.

  13. GESTATIONAL DIABETES MELLITUS ALTERS APOPTOTIC AND INFLAMMATORY GENE EXPRESSION OF TROPHOBASTS FROM HUMAN TERM PLACENTA

    Science.gov (United States)

    MAGEE, Thomas R.; ROSS, Michael G.; WEDEKIND, Lauren; DESAI, Mina; KJOS, Siri; BELKACEMI, Louiza

    2014-01-01

    AIM Increased placental growth secondary to reduced apoptosis may contribute to the development of macrosomia in GDM pregnancies. We hypothesize that reduced apoptosis in GDM placentas is caused by dysregulation of apoptosis related genes from death receptors or mitochondrial pathway or both to enhance placental growth in GDM pregnancies. METHODS Newborn and placental weights from women with no pregnancy complications (controls; N=5), or with GDM (N=5) were recorded. Placental villi from both groups were either fixed for TUNEL assay, or snap frozen for gene expression analysis by apoptosis PCR microarrays and qPCR. RESULTS Maternal, placental and newborn weights were significantly higher in the GDM group vs. Controls. Apoptotic index of placentas from the GDM group was markedly lower than the Controls. At a significant threshold of 1.5, seven genes (BCL10, BIRC6, BIRC7, CASP5, CASP8P2, CFLAR, and FAS) were down regulated, and 13 genes (BCL2, BCL2L1, BCL2L11, CASP4, DAPK1, IκBκE, MCL1, NFκBIZ, NOD1, PEA15, TNF, TNFRSF25, and XIAP) were unregulated in the GDM placentas. qPCR confirmed the consistency of the PCR microarray. Using Western blotting we found significantly decreased placental pro-apoptotic FAS receptor and FAS ligand (FASL), and increased mitochondrial anti-apoptotic BCL2 post GDM insult. Notably, caspase-3, which plays a central role in the execution-phase of apoptosis, and its substrate poly (ADP-ribose) polymerase (PARP) were significantly down regulated in GDM placentas, as compared to non-diabetic Control placentas. CONCLUSION . Women with gestational diabetes (GDM) are at increased risk for having macrosomic newborns, and larger placentas with reduced apoptosis. Decreased apoptosis subsequent to alterations in apoptotic and inflammatory genes may promote elevated weight in the GDM placentas. PMID:24768206

  14. Color-dye injection of monochorionic placentas and correlation with pregnancy complications.

    Science.gov (United States)

    Lanna, Mariano Matteo; Consonni, Dario; Faiola, Stefano; Schena, Vito; Ratti, Martina; Ferrazzi, Enrico; Rustico, Maria Angela

    2015-10-01

    Vascular anastomoses in monochorionic (MC) twin placenta can be easily identified with color-dye injection. The aim of this study is to analyze the relationship between different type of anastomoses and twin pregnancy complications. From January 2011 to October 2014, MC placentas were analyzed with color-dye injection and five group of pregnancies were identified: those that were not complicated (NC), those complicated with selective intrauterine growth restriction (sIUGR), twin-twin transfusion syndrome (TTTS), or twin anemia-polycitemia sequence (TAPS) and those with amniotic fluid discordance (AFD) between twins. Cases of TTTS treated with endoscopic laser coagulation of placenta anastomoses or cases with in utero death of one twin were excluded. A total of 118 MC placentas were observed, 58 (49%) NC, 35 (30%) sIUGR, 10 (8%) TTTS, 13 (11%) AFD and 2 (2%) TAPS. The median number of anastomoses was 7 (range 1-15), 8 (2-18), 4 (2-11), 7 (2-13) and 1 (1-1), respectively. At least one artero-venous anastomoses was found in the placenta observed, while the prevalence of artero-arterial anastomoses was 95% for NC, 91% for sIUGR, 60% for TTTS, and 77% for AFD; no TAPS placenta had this type of anastomoses. The diameter of arteroarterial anastomoses was greater in the AFD group (3.3 mm), compared to the NC, sIUGR and TTTS groups (2.3, 2.5 and 1.4 respectively, p 0.04). In this large serie of MC placenta analyzed with color-dye injection, a specific distribution of anastomoses emerged for twins with amniotic fluid discordance, which points to a need for intensive surveillance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Measurement of elasticity of normal placenta using the Virtual Touch quantification technique

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Size; Nan, Ruixia; Cui, Xiao Jing; Liang, Xian; Zhao, Yanan [Dept. of Ultrasound, Affiliated Hospital of Hainan Medical College, Haikou (China); Li, Yueping [Dept. of Obstetrics and Gynecology, Affiliated Hospital of Hainan Medical College, Haikou (China)

    2016-07-15

    The aim of this study was to measure the elasticity of normal placentas using the Virtual Touch quantification (VTQ) technique. This study was approved by the Institutional Ethics Committee. Fifty randomly selected, healthy pregnant women in their second trimester and 50 randomly selected, healthy pregnant women in their third trimester with a single fetus were included, and their placentas underwent VTQ through shear wave velocity (SWV) measurements. The measurements were performed at different locations to sample different areas of the placenta. Measurements were performed 3-4 times in each location, the mean shear wave velocities were calculated without the highest and lowest values of measurements in each region, and the results were compared. The SWV of the placenta was 0.983±0.260 m/sec, and the minimal and maximal speed was 0.63 m/sec and 1.84 m/sec, respectively. There was no significant difference between the second and third trimester of VTQ of the placenta in terms of SWV (0.978±0.255 m/sec vs. 0.987±0.266 m/sec, P=0.711). The maternal age between second and third trimester was 27.9±4.3 years and 29.2±4.4 years, respectively; there was no significant difference between them (P=0.159). The results of this study show that the SWV of normal placenta tissue is 0.983±0.260 m/sec, it has little variation between the second and third trimesters, and the VTQ technique may potentially play an additional role in placenta evaluation.

  16. Anatomopathological characterization of placentas from HIV+ patients associated with p24 expression

    Directory of Open Access Journals (Sweden)

    Consuelo Lozoya López

    2013-12-01

    Full Text Available INTRODUCTION: The study of placentas from pregnant human immunodeficiency virus (HIV positive women has become the subject of numerous studies in the literature. Morphological, viral, immune and inflammatory placental aspects have been analyzed in order to grasp the vertical transmission of the virus. OBJECTIVE: To identify the most frequent findings in the placentas by associating them with a viral antigen and correlating them with the infection of newborns. MATERIAL AND METHODS: Thirty-five placentas from HIV- positive pregnant women were pathologically and immunohistochemically analyzed with the use of p24 antibody in the period from 1992 to1997 in accordance with the routine laboratory testing from the Anatomopathological Department - Hospital Universitário Antônio Pedro - Universidade Federal Fluminense (APD/HUAP/UFF. RESULTS: The microscopic alterations detected in all cases, including those with vertical transmission, were arteriopathy in the fetal blood circulation, chorioamnionitis, perivillous fibrin deposition, syncytial knotting, villous edema and villous immaturity. No specific macroscopic or histopathological changes were found in these placentas. The neonatal infection was observed in five cases. Vertical transmission was identified in two out of five placentas that had low weight for the respective stage of pregnancy. Immunohistochemical analysis revealed 14 positive cases, two of which showed vertical transmission. The viral protein was not identified in 10 out of 14 placentas from patients who had been medicated with zidovudine (AZT. CONCLUSION: Our study has contributed to the anatomopathological investigation into placentas from HIV-positive patients, although p24 expression per se did not allow a definite and early diagnosis of the vertical transmission.

  17. A 5-year review of pattern of placenta previa in Ilorin, Nigeria.

    Science.gov (United States)

    Omokanye, L O; Olatinwo, A W O; Salaudeen, A G; Ajiboye, A D; Durowade, K A

    2017-01-01

    Placenta previa, a major cause of obstetric hemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. This is a retrospective study of all cases of placenta previa managed at the University of Ilorin Teaching Hospital over a 5-year from January 2011 to December 2015. A pro forma template was used to harvest information from case notes of patients involved in the study. There were a total of 10,250 deliveries over the 5-year study and 164 cases of placenta previa were managed during this period; giving an incidence of 1.6% of the total deliveries. Of these patients, 65.9% were unbooked while 34.1% were booked. 110 (67%) were above 30 years of age and 51.2% were grand multiparous women. The majority (81.7%) of the patients belonged to the low socioeconomic class. Painless vaginal bleeding (62.2%), intrapartum hemorrhage (22.6%), and abnormal lie presentation (8.5%) were the most common mode of presentation. Vaginal delivery occurred in (29.3%) of patients while 70. 7% were delivered through cesarean section. There was a significant association between patients' age, parity, booking status, and types of placenta previa (P placenta previa (P placenta previa are advanced maternal age above 35 years, grand multiparity, and booking status. Early recognition, appropriate referral of these patients and availability of ultrasound facilities, blood transfusion facilities, improvement in neonatal facilities and trained personnel will go a long way in reducing the perinatal mortality from placenta previa.

  18. Expression of thyroid hormone transporters in the human placenta and changes associated with intrauterine growth restriction.

    Science.gov (United States)

    Loubière, L S; Vasilopoulou, E; Bulmer, J N; Taylor, P M; Stieger, B; Verrey, F; McCabe, C J; Franklyn, J A; Kilby, M D; Chan, S-Y

    2010-04-01

    Thyroid hormones (TH) are important for the development of the human fetus and placenta from very early gestation. The transplacental passage of TH from mother to fetus and the supply of TH into trophoblasts require the expression of placental TH plasma membrane transporters. We describe the ontogeny of the TH transporters MCT8, MCT10, LAT1, LAT2, OATP1A2 and OATP4A1 in a large series (n = 110) of normal human placentae across gestation and describe their expression changes with intrauterine fetal growth restriction (IUGR n = 22). Quantitative RT-PCR revealed that all the mRNAs encoding TH transporters are expressed in human placenta from 6 weeks gestation and throughout pregnancy. MCT8, MCT10, OATP1A2 and LAT1 mRNA expression increased with gestation. OATP4A1 and CD98 (LATs obligatory associated protein) mRNA expression reached a nadir in mid-gestation before increasing towards term. LAT2 mRNA expression did not alter throughout gestation. Immunohistochemistry localised MCT10 and OATP1A2 to villous cytotrophoblasts and syncytiotrophoblasts, and extravillous trophoblasts while OATP4A1 was preferentially expressed in the villous syncytiotrophoblasts. Whilst MCT8 protein expression was increased, MCT10 mRNA expression was decreased in placentae from IUGR pregnancies delivered in the early 3rd trimester compared to age matched appropriately grown for gestational age controls. No significant change was found in the mRNA expression of the other transporters with IUGR. In conclusion, several TH transporters are present in the human placenta from early 1st trimester with varying patterns of expression throughout gestation. Their coordinated effects may regulate both transplacental TH passage and TH supply to trophoblasts, which are critical for the normal development of the fetus and placenta. Increased MCT8 and decreased MCT10 expression within placentae of pregnancies complicated by IUGR may contribute to aberrant development of the fetoplacental unit.

  19. 前置胎盘胎盘植入研究进展%Research Progress on the Placenta Accrete of Placenta Previa

    Institute of Scientific and Technical Information of China (English)

    池一婵; 隗伏冰(综述); 唐莉(审校)

    2015-01-01

    前置胎盘是常见的妊娠晚期出血性疾病,可危及母儿生命。胎盘植入与前置胎盘、剖宫产史等因素高度相关。出血多且采取保守治疗无效时应及时行子宫切除术。对于凶险性前置胎盘要引起高度重视,切实做好术前准备、术中有效处理,以减少出血量及子宫切除率。该文就前置胎盘胎盘植入病因、对母儿影响、临床表现及诊断、治疗、预防等方面的研究进展予以综述。%Placenta previa is one of the most common hemorrhagic diseases in late trimester of preganancy ,it may threaten the maternal and fetal life .Placenta accrete is associated with previous cesarean section and pla-centa previa,hysterectomy would be performed if massive bleeding could not be alleviated with conservative treatment.Dangerous type of placenta previa should be paid a lot of attention ,in order to make necessary pre-operative preparation and conduct effective intraoperative treatment to control massive bleeding and hysterec-tomy rate.Here is to make a review of the research progress on the pathogenesis,impact on mothers and infants,clinical manifestations,diagnosis,treatment,and prevention of placenta previa.

  20. Histological features of the placenta and their relation to the gross and data from Thoroughbred mares

    Directory of Open Access Journals (Sweden)

    Fernanda M. Pazinato

    Full Text Available Abstract: The placenta is a transitory organ that originates from maternal and fetal tissues, the function of which is transporting nutrients from the mother to the fetus. The aim of this study was describe the histological features of placentas in healthy Thoroughbred mares at foaling and evaluate their relation with the gross placental and data of these mares. For this study 188 Thoroughbred mares were used. It was performed clinical observation for signs of placentitis during daily health checks and ultrasonic examination monthly to assess the fetus and placenta. All of the mares that exhibited clinical signs of placentitis were treated during gestation. The parturition was assisted, the placentas were grossly evaluated and samples were collected immediately after expulsion. The following data were considered for each mare: age, gestational age, number of parturition, time for placental expulsion, umbilical-cord length, placental weight and clinical signs of placentitis. Histological evaluation of the placentas revealed extensive cytoplasmic vacuolization of the epithelial areolar cells, presence of inflammatory infiltrates and hypoplasia-atrophy of the microcotyledons. Most of the gross placental findings were consistent with the histological results. In conclusion the mares with a vacuolated placental chorionic epithelium were older and had experienced a larger number of births. Great part of the mares with inflammatory infiltrates did not showed any clinical signs of placentitis during gestation.

  1. Placenta increta as an important cause of uterine mass after first-trimester Curettage (case report

    Directory of Open Access Journals (Sweden)

    Safoura Rouholamin

    2014-01-01

    Full Text Available Placenta increta during the first trimester of pregnancy is very rare. This report describes two cases of placenta increta that caused prolonged vaginal bleeding after a first-trimester abortion. We were encountered two cases of placenta increta in October 2012 and May 2013. Case I: A 35-year-old patient with continues vaginal bleeding from 2 months after curettage due to missed abortion in the first trimester. The uterus was large, the human chorionic gonadotropin (BHCG level was 112 mUI/mL and ultrasound showed an echogenic mass in the lower segment of the uterine cavity. She was a candidate for curettage but received hysterectomy because of massive vaginal bleeding. Pathology reported placenta increta. Case II: A 32-year-old patient in the 12th week of gestation with missed abortion. After 6 weeks from curettage, she returned with continues vaginal bleeding, BHCG = 55 mUI/mL and sonography showing mixed echo lesion in the uterine cavity like hydatiform mole. Total abdominal hysterectomy was performed. Pathology reported placenta increta. In patients with a history of recent first-trimester abortion presenting with prolonged vaginal bleeding, uterine mass and low-level BHCG, a diagnosis of abnormal placentaion should be kept in mind.

  2. The placenta shed from goats with classical scrapie is infectious to goat kids and lambs.

    Science.gov (United States)

    Schneider, David A; Madsen-Bouterse, Sally A; Zhuang, Dongyue; Truscott, Thomas C; Dassanayake, Rohana P; O'Rourke, Katherine I

    2015-08-01

    The placenta of domestic sheep plays a key role in horizontal transmission of classical scrapie. Domestic goats are frequently raised with sheep and are susceptible to classical scrapie, yet potential routes of transmission from goats to sheep are not fully defined. Sparse accumulation of disease-associated prion protein in cotyledons casts doubt about the role of the goat's placenta. Thus, relevant to mixed-herd management and scrapie-eradication efforts worldwide, we determined if the goat's placenta contains prions orally infectious to goat kids and lambs. A pooled cotyledon homogenate, prepared from the shed placenta of a goat with naturally acquired classical scrapie disease, was used to orally inoculate scrapie-naïve prion genotype-matched goat kids and scrapie-susceptible lambs raised separately in a scrapie-free environment. Transmission was detected in all four goats and in two of four sheep, which importantly identifies the goat's placenta as a risk for horizontal transmission to sheep and other goats.

  3. Organochlorine pesticide residues in human breast milk and placenta in Tohoku, Japan

    Energy Technology Data Exchange (ETDEWEB)

    Nakai, K.; Suzuki, K.; Oka, T.; Sugawara, N.; Ohba, T.; Kameo, S.; Satoh, H. [Environmental Heath Sciences, Tohoku Univ. Graduate School of Medicine, Sendai (Japan); Nakamura, T.; Saitoh, Y. [Miyagi Prefectural Inst. of Piblic Health and Environment (Japan); Okamura, K. [Dept. of Obstetrics, Tohoku Univ. Graduate School of Medicine, Sendai (Japan)

    2004-09-15

    Recently, we have started a birth cohort study to examine the effects of exposure to persistent organochemical pollutants and heavy metals on neurodevelopment in Japanese children, The Tohoku Study of Child Development. In this cohort study, biological samples, including maternal peripheral blood, cord blood, placenta, cord tissue, and breast milk have been collected from more than six hundred mother-infant pairs for chemical determinations. The growth of infants has been monitored using neurodevelopmental tests, including the Brazelton Neonatal Behavioral Assessment Scale, the Bayley Scale of Infant Development, the Kyoto Scale of Psychological Development, and others. Exposures to dioxin and related compounds, polychlorinated biphenyls, methylmercury, and several heavy metals were assessed. Additionally, since perinatal exposure to organochlorine pesticides may affect the neurodevelopment of children, we examined the effects of those pesticides in the cohort study. In the present study, several organochlorine pesticides were analyzed in human breast milk and placenta from 20 mothers to identify the major pesticide compounds found in the cohort subjects. The relationship between pesticides in breast milk and the placenta was analyzed to examine the utilization of the placenta as the material for exposure assessment. Some information regarding the factors affecting the contamination of breast milk and the placenta with organochlorine pesticides are also discussed.

  4. Transplacental transfer of acrylamide and glycidamide are comparable to that of antipyrine in perfused human placenta.

    Science.gov (United States)

    Annola, Kirsi; Karttunen, Vesa; Keski-Rahkonen, Pekka; Myllynen, Päivi; Segerbäck, Dan; Heinonen, Seppo; Vähäkangas, Kirsi

    2008-11-10

    Most drugs can penetrate the placenta but there are only a few studies on placental transfer of environmental toxic compounds. In this study, we used dual recirculating human placental perfusion to determine the transfer rate through the placenta of a neurotoxic and carcinogenic compound found in food, acrylamide and its genotoxic metabolite glycidamide. Putative acrylamide metabolism into glycidamide during the 4-h perfusions and acrylamide-derived DNA adducts in placental DNA after perfusions were also analyzed. Placentas were collected immediately after delivery and kept physiologically functional as confirmed by antipyrine kinetics, glucose consumption and leak from fetal to maternal circulation. Acrylamide (5 or 10 microg/ml) or glycidamide (5 microg/ml), both with antipyrine (100 microg/ml), was added to maternal circulation. Acrylamide and glycidamide were analyzed in the perfusion medium by liquid chromatography/mass spectrometry. Acrylamide and glycidamide crossed the placenta from maternal to fetal circulation with similar kinetics to antipyrine, suggesting fetal exposure if the mother is exposed. The concentrations in maternal and fetal circulations equilibrated within 2h for both studied compounds and with both concentrations. Acrylamide metabolism into glycidamide was not detected during the 4-h perfusions. Moreover, DNA adducts were undetectable in the placentas after perfusions. However, fetuses may be exposed to glycidamide after maternal metabolism. Although not found in placental tissue after 4h of perfusion, it is possible that glycidamide adducts are formed in fetal DNA.

  5. Placenta previa and long-term morbidity of the term offspring.

    Science.gov (United States)

    Walfisch, Asnat; Beharier, Ofer; Shoham-Vardi, Ilana; Sergienko, Ruslan; Landau, Daniella; Sheiner, Eyal

    2016-08-01

    The long-term impact of placenta previa on term infants is unknown. We aimed to investigate whether abnormal placentation increases the risk for long-term morbidity of the term offspring. A population-based cohort study compared the incidence of long-term hospitalizations up to the age of 18 due to cardiovascular, endocrine, neurological, hematological, respiratory and urinary morbidity of children born at term in pregnancies diagnosed with placenta previa and those without. Deliveries occurred between the years 1991-2013 in a tertiary medical center. Multiple pregnancies, and fetal congenital malformations were excluded. Kaplan-Meier survival curves were used to compare cumulative morbidity incidence over time. A multivariable generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders and for maternal clusters. During the study period 233,123 term deliveries met the inclusion criteria; 0.2% (n=502) of the children were born to mothers with placenta previa. During the follow-up period, children born to mothers with placenta previa did not have an increased risk for long-term cardiovascular, endocrine, hematological, neurological, respiratory, and urinary morbidity. Term offsprings of mothers diagnosed with placenta previa do not appear to be at an increased risk for long-term morbidity up to the age of 18. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Transecting versus avoiding incision of the anterior placenta previa during cesarean delivery.

    Science.gov (United States)

    Verspyck, Eric; Douysset, Xavier; Roman, Horace; Marret, Stephane; Marpeau, Loïc

    2015-01-01

    To compare maternal outcomes after transection and after avoiding incision of the anterior placenta previa during cesarean delivery. In a retrospective study, records were reviewed for women who had anterior placenta previa and delivered by cesarean after 24 weeks of pregnancy at a tertiary center in Rouen, France. During period A (January 2000 to December 2006), the protocol was to systematically transect the placenta when it was unavoidable. During period B (January 2007 to December 2010), the technique was to avoid incision by circumventing the placenta and passing a hand around its margin. Logistic regression was used to identify independent risk factors associated with maternal transfusion of packed red blood cells. Eighty-four women were included (period A: n=43; period B: n=41). During period B, there was a reduction in frequency of intraoperative hemorrhage (>1000 mL) (P=0.02), intraoperative hemoglobin loss (P=0.005), and frequency of blood transfusion (P=0.02) as compared with period A. In multivariable analysis, period B was associated with a reduced risk of maternal transfusion (odds ratio 0.27; 95% confidence interval 0.09-0.82; P=0.02). Avoiding incision of the anterior placenta previa was found to reduce frequency of maternal blood transfusion during or after cesarean delivery. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. A Case of Vaginal Stillbirth in the Presence of Placenta Previa at 33 Weeks of Gestation

    Science.gov (United States)

    Chinen, Yukiko; Kinjo, Tadatsugu; Nitta, Hayase; Kinjo, Yui; Masamoto, Hitoshi

    2016-01-01

    It was demonstrated that second- and third-trimester therapeutic termination of pregnancy (TOP) is feasible in cases with placenta previa. We report a 34-year-old woman with complex fetal malformations associated with placenta previa. An ultrasound examination at 21 weeks of gestation revealed fetal growth restriction (FGR) and complex fetal malformations associated with a placenta previa. After extensive information, the parents opted for careful observation. Thereafter, FGR gradually progressed and we observed arrest of end-diastolic velocity of the umbilical artery. Finally, intrauterine fetal death (IUFD) was confirmed at 33 weeks of gestation. Two days after IUFD, the patient experienced labor pain. The placenta and dead fetus weighing 961 g were vaginally delivered, and total bleeding was 270 mL. Although further studies to confirm the dynamic change of the uteroplacental blood flow are necessary to avoid the risk of maternal hemorrhage, vaginal TOP with placenta previa after feticide or IUFD would be feasible. PMID:27579202

  8. Does previa location matter? Surgical morbidity associated with location of a placenta previa.

    Science.gov (United States)

    Young, B C; Nadel, A; Kaimal, A

    2014-04-01

    To evaluate the effect of placenta previa location (anterior vs posterior) on cesarean morbidity. Retrospective cohort of women undergoing cesarean for placenta previa. The rate of hysterectomy and blood transfusion in the setting of anterior previa was compared with posterior previa. Planned stratified analysis based on delivery history was performed. Logistic regression was performed to control for potential confounders. Two hundred and eighty-five women undergoing cesarean delivery for placenta previa were identified. Women undergoing primary cesareans with an anterior previa had higher rates of blood transfusion (adjusted odds ratio (aOR) 3.13 95% confidence interval (CI) (1.18 to 8.36) and hysterectomy (7.4% vs 0, P=0.001) compared with those with a posterior previa; similarly, women undergoing repeat cesarean with anterior previa had higher rates of hysterectomy (aOR 4.60 95% CI (1.02 to 20.7). The majority of hysterectomies (93.8%) were due to abnormal placentation. An anterior placenta previa increases the risk of hysterectomy for both primary and repeat cesareans due to abnormal placentation. In the absence of accreta, blood transfusion remained a significant cause of maternal morbidity in both anterior and posterior placenta previas. This information may be useful for operative planning.

  9. Frequency of placenta previa in previously scarred and non scarred uterus.

    Science.gov (United States)

    Majeed, Tayyaba; Waheed, Fatima; Mahmood, Zahid; Saba, Kanwal; Mahmood, Hamis; Bukhari, Mulazim Hussain

    2015-01-01

    To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus. A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections (37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus) in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008- December 2011. Most patients (47.36%) were between 26-30 years age group, presented with gestational age between 36-40 weeks (70.17%), were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% (37 cases), and frequency in previously scarred uterus was 67.54% (77 cases). Major degree Previa was found in 88 cases (77.19%). There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa (10.67%) from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections. A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus.

  10. Functional full-term placentas formed from parthenogenetic embryos using serial nuclear transfer.

    Science.gov (United States)

    Hikichi, Takafusa; Ohta, Hiroshi; Wakayama, Sayaka; Wakayama, Teruhiko

    2010-09-01

    Mammalian parthenogenetic embryos invariably die in mid-gestation from imprinted gene defects and placental hypoplasia. Based on chimera experiments, trophoblastic proliferation is supposed to be inhibited in the absence of a male genome. Here, we show that parthenogenetic mouse embryonic cell nuclei can be reprogrammed by serial rounds of nuclear transfer without using any genetic modification. The durations of survival in uteri of cloned foetuses derived from green fluorescent protein (GFP)-labelled parthenogenetic cell nuclei were extended with repeated nuclear transfers. After five repeats, live cloned foetuses were obtained up to day 14.5 of gestation; however, they did not survive longer even when we repeated nuclear transfer up to nine times. All foetuses showed intestinal herniation and possessed well-expanded large placentas. When embryonic stem (ES) cells derived from fertilised embryos were aggregated with the cloned embryos, full-term offspring with large placentas were obtained from the chimeric embryos. Those placentas were derived from parthenogenetic cell nuclei, judging from GFP expression. The patterns of imprinted gene expression and methylation status were similar to their parthenogenetic origin, except for Peg10, which showed the same level as in the normal placenta. These results suggest that there is a limitation for foetal development in the ability to reprogramme imprinted genes by repeated rounds of nuclear transfer. However, the placentas of parthenogenetic embryos can escape epigenetic regulation when developed using nuclear transfer techniques and can support foetal development to full gestation.

  11. Barrier Effect of Placenta Membrane of Pregnant Rat on Mixed Rare Earth Changle

    Institute of Scientific and Technical Information of China (English)

    周莉; 陈辉; 黄可欣; 李树蕾; 聂毓秀

    2003-01-01

    To assess the potential health risks of mixed rare earths Changle for human embryo, whether it crosses placenta membrane or placenta barrier should be determined. In order to arrive at the aim placenta tissue was observed after contamination with optical and electron microscope to show distribution and destiny of mixed rare earth Changle in placenta tissue. Meanwhile the amount of rare earths in serum of pregnant rat, amniotic fluid and extract of embryo tissue were measured by using Inductively Coupled Plasma-Mass Spectrometer (ICP-MS). The rats were administered to 0.3, 2, 5 and 20 mg*kg-1 mixed rare earths Changle every day, respectively by oral from the 6th to 18th day after pregnancy. The results show that many particles are found in syncytiotrophoblast around capillaries of placental villi in contaminated groups under light microscope, and there are more particles following increased dose. It also was observed that some dense bodies with the envelope in placenta membrane and to difference extent damages the mitochondria crista within syncytiotrophoblast cytoplasm in contaminated groups under transmission electron microscope (TEM). Results of ICP-MS assay indicate that the level of Ce increases with contamination dose in the serum of pregnant rats, and the level of total rare earth element remarkably rises in amniotic fluid and serum of pregnant rats for 20 mg*kg-1 group as compared with the control without change for the other groups.

  12. A case-control review of placentas from patients with intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Patel, Shivani; Pinheiro, Meaghan; Felix, Juan C; Opper, Neisha; Ouzounian, Joseph G; Lee, Richard H

    2014-08-01

    To compare the incidence of histopathological features in placentas from women with cholestasis of pregnancy to healthy individuals without ICP. Placentas from mothers with and without cholestasis of pregnancy were reviewed by a pathologist masked to the study group. Subjects were excluded if they had medical problems already associated with placental histopathology. Twenty-four cases and 30 controls placentas were reviewed. Seventeen placental histopathological features were found. There was no statistically significant difference between the groups. Amongst patients with cholestasis, there was a decrease in villitis of unknown etiology in those treated with ursodeoxycholic acid. There is no difference in the placental histopathology in cholestasis of pregnancy compared to normal pregnancies, but treatment of patients with cholestasis of pregnancy with ursodeoxycholic acid may decrease findings of villitis of unknown etiology.

  13. Abdominal pregnancy with placenta inserted in the spleen left in situ causing subphrenic abscess

    Directory of Open Access Journals (Sweden)

    Čolović Radoje B.

    2002-01-01

    Full Text Available Abdominal pregnancy appears once in 3000 pregnancies. It usually terminates with abortion and urgent surgery. Thanks to ultrasonography and computed tomography the diagnosis is possible before surgery. Most frequently the diagnosis has been established during emergency laparotomy. Gynaecologists are not in agreement wheather removal of placenta is mandatory or not, as it may include removal of parts or entire organs or may be followed with serious bleeding difficult to control. We present a 21-year old woman in whom during an urgent laparotomy performed for abdominal pregnancy placenta inserted in the spleen was left in situ. Postoperatively the patient developed subphrenic abscess which could not be solved without reoperation during which both the placenta and the spleen were removed. Ten years after surgery she is symptom-free.

  14. Flame retardants in placenta and breast milk and cryptorchidism in newborn boys

    DEFF Research Database (Denmark)

    Main, Katharina Maria; Kiviranta, Hannu; Virtanen, Helena Eeva

    2007-01-01

    , 1997-2001, all boys were examined for cryptorchidism. We analyzed whole placentas (for 95 cryptorchid/185 healthy boys) and individual breast milk samples (62/68) for 14 PBDEs and infant serum samples for gonadotropins, sex-hormone binding globulin, testosterone, and inhibin B. RESULTS: In 86 placenta-milk...... of PBDEs in breast milk was significantly higher in boys with cryptorchidism than in controls (sum of BDEs 47, 153, 99, 100, 28, 66, and 154: median, 4.16 vs. 3.16 ng/g fat; p serum luteinizing hormone (p ... pairs, placenta PBDE concentrations in fat were lower than in breast milk, and a larger number of congeners were nondetectable. There was no significant difference between boys with and without cryptorchidism for individual congeners, the sum of 5 most prevalent, or all 14 congeners. The concentration...

  15. Growth and maturation of villi in placentae from well-controlled diabetic women

    DEFF Research Database (Denmark)

    Mayhew, T M; Sørensen, Flemming Brandt; Klebe, J G

    1994-01-01

    with group, mode of delivery and sex of newborn as the principal effects. Mean weights were similar in controls and diabetic groups. Diabetic placentae had a more voluminous fetal capillary bed of greater length, diameter and surface area. In addition, the diffusion distances across fetal plasma (erythrocyte...... to endothelium) were shorter. Stromal diffusion distance and villous diameter were greater in vaginal deliveries. Interaction effects influenced also villous capillarization, capillary volume, capillary diameter, trophoblast thickness and stromal thickness. Our results emphasize the importance of adaptations...... on the fetal side of the diabetic placenta. They show that changes can affect the placentae of appropriate-for-age as well as large-for-age babies and provide no evidence that they increase with the severity and duration of diabetes....

  16. Functional studies of the placenta of the lizard Mabuya sp. (Scincidae) using immunocytochemistry.

    Science.gov (United States)

    Wooding, F B P; Ramirez-Pinilla, M P; Forhead, A S

    2010-08-01

    Most lizards lay eggs. However viviparity has evolved in the Squamata on many separate occasions by the process of extended retention of the egg coincident with gradual loss of the eggshell. This process is linked to reduction of the amount of yolk which is coupled with development of placental nutrient transfer. The family Scincidae currently show a range of multiple independent origins of viviparity and placentation along this pathway, and the genus Mabuya shows one of the most structurally complex placentas. This study investigates the transport potential of the different areas of the Mabuya placenta using immunocytochemistry to localize the systems in place for calcium, glucose and water transfer. The localization of these transporters demonstrated restricted distributions in the specialized areas of this morphologically complex placenta.

  17. Morphology, histochemistry and glycosylation of the placenta and associated tissues in the European hedgehog (Erinaceus europaeus)

    DEFF Research Database (Denmark)

    Jones, Carolyn J P; Carter, A M; Allen, W R

    2016-01-01

    INTRODUCTION: There are few descriptions of the placenta and associated tissues of the European hedgehog (Erinaceus europaeus) and here we present findings on a near-term pregnant specimen. METHODS: Tissues were examined grossly and then formalin fixed and wax-embedded for histology and immunocyt......INTRODUCTION: There are few descriptions of the placenta and associated tissues of the European hedgehog (Erinaceus europaeus) and here we present findings on a near-term pregnant specimen. METHODS: Tissues were examined grossly and then formalin fixed and wax-embedded for histology...... glycosylated. Yolk sac inner and outer endoderm expressed similar glycans except for N-acetylgalactosamine residues in endodermal acini. DISCUSSION: New features of near-term hedgehog placenta and associated tissues are presented, including their glycosylation, and novel yolk sac acinar structures...

  18. Endoplasmic reticulum stress is induced in the human placenta during labour.

    Science.gov (United States)

    Veerbeek, J H W; Tissot Van Patot, M C; Burton, G J; Yung, H W

    2015-01-01

    Placental endoplasmic reticulum (ER) stress has been postulated in the pathophysiology of pre-eclampsia (PE) and intrauterine growth restriction (IUGR), but its activation remains elusive. Oxidative stress induced by ischaemia/hypoxia-reoxygenation activates ER stress in vitro. Here, we explored whether exposure to labour represents an in vivo model for the study of acute placental ER stress. ER stress markers, GRP78, P-eIF2α and XBP-1, were significantly higher in laboured placentas than in Caesarean-delivered controls localised mainly in the syncytiotrophoblast. The similarities to changes observed in PE/IUGR placentas suggest exposure to labour can be used to investigate induction of ER stress in pathological placentas. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Lower uterine segment pregnancy with placenta increta complicating first trimester induced abortion: diagnosis and conservative management

    Institute of Scientific and Technical Information of China (English)

    刘欣燕; 范光升; 金征宇; 杨宁; 姜玉新; 盖铭英; 郭丽娜; 王友芳; 郎景和

    2003-01-01

    Objective To discuss the diagnosis of and conservative management for lower uterine segment pregnancy with placenta increta complicating first trimester abortion. Methods Four patients with previous caesarean section and severe hemorrhage in induced abortion during the first trimester were studied. Uterine artery embolization (UAE) was used to control bleeding and preserve the uterus. Results UAE controlled heavy uterine bleeding satisfactorily. One of the four patients asked for a hysterectomy after UAE, and her pathology report confirmed "lower uterine segment pregnancy with placenta increta". Conclusion Previous caesarean section is a risk factor for lower uterine segment pregnancy with placenta increta. UAE is one of the best conservative management methods for heavy hemorrhage, especially for women who desire future fertility.

  20. Shear wave elastography of the placenta in patients with gestational diabetes mellitus.

    Science.gov (United States)

    Yuksel, Mehmet Aytac; Kilic, Fahrettin; Kayadibi, Yasemin; Alici Davutoglu, Ebru; Imamoglu, Metehan; Bakan, Selim; Mihmanli, Ismail; Kantarci, Fatih; Madazli, Riza

    2016-07-01

    To evaluate placental elasticty in women with gestational diabetes mellitus (GDM) and non-diabetic controls. Thirty-three pregnant women with GDM according to the current criteria of the American Diabetes Association and 43 healthy pregnant women who were admitted to the antenatal clinic were recruited for this case-control study. Elasticity values of both the peripheral and the central parts of the placentas of the patients in both groups were determined by shear wave elastography (SWE) imaging. Mean elasticity values of both the central and the peripheral part of the placentas were significantly higher in GDM pregnancies (p  0.05). SWE imaging technology might provide a quantitative assessment of the morphological pathologies of placentas in pregnant women with GDM.

  1. Parturition in gilts: duration of farrowing, birth intervals and placenta expulsion in relation to maternal, piglet and placental traits

    NARCIS (Netherlands)

    Rens, van B.T.T.M.; Lende, van der T.

    2004-01-01

    Large White×Meishan F2 crossbred gilts (n=57) were observed continuously during farrowing while the placentae of their offspring were labeled in order to examine the duration of farrowing and placenta expulsion in relation to maternal-, piglet- and placental traits and the duration of birth interval

  2. Genome, transcriptome, and secretome analysis of wood decay fungus Postia placenta supports unique mechanisms of lignocellulose conversion

    Science.gov (United States)

    Diego Martinez; Jean Challacombe; Ingo Morgenstern; David Hibbett; Monika Schmoll; Christian P. Kubicek; Patricia Ferreira; Francisco J. Ruiz-Duenas; Angel T. Martinez; Philip J. Kersten; Kenneth E. Hammel; Jill A. Gaskell; Daniel Cullen

    2009-01-01

    Brown-rot fungi such as Postia placenta are common inhabitants of forest ecosystems and are also largely responsible for the destructive decay of wooden structures. Rapid depolymerization of cellulose is a distinguishing feature of brown-rot, but the biochemical mechanisms and underlying genetics are poorly understood. Systematic examination of the P. placenta genome,...

  3. Physiology: Capacity for Hormone Production of Cultured Trophoblast Cells Obtained from Placentae at Term and in Early Pregnancy

    OpenAIRE

    2001-01-01

    Problem: There is an increased doubt about the identity of isolated cytotrophoblast cells at term. Therefore, we compared pregnancy serum levels of three hormones [human placental lactogen (hPL), human chorionic gonadotropin (hCG), and leptin] with the capacity for hormone production of early placentae [EP; 8–13 weeks of gestation (WG)] and term placentae (TP; 38–42 WG).

  4. 40 CFR 26.305 - Protections applicable, after delivery, to the placenta, the dead fetus, or fetal material.

    Science.gov (United States)

    2010-07-01

    ... Supported by EPA § 26.305 Protections applicable, after delivery, to the placenta, the dead fetus, or fetal material. The provisions of 45 CFR 46.206 are applicable to this section. ..., to the placenta, the dead fetus, or fetal material. 26.305 Section 26.305 Protection of...

  5. Observations on the delivered placenta and fetal membranes of the Aardvark, Orycteropus afér (Pallas, 1766)

    NARCIS (Netherlands)

    Taverne, M.A.M.; Bakker-Slotboom, M.F.

    1970-01-01

    A macroscopical description is given of the delivered placenta and foetal membranes of an Aardvark. Special attention is paid to the umbilical cord and the relative position of the foetal membranes at the places where these attach to the placenta. Amniotic pustules were found on the umbilical cord

  6. Early preterm delivery due to placenta previa is an independent risk factor for a subsequent spontaneous preterm birth.

    Science.gov (United States)

    Erez, Offer; Novack, Lena; Klaitman, Vered; Erez-Weiss, Idit; Beer-Weisel, Ruthy; Dukler, Doron; Mazor, Moshe

    2012-08-10

    To determine whether patients with placenta previa who delivered preterm have an increased risk for recurrent spontaneous preterm birth. This retrospective population based cohort study included patients who delivered after a primary cesarean section (n = 9983). The rate of placenta previa, its recurrence, and the risk for recurrent preterm birth were determined. Patients who had a placenta previa at the primary CS pregnancy had an increased risk for its recurrence [crude OR of 2.65 (95% CI 1.3-5.5)]. The rate of preterm birth in patients with placenta previa in the primary CS pregnancy was 55.9%; and these patients had a higher rate of recurrent preterm delivery than the rest of the study population (p placenta previa in the primary CS pregnancy, those who delivered preterm had a higher rate of recurrent spontaneous preterm birth regardless of the location of their placenta in the subsequent delivery [OR 3.09 (95% CI 2.1-4.6)]. In comparison to all patients with who had a primary cesarean section, patients who had placenta previa and delivered preterm had an independent increased risk for recurrent preterm birth [OR of 3.6 (95% CI 1.5-8.5)]. Women with placenta previa, who deliver preterm, especially before 34 weeks of gestation, are at increased risk for recurrent spontaneous preterm birth regardless to the site of placental implantation in the subsequent pregnancy. Thus, strict follow up by high risk pregnancies specialist is recommended.

  7. 45 CFR 46.206 - Research involving, after delivery, the placenta, the dead fetus or fetal material.

    Science.gov (United States)

    2010-10-01

    ..., Human Fetuses and Neonates Involved in Research § 46.206 Research involving, after delivery, the placenta, the dead fetus or fetal material. (a) Research involving, after delivery, the placenta; the dead... 45 Public Welfare 1 2010-10-01 2010-10-01 false Research involving, after delivery, the...

  8. Stereological analysis of terminal villi of the placentas of pregnant woman with sideropenic anemia

    Directory of Open Access Journals (Sweden)

    Melisa Lelic

    2014-08-01

    Full Text Available Iron deficiency, causing maternal sideropenic anemia, is one of the most frequent nutritive disorder that develops during the pregnancy. We collected 30 placentas from anemic mothers and 30 placentas from mothers belonging to the control group. Terminal villi (magnification 10x and terminal villi capillaries (magnification 40x were stereologically analyzed and numerically determined.In the placentas from anemic mothers we noted the values a terminal villi: volume density 0,43 mm0, surface density 24.13 mm-1, total volume 185.57 cm3 and total surface 10.27 m2; b capillaries of terminal villi: volume density 0.53 mm0 and total volume 224.18 cm3. In the placentas from mothers belonging to the control group we observed the following values a terminal villi: volume density 0.44 mm0, surface density 22.27 mm-1, total volume 200.17 cm3 and total surface 10.15 m2; b capillaries of terminal villi: volume density 0.42 mm0 and total volume 197.00 cm3. Compared with the control group anemic mothers' placentas have a significant higher values of surface density of terminal villi (p<0.05, volume density (p <0.01 and absolute volume (p<0.0001 of terminal villi capillaries, and significant lower values of absolute volume of terminal villi (p<0.05.In anemic mothers’ placentas, the total volume of terminal villi changes disproportionately to the total surface of terminal villi with statistically significant increase of terminal villi capillaries compared with control group. 

  9. Structure and steroidogenesis of the placenta in the Antarctic minke whale (Balaenoptera bonaerensis).

    Science.gov (United States)

    Sasaki, Motoki; Amano, Yoko; Hayakawa, Daisuke; Tsubota, Toshio; Ishikawa, Hajime; Mogoe, Toshihiro; Ohsumi, Seiji; Tetsuka, Masafumi; Miyamoto, Akio; Fukui, Yutaka; Budipitojo, Teguh; Kitamura, Nobuo

    2013-01-01

    There are few reports describing the structure and function of the whale placenta with the advance of pregnancy. In this study, therefore, the placenta and nonpregnant uterus of the Antarctic minke whale were observed morphologically and immunohistochemically. Placentas and nonpregnant uteri were collected from the 15th, 16th and 18th Japanese Whale Research Programme with Special Permit in the Antarctic (JARPA) and 1st JARPA II organized by the Institute of Cetacean Research in Tokyo, Japan. In the macro- and microscopic observations, the placenta of the Antarctic minke whale was a diffuse and epitheliochorial placenta. The chorion was interdigitated to the endometrium by primary, secondary and tertiary villi, which contained no specialized trophoblast cells such as binucleate cells, and the interdigitation became complicated with the progress of gestation. Furthermore, fetal and maternal blood vessels indented deeply into the trophoblast cells and endometrial epithelium respectively with fetal growth. The minke whale placenta showed a fold-like shape as opposed to a finger-like shape. In both nonpregnant and pregnant uteri, many uterine glands were distributed. The uterine glands in the superficial layer of the pregnant endometrium had a wide lumen and large epithelial cells as compared with those in the deep layer. On the other hand, in the nonpregnant endometrium, the uterine glands had a narrower lumen and smaller epithelial cells than in the pregnant endometrium. In immunohistochemical detection, immunoreactivity for P450scc was detected in most trophoblast cells, but not in nonpregnant uteri, suggesting that trophoblast epithelial cells synthesized and secreted the sex steroid hormones and/or their precursors to maintain the pregnancy in the Antarctic minke whale.

  10. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Directory of Open Access Journals (Sweden)

    Hee Young Cho

    Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  11. The effect of morphine consumption on plasma corticosteron concentration and placenta development in pregnant rats

    Directory of Open Access Journals (Sweden)

    Masoomeh Kazemi

    2011-01-01

    Full Text Available Background: Previous studies have shown that morphine consumption during pregnancy may delay embryo development or cause abnormal nervous system function. Objective: The present study focused on the effect of maternal morphine consumption on development of placenta and blood corticosteron concentration in addictive pregnant mothers.Materials and Methods: 24 female rats, 170-200g weight, were used. The experimental groups after pregnancy received an oral dose of 0.05 mg/ml of morphine by tap water while the control group received only tap water. On 10th and 14th day of pregnancy, rats were anesthetized and placenta removed surgically, 1ml blood was collected from each pregnant mother from retro-orbital sinus, the concentration of blood corticosteron was determined by corticosteron Elisa kit after centrifugation. The fixed tissue was processed, sectioned and stained with hematoxylin and eosin. Placenta was studied microscopically according to the thickness of layers, area of blood cisterns, and the number of cells.Results: Comparing the plasma corticosteron concentration of the treatment and the control groups, not only a severe increase in the treatment group was detected, but also the thickness of maternal and embryonic portions of the placenta at day 10th and 14th of gestation was different significantly (p≤0.05. Furthermore, an increase in number of cells in maternal and embryonic portion of placenta and a decrease in blood cistern area were demonstrated in both the experimental and the control groups.Conclusion: The effects of morphine, including an increase in blood concentration of corticosteron, in dependent pregnant mothers were seen. Development of placenta in the experimental group was delayed.

  12. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients

    Science.gov (United States)

    Cho, Hee Young; Park, Yong Won; Kim, Young Han; Jung, Inkyung; Kwon, Ja-Young

    2015-01-01

    Purpose The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation. Methods We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL. Results Sixty-four patients (46.7%) required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1%) had placenta previa totalis. The overall success rate was 75% (48/64) for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all ptamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance. PMID:26263014

  13. Structure and Steroidogenesis of the Placenta in the Antarctic Minke Whale (Balaenoptera bonaerensis)

    Science.gov (United States)

    SASAKI, Motoki; AMANO, Yoko; HAYAKAWA, Daisuke; TSUBOTA, Toshio; ISHIKAWA, Hajime; MOGOE, Toshihiro; OHSUMI, Seiji; TETSUKA, Masafumi; MIYAMOTO, Akio; FUKUI, Yutaka; BUDIPITOJO, Teguh; KITAMURA, Nobuo

    2012-01-01

    Abstract There are few reports describing the structure and function of the whale placenta with the advance of pregnancy. In this study, therefore, the placenta and nonpregnant uterus of the Antarctic minke whale were observed morphologically and immunohistochemically. Placentas and nonpregnant uteri were collected from the 15th, 16th and 18th Japanese Whale Research Programme with Special Permit in the Antarctic (JARPA) and 1st JARPA II organized by the Institute of Cetacean Research in Tokyo, Japan. In the macro- and microscopic observations, the placenta of the Antarctic minke whale was a diffuse and epitheliochorial placenta. The chorion was interdigitated to the endometrium by primary, secondary and tertiary villi, which contained no specialized trophoblast cells such as binucleate cells, and the interdigitation became complicated with the progress of gestation. Furthermore, fetal and maternal blood vessels indented deeply into the trophoblast cells and endometrial epithelium respectively with fetal growth. The minke whale placenta showed a fold-like shape as opposed to a finger-like shape. In both nonpregnant and pregnant uteri, many uterine glands were distributed. The uterine glands in the superficial layer of the pregnant endometrium had a wide lumen and large epithelial cells as compared with those in the deep layer. On the other hand, in the nonpregnant endometrium, the uterine glands had a narrower lumen and smaller epithelial cells than in the pregnant endometrium. In immunohistochemical detection, immunoreactivity for P450scc was detected in most trophoblast cells, but not in nonpregnant uteri, suggesting that trophoblast epithelial cells synthesized and secreted the sex steroid hormones and/or their precursors to maintain the pregnancy in the Antarctic minke whale. PMID:23269486

  14. Review: The placenta and developmental programming: balancing fetal nutrient demands with maternal resource allocation.

    Science.gov (United States)

    Burton, G J; Fowden, A L

    2012-02-01

    The placenta evolved to support development of the fetus, and so potentially plays a key role in the aetiology of developmental programming through its impact on nutrient transfer. Placental transport efficiency depends on a variety of parameters, including surface area for exchange, thickness of the interhaemal membrane and density of transporter proteins inserted into the trophoblast membranes. Here, we review recent studies that tested whether adaptations of placental efficiency are induced in the mouse placenta when maternal nutrient supply and fetal demand are manipulated experimentally. Naturally small placentas, and those exposed to maternal undernutrition, displayed structural changes indicative of accelerated maturation at E16, with enlargement of the labyrinth exchange zone at the expense of the endocrine junctional zone. These changes were associated with increased transport of a non-metabolisable amino acid analogue per gram of placenta, and expression of genes encoding specific System A transporters. Up-regulation of transporters was also observed when a mismatch between placental size and fetal demand was generated through genetic manipulation of the Igf2/H19 axis. Conversely, overgrowth of the placenta induced by deletion of H19 resulted in reduced transport capacity and expression of transporter genes. We conclude that under conditions when the maternal nutrient supply or placental size may be limiting for normal fetal growth, the placenta adapts so as to increase its transport capacity. Hence, it ameliorates the effects of environmental cues that would otherwise lead to more extensive developmental programming. The P0 transcript of Igf2 appears to be a strong candidate as a mediator of these adaptations in the mouse.

  15. Marcadores de estrés oxidativo en placentas de gestantes añosas

    Directory of Open Access Journals (Sweden)

    Silvia Suárez

    2007-12-01

    Full Text Available Introducción: Un factor de riesgo alto ginecoobstétrico que contribuye a la morbimortalidad materna perinatal es la edad materna mayor de 35 años. Es posible que el estado oxidativo en la placenta de la gestante añosa sea mayor a la de la gestante no añosa. Objetivo: Evaluar el estado oxidativo de la placenta en gestantes mayores de 35 años. Diseño: Estudio observacional y transversal. Lugar: Hospital Nacional Docente Materno Infantil San Bartolomé y Centro de Investigación de Bioquímica y Nutrición de la Universidad Nacional Mayor de San Marcos. Material biológico: 28 placentas de gestantes de 35 años o más y 28 placentas de gestantes de menos de 35 años, obtenidas de partos vaginales a término. Intervenciones: La muestra de placenta se homogenizó al 10% con buffer fosfato 10 mM, pH 7,4, se centrifugó a 2000 rpm por 5’. Parte del sobrenadante se usó para analizar lipoperoxidación y glutatión (GSH; el sobrenadante restante fue centrifugado a 42 000 rpm por 1 hora, para medir actividad de superóxido dismutasa (SOD. Principales medidas de resultados: Estado oxidativo de placentas obtenidas de mujeres añosas y no añosas. Resultados: La actividad de la SOD y el contenido de GSH placentarios en añosas fue 43,52 U/g de tejido y 4,67 µmol/mL x 10-²; para el grupo control fueron 54,13 U/g de tejido y 6,02 µmol/mL x 10-², respectivamente; en ambos hubo significancia estadística (p < 0,05. La medición de TBARS (lipoperoxidación no mostró diferencias significativas. Conclusiones: Las placentas obtenidas de mujeres añosas muestran menor capacidad de defensa antioxidante frente a las placentas obtenidas de mujeres no añosas.

  16. Localization of placenta in scanning by /sup 113m/In radiopharmaceuticals

    Energy Technology Data Exchange (ETDEWEB)

    Cho, O.K.; Oh, K.K.; Park, C.Y.; Choi, B.S.; Ha, C.H.; Chung, S.O.; Kwak, H.M.

    1975-01-01

    Placenta previa is a common grave complication of late pregnancy, usually manifestated clinically by painless antenatal vaginal bleeding. Digital and rectal examinations are dangerous, due to the possibility that profuse hemorrhage from the vagina may result. Various radiological examinations have been performed in placenta previa for diagnosis and localization. However radioisotopic methods are superior due to safety, simplicity and a lower radiation dose, both fetal and maternal, compared to plain radiography. Among radiopharmaceuticals, In/sup 113m/ (transferrin for blood pool scan) is useful, giving more satisfactory results without any complications or untoward reactions.

  17. HISTOPATHOLOGICAL AND GROSS ANATOMICAL STUDY OF HUMAN PLACENTA IN PATIENTS WITH PREECLAMPSIA

    Directory of Open Access Journals (Sweden)

    Vimla Kumari

    2016-07-01

    Full Text Available BACKGROUND The beginning reason for preeclampsia is the placenta. Preeclampsia starts to lessen with the conveyance of the placenta and can happen without a baby, however, with the nearness of trophoblast tissue with hydatidiform moles. In perspective of this, investigation of the placenta ought to give knowledge into the pathophysiology of preeclampsia. In this presentation, we look at placental pathological and anatomical changes with preeclampsia and Foetal Development Limitation (FGR. No doubt, this examination ought to enlighten as both conditions are associated with comparably unusual placentation yet just in preeclampsia is there a maternal pathophysiological disorder. Comparative bits of knowledge about ahead of schedule and late onset preeclampsia ought to likewise be given by such information. METHODS A prospective study was led in the Department of Obstetrics and Gynaecology, Government Medical College, Bettiah. 250 instances of pregnancy actuated hypertension were concentrated on. The cases with systolic circulatory strain more prominent than 130 mmHg, diastolic pulse more noteworthy than 90 mmHg on two estimations dismantled 6 hours in relationship with histological finding were incorporated into the study. These cases were further separated as mild preeclampsia if the diastolic circulatory strain was ≤100 mmHg and as moderate preeclampsia if the diastolic pulse was 110 mmHg. Extreme cases were characterised if the systolic pulse - ≥160 mmHg, diastolic circulatory strain ≥110 mmHg. Maternal and foetal result was considered and post conveyance placenta was sent for histopathologic examination. Gross anatomical and microscopic examination was done and discoveries were connected with the seriousness of PIH. RESULTS Out of 250 cases, there were 156 instances of mild PIH, 53 moderate and 41 were of severe PIH. On gross examination (Table 1, the mean weight of placenta was 429.9 gm in gentle instances of PIH, 364 gm in moderate

  18. The Human Placenta Project: placental structure, development, and function in real time.

    Science.gov (United States)

    Guttmacher, A E; Maddox, Y T; Spong, C Y

    2014-05-01

    Despite its crucial role in the health of both the fetus and the pregnant woman, the placenta is the least understood human organ. Since a growing body of evidence also underscores the importance of placental development in the lifelong health of both mother and offspring, this lack of knowledge about placental structure and function is particularly concerning. Given modern approaches and technologies and the ability to develop new methods, we propose a coordinated "Human Placenta Project", with the ultimate goal of understanding human placental structure, development, and function in real time.

  19. Transplacental transfer of monomethyl phthalate and mono(2-ethylhexyl) phthalate in a human placenta perfusion system

    DEFF Research Database (Denmark)

    Mose, Tina; Knudsen, Lisbeth E; Hedegaard, Morten;

    2007-01-01

    and after perfusion were also analyzed. Placentas were obtained immediately after elective cesarean section and dually perfused in a recirculation system. mMP or mEHP was added to maternal perfusion medium to obtain concentrations at 10 and 25 microg/L, respectively. The placental transfer was followed...... plasma samples. mMP and possibly other short-chained phthalate monoesters in maternal blood can cross the placenta by slow transfer, whereas the results indicate no placental transfer of mEHP. Further studies are recommended....

  20. First isolation and molecular characterization of Toxoplasma gondii from a human placenta in Argentina.

    Science.gov (United States)

    Pardini, Lais; Carral, Liliana A; Bernstein, Mariana; Gos, María L; Olejnik, Patricia; Unzaga, Juan M; Kaufer, Federico J; Freuler, Cristina B; Durlach, Ricardo A; Venturini, María C

    2014-04-01

    Blood sample and placenta were taken from a 37-week pregnant woman; serologic results indicated acute toxoplasmosis. Placenta was inoculated into mice. Seropositive mice were sacrificed and tissue cysts from brain were inoculated into new mice. Specific DNA was detected by PCR, and the isolate was characterized as Type II by nPCR-RFLP for nSAG2, SAG3, BTUB, GRA6, c29-2, c22-8, L358, PK1 and Apico markers. This is the first isolation and molecular characterization of Toxoplasma gondii from humans in Argentina. © 2013.

  1. Balloon occlusion of the internal iliac arteries in the multidisciplinary management of placenta percreta

    DEFF Research Database (Denmark)

    Clausen, Caroline; Stensballe, Jakob; Albrechtsen, Charlotte K;

    2013-01-01

    Objective. To evaluate our experience with prophylactic balloon occlusion of the internal iliac arteries as a part of a multidisciplinary algorithm for the management of placenta percreta. Design. Consecutive case series. Setting. Rigshospitalet, Copenhagen University Hospital, Denmark. Sample....... Prophylactic balloon occlusion of the internal iliac arteries as part of a multidisciplinary algorithm allowed for a safe management of all cases in our consecutive series of 17 women with placenta percreta. However, intraoperative blood loss and transfusion requirements were significant. We have therefore...... decided to modify our multidisciplinary algorithm to include balloon occlusion of the common iliac arteries rather than the internal iliac arteries....

  2. The Human Placenta Project: Placental Structure, Development, and Function in Real Time

    Science.gov (United States)

    Guttmacher, Alan E.; Maddox, Yvonne T.; Spong, Catherine Y.

    2014-01-01

    Despite its crucial role in the health of both the fetus and the pregnant woman, the placenta is the least understood human organ. Since a growing body of evidence also underscores the importance of placental development in the lifelong health of both mother and offspring, this lack of knowledge about placental structure and function is particularly concerning. Given modern approaches and technologies and the ability to develop new methods, we propose a coordinated “Human Placenta Project,” with the ultimate goal of understanding human placental structure, development, and function in real time. PMID:24661567

  3. Expression of thyroid hormone transporters in the human placenta and changes associated with intrauterine growth restriction

    OpenAIRE

    Loubière, L S; Vasilopoulou, E.; Bulmer, J N; Taylor, P. M.; Stieger, B.; Verrey, F.; McCabe, C. J.; Franklyn, J.A.; Kilby, M. D.; Chan, S-Y

    2010-01-01

    Thyroid hormones (TH) are important for the development of the human fetus and placenta from very early gestation. The transplacental passage of TH from mother to fetus and the supply of TH into trophoblasts require the expression of placental TH plasma membrane transporters. We describe the ontogeny of the TH transporters MCT8, MCT10, LAT1, LAT2, OATP1A2 and OATP4A1 in a large series (n = 110) of normal human placentae across gestation and describe their expression changes with intrauterine ...

  4. Noninvasive monitoring of placenta-specific transgene expression by bioluminescence imaging.

    Directory of Open Access Journals (Sweden)

    Xiujun Fan

    Full Text Available BACKGROUND: Placental dysfunction underlies numerous complications of pregnancy. A major obstacle to understanding the roles of potential mediators of placental pathology has been the absence of suitable methods for tissue-specific gene manipulation and sensitive assays for studying gene functions in the placentas of intact animals. We describe a sensitive and noninvasive method of repetitively tracking placenta-specific gene expression throughout pregnancy using lentivirus-mediated transduction of optical reporter genes in mouse blastocysts. METHODOLOGY/PRINCIPAL FINDINGS: Zona-free blastocysts were incubated with lentivirus expressing firefly luciferase (Fluc and Tomato fluorescent fusion protein for trophectoderm-specific infection and transplanted into day 3 pseudopregnant recipients (GD3. Animals were examined for Fluc expression by live bioluminescence imaging (BLI at different points during pregnancy, and the placentas were examined for tomato expression in different cell types on GD18. In another set of experiments, blastocysts with maximum photon fluxes in the range of 2.0E+4 to 6.0E+4 p/s/cm(2/sr were transferred. Fluc expression was detectable in all surrogate dams by day 5 of pregnancy by live imaging, and the signal increased dramatically thereafter each day until GD12, reaching a peak at GD16 and maintaining that level through GD18. All of the placentas, but none of the fetuses, analyzed on GD18 by BLI showed different degrees of Fluc expression. However, only placentas of dams transferred with selected blastocysts showed uniform photon distribution with no significant variability of photon intensity among placentas of the same litter. Tomato expression in the placentas was limited to only trophoblast cell lineages. CONCLUSIONS/SIGNIFICANCE: These results, for the first time, demonstrate the feasibility of selecting lentivirally-transduced blastocysts for uniform gene expression in all placentas of the same litter and early

  5. Human Placenta: a Source of Progenitor/Stem Cells?

    Directory of Open Access Journals (Sweden)

    Parolini O

    2006-01-01

    Full Text Available Regenerative medicine based on cell therapy and tissue engineering methodologies is a newly emerging, multidisciplinary field involving biology, medicine, and genetic manipulation. This type of therapy is aimed at maintaining, restoring, or enhancing tissue and organ function, and is intended to assist in the treatment of a number of human conditions which range in severity from chronic to life threatening. In diseases where tissue or organ function is compromised, stem cell research holds great promise for providing an efficient avenue for regenerative therapy. However, the application of this type of research to the treatment of human disease will not be possible until much more is known about the biological properties of all types of stem cells. In the context of disease treatment, decisions will need to be made as to which is the best type of stem cell to use. Whether it is better to identify a stem cell able to differentiate into all tissue and organ types as opposed to using committed, lineage-specific stem cells, or perhaps embryonic cells are better than adult-derived stem cells, as well as the possible clinical applications of these cells. For some time, these questions have not only required significant scientific and medical consideration, but have also posed important social and ethical questions. There is no doubt that stem cells hold great therapeutic potential, however there is still much research required before their use can be accepted as a valuable tool in disease treatment. In particular, it is necessary to identify a source of stem cells that is easily accessible, provides a high cell yield and for which cell recovery does not provoke serious ethical debate. The aim of this review is to consider and discuss the findings regarding a new source of "adult" stem cells isolated from human term placenta tissue. So far, the placental tissue has generally been discarded post partum, but it is now becoming recognised as a potential

  6. Anticoagulants to prevent recurrent placenta-mediated pregnancy complications: Is it time to put the needles away?

    Science.gov (United States)

    Skeith, Leslie; Rodger, Marc

    2017-03-01

    Placenta-mediated pregnancy complications, such as pre-eclampsia, placental abruption, birth of a small-for-gestational age infant and late pregnancy loss, are common and carry significant morbidity and mortality. The etiology of placenta-mediated pregnancy complications is likely multifactorial and may include abnormal coagulation activation of the maternal-fetal interface. The use of antepartum low-molecular-weight heparin (LMWH) prophylaxis to prevent recurrent placenta-mediated pregnancy complications has become common practice despite limited and conflicting evidence to support its use. This paper reviews the evidence, including recently published data from an individual patient level meta-analysis, which challenges the role of LMWH in preventing recurrent placenta-mediated pregnancy complications. Incorporating this recent evidence, we recommend against the use of LMWH to prevent recurrent placenta-mediated pregnancy complications in women with and without inherited thrombophilia.

  7. Evaluation of 5-HT7 receptor expression in the placentae of normal and pre-eclamptic women.

    Science.gov (United States)

    Irge, Emine; Halici, Zekai; Yilmaz, Mehmet; Cadirci, Elif; Karakus, Emre

    2016-01-01

    In this study, by examining 5-HT7 receptor expression in placentae from pre-eclamptic and normal pregnancies, we aimed to discover a new step of pathophysiological cascade for preeclampsia. Patients whose blood pressure over the 140/90 mmHg were included when study after 20 weeks of gestation. 5-HT7 receptor expression was investigated on the placentae obtained after birth by real time PCR (RT-PCR) analysis. Pre-natal-post-natal, systolic-diastolic blood pressure values, proteinuria and renal function indicators as BUN and creatinine levels of pre-eclamptic pregnant women were higher than the healthy group. Similarly, 5-HT7 receptor expression determined in healthy placentae increased 8-fold in pre-eclamptic women. This study, for the first time we showed 5-HT7 receptor expression in normal placenta and increased expression in pre-eclamptic placenta.

  8. The Improvement Two Cases Coughing and Sputum sign Sequela of Pneumonia by Homins Placenta Aqua-Acupuncture

    Directory of Open Access Journals (Sweden)

    Kim, Eun-Gon

    2003-12-01

    Full Text Available Coughing and sputum are symptoms of sequela of Pneumonia. Oriental medicine call it Hae su. Hae su is common sign of lung disease. Hominis Placenta is the dried placenta of a healthy women. The nature of Hominis Placenta is warm and its taste sweet-salty. It has correspondence to the meridians of lung and kindey. Hominis Placenta acupuncture therapy has effect on invigoration of vital energy nourishing blood and tonifying the essence. It can be applied to the disease as Asthma, pulmonary tuberculosis, chronic hepatitis, liver cirrhosis, degenerative change and cerebrovascular disease. We treated two cases coughing and sputum sign Sequela of Pneumonia by Hominis Placenta Aqua-Acupuncture. The symptoms was improved and the patients satisfied

  9. Profiling gene expression in human placentae of different gestational ages: an OPRU Network and UW SCOR Study.

    Science.gov (United States)

    Mikheev, Andrei M; Nabekura, Tomohiro; Kaddoumi, Amal; Bammler, Theo K; Govindarajan, Rajgopal; Hebert, Mary F; Unadkat, Jashvant D

    2008-11-01

    We used the whole-genome approach to identify major functional categories of genes whose expression depends on gestational age. Using microarray analysis, we compared gene expression profiles in the villous tissues of first (45-59 days) and second trimester (109-115 days) placentae with C-section term placentae. We found that in first trimester placentae, genes related to cell cycle, DNA, amino acids, and carbohydrate metabolism were significantly overrepresented, while genes related to signal transduction were underrepresented. Among genes involved in organism defense, we identified genes involved in chemical response, metabolism, and transport. Analysis of signal transduction pathways suggested, and subsequently confirmed independently, that the Wnt pathway was changed with gestational age leading to inhibition of beta-catenin protein expression. Our study will serve as a reference database to gain insight into the regulation of gene expression in the developing placentae and to compare with gene expression in placentae from complicated pregnancies.

  10. The effect of litter size, parity and farrowing duration on placenta expulsion and retention in sows.

    Science.gov (United States)

    Björkman, S; Oliviero, C; Rajala-Schultz, P J; Soede, N M; Peltoniemi, O A T

    2017-04-01

    The hypothesis was that a prolonged parturition impairs placenta expulsion and can lead to retained placentas in sows. Furthermore, we hypothesized that application of oxytocin around the time of expulsion of the first placental part improves placenta expulsion. We recorded 142 parturitions of 101 Yorkshire x Large White sows. We determined parity, gestation length, number of liveborn and stillborn piglets, farrowing duration (time between first and last piglet) and the outcome variables: number of expelled placental parts, placenta expulsion duration (time between first and last placental part), first placental part expulsion (time between last piglet and first placental part) and last placental part expulsion (time between last piglet and last placental part). The relationship between farrowing duration and each of the outcome variables was investigated using four distinct multivariable models. Use of oxytocin (used in 44 out of 142 parturitions) increased number of expelled placental parts (3.8 ± 0.2 vs. 2.9 ± 0.3; P = 0.035), decreased the placenta expulsion duration (172 ± 44 vs. 328 ± 26 min; P = 0.011) and time of last placental part expulsion (148 ± 48 vs. 300 ± 24 min; P = 0.025). If oxytocin was not used, farrowing duration obeyed a quadratic relationship with the number of expelled placental parts (P = 0.001), placenta expulsion duration (P = 0.002) and time of last placental part expulsion (P = 0.024). If oxytocin was used, number of expelled placental parts was positively associated with number of liveborn piglets (β = 0.2 ± 0.1; P = 0.002) and affected by parity. 5th parity sows expelled more placental parts (4.3 ± 0.4) than 4th (3.2 ± 0.3; P = 0.024) and 3rd parity sows (2.7 ± 0.4; P = 0.008). Furthermore, placenta expulsion duration was positively associated with number of liveborn piglets (β = 18 ± 8 min; P = 0.025). First placental part expulsion was negatively correlated with farrowing

  11. The Application of MRI for Diagnosis of Placenta Praevia Combined with Placenta Accrete%MRI技术在前置胎盘合并胎盘植入中的诊断应用体会

    Institute of Scientific and Technical Information of China (English)

    陈蕾; 徐梓毓; 王秀荣; 赖文娟; 吴武林; 娄明武

    2016-01-01

    目的:探讨MRI在前置胎盘合并胎盘植入诊断的临床效果。方法回顾性分析2014年8月-2015年2月在我院经手术证实为前置胎盘50例患者的MRI资料,分析其影像学特点。结果采用MRI技术检查的50例患者中,明确诊断为前置胎盘患者为45例,其中4例为边缘性前置胎盘,12例为部分性前置胎盘,29例为完全性前置胎盘,诊断准确性90.00%,前置胎盘患者中,诊断合并胎盘植入患者19例,准确性为79.17%。结论 MRI技术对前置胎胎盘及胎盘植入诊断率高,能明确具体部位及胎盘植入情况,值得在临床推广应用。%Objective To investigate the application of MRI for diagnosis of placenta praevia combined with placenta accrete. Methods Totally 50 cases of placenta praevia combined with placenta accrete admitted to our hospital from August 2014 to February 2015 who was diagnosed by MRI were retrospectively analyzed.Results Based on MRI examination, 45 cases of placenta praevia was conifrmed. There were 4 cases, 12 cases and 29 cases of marginal placenta previa, partial placenta previa and complete placenta previa respectively. The MRI based diagnosis currency is 90%. There were 19 cases of placenta praevia combined with placenta accrete among all placenta accrete cases which suggested a diagnosis accuracy of 79.17%.Conclusion MRI technology demonstrated a high efficiency for placenta praevia combined with placenta accrete and could be a value toll for diagnosis.

  12. 凶险型前置胎盘并胎盘植入的超声诊断价值%The sonographic diagnostic value of pernicious placenta previa and placenta accreta

    Institute of Scientific and Technical Information of China (English)

    马芬; 李燕; 陶溢潮; 陈奕; 田荣华

    2016-01-01

    Objective To evaluate the ultrasonographic features and the ultrasonic value of pernicious placenta previa and placenta accrete, and to improve the prenatal diagnosis rate.Methods Clinical data and imaging features of 22 patients with pernicious placenta previa and placenta accreta were retrospective analyzed.Results Twenty-two cases with placenta previa and placenta implantation were complete placenta previa, 13 cases with placenta previa and implantation were diagnosed by prenatal ultrasound,9 cases with placenta accreta were missed diagnosis,and 2 cases with placenta praevia were misdiagnosis. Conclusion The observation is focused on the essence of placenta,lacenta rear keyed vocal myometrium,bladder with uterine serous hyperechoic and the corresponding blood flow changes combined with a variety of ultrasonic methods,to advance the detection rate of pernicious placenta previa combined with placenta accreta and reduce misdiagnosis.%目的 探讨凶险型前置胎盘并胎盘植入的声像图特征和超声诊断价值,提高产前诊断率.方法 回顾分析我院产后经临床和病理证实的22例凶险型前置胎盘并胎盘植入患者的临床资料及超声表现.结果 22例凶险型前置胎盘并胎盘植入均为完全型前置胎盘,产前超声准确诊断前置胎盘并胎盘植入13例,漏诊胎盘植入9例;误诊前置胎盘类型2例.结论 联合应用多种超声检查方法,重点观察胎盘实质、胎盘后方子宫肌层、子宫膀胱浆膜强回声带及相应血流变化,可以提高凶险型前置胎盘并胎盘植入的检出,减少误漏诊的发生.

  13. Clinical analysis of 12 cases placenta previa combined with placenta accreta%前置胎盘合并胎盘植入12例临床分析

    Institute of Scientific and Technical Information of China (English)

    兰景尤; 周雪勤

    2014-01-01

    Objective To investigate the high risk factors,diagnosis and management of placenta previa combined with placenta accreta .Methods The clinical data of 12 cases of placenta previa combined with placenta accrete ( placenta accreta group ) and 82 cases of placenta previa ( placenta previa group ) were analyzed retrospective-ly.Results The age, gravidity, the types of placenta previa and uterine operation history were high risk factors of placenta accreta;The incidences of premature delivery , neonatal asphyxia and postpartum hemorrhage of placenta ac-creta group were higher than those of placenta previa group ( all P<0.05 );The accuracy rate of prenatal color doppler ultrasound in the diagnosis of placenta previa with accreta was 83.3%(10/12).Placenta thickening, the hypoecho of uterine wall muscle layer at the rear of placenta band of being thinning (≤1 mm) or disappeaing , placental parenchy-ma′s rich blood flow , placental cavity gap were characteristic sonogram of placenta previa combined with placenta ac -creta;Expectant treatment and timely termination of pregnancy were the main treatment methods .Conclusion Over 30 years of age ,pregnancy over three times , central type of placenta previa and uterine operation history are high risk factors.Color Doppler ultrasound is currently the most convenient method in diagnosis of placenta accreta .The indi-vidual treatment can improve maternal and neonatal outcomes .%目的:探讨前置胎盘合并胎盘植入的高危因素、诊断及治疗方法。方法对82例前置胎盘(前置胎盘组)和前置胎盘合并胎盘植入12例(胎盘植入组)孕产妇的临床资料进行回顾性分析。结果孕妇的年龄、孕次、前置胎盘类型及子宫手术史是发生胎盘植入的高危因素;胎盘植入组早产、新生儿窒息和产后出血的发生率均高于前置胎盘组( P<0.05);产前彩色多普勒超声诊断前置胎盘合并胎盘植入的正确率为83.3%(10/12),胎

  14. Regenerative efficacy of mesenchymal stromal cells from human placenta in sensorineural hearing loss.

    Science.gov (United States)

    Kil, Kicheol; Choi, Mi Young; Kong, Ji Sun; Kim, Woo Jin; Park, Kyoung Ho

    2016-12-01

    Hearing loss is a common chronic disorder characterized by decline of auditory function. The global population have suffered from deafness and the transplantation of stem cells is regarded as a therapeutic strategy for this disease. We collected placenta from a total of 13 samples of full term pregnant women and isolated MSCs derived from human placenta and transplanted MSCs on deaf animal model. The normal group and the sensorineural hearing loss (SNHL) group and the experimental (transplanted MSCs) group were compared and estimated hearing level using auditory brainstem response (ABR) recordings and the otoacoustic emission (OAE) test. ABR threshold value and DPOAE level showed that MSCs transplantation groups was improved than the SNHL group. And the number of spiral ganglion neurons were increased in all turn of the cochlea. And there was no evidence of acute immunological rejection and inflammation response was not observed. This study is to evaluate regenerative efficacy of hearing loss by transplanting mesenchymal stromal cells (MSCs) derived from human placenta (amnion and chorion) in deaf animal model. We identified that MSCs transplantation restored auditory impairment and promoted cell regeneration. We hope to overcome sensorineural hearing loss by transplanting stem cells such as mesenchymal stromal cells (MSCs) from easily accessible adult stem cell source in placenta. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Molecular cloning and characterization of heparanase mRNA in porcine placenta throughout gestation

    Science.gov (United States)

    The porcine placenta is classified as epitheliochorial and is composed of a folded-bilayer consisting of intact epithelium from the endometrium and trophectoderm embedded in loose stroma. As pregnancy progresses, the fold width increases and becomes more complex providing greater surface area for f...

  16. Molecular Cloning and Characterisation of Heparanase mRNA in Porcine Placenta Throughout Gestation

    Science.gov (United States)

    The placenta contains a complex extracellular matrix composed of several glycosaminoglycans including heparan sulfate (HS). Heparanase (HPSE) is an endoglycosidase that specifically degrades HS. The objective of this study was to clone cDNA encoding porcine HPSE and characterize the expression lev...

  17. Effect of inbreeding on the incidence of retained placenta in Friesian horses

    NARCIS (Netherlands)

    Sevinga, M.; Vrijenhoek, T.; Hesselink, J.W.; Barkema, H.W.; Groen, A.F.

    2004-01-01

    This study was motivated by the hypothesis that the incidence of retained placenta (RP) in Friesian horses is associated with inbreeding. The objectives were to 1) calculate the inbreeding rate in the total registered Friesian horse population; 2) study the association of the inbreeding coefficient

  18. Parental factors affecting the weights of the placenta and the offspring

    NARCIS (Netherlands)

    L'Abee, Carianne; Vrieze, Ingrid; Kluck, Tom; Erwich, Jan Jaap H. M.; Stolk, Ronald P.; Sauer, Pieter J. J.

    2011-01-01

    Aim: To determine parental, especially paternal factors associated with the weight of the placenta and offspring. Methods: This population-based birth-cohort study includes 2947 singleton children born from April 2006 to 2007 and living in Drenthe, The Netherlands. Placental weight and birth weight

  19. Management of Neuraxial Anaesthesia for Emergent Caesarean Section for Placenta Previa.

    Science.gov (United States)

    Günaydın, Berrin; Kurdoğlu, Mertihan; Güler, İsmail; Bashiri, Mehrnoosh; Büyüktaşkın, Fırat; Keleşoğlu, Mine Dağgez; İnan, Gözde

    2016-02-01

    Abnormal placental attachments, such as placenta accreta, increta or percrata, can result in increased morbidity and mortality because of the risk of severe postpartum haemorrhage. We aimed to present the management of spinal anaesthesia and surgical approach for emergent caesarean section because of vaginal bleeding in a multiparous pregnant woman with placenta previa at 36 weeks' gestation. Hyperbaric bupivacaine 12 mg, fentanyl 10 μg and morphine 150 μg were intrathecally administered for spinal anaesthesia. Oxytocin, methyl ergonovin and tranexamic acid were administered after umbilical cord clamping. Breech delivery of the baby was provided by a vertical incision to the uterus for avoiding placental harm. Subtotal hysterectomy was performed leaving the placenta in situ. Two units of red blood cells were transfused during the operation, lasting approximately 40 min. The patient was uneventfully discharged on the postoperative fourth day. In conclusion, a single-shot spinal anaesthesia was successfully maintained without conversion to general anaesthesia until the end of the hysterectomy in the patient in whom placenta increta was observed during caesarean delivery.

  20. Review: The evolving placenta: Different developmental paths to a hemochorial relationship

    DEFF Research Database (Denmark)

    Enders, A C; Carter, A M

    2012-01-01

    confined to lacunae; and fetal villi entering preexisting maternal blood sinuses. Although it might be considered logical that developing placentas would pass through an endotheliochorial stage to become hemochorial, this developmental pattern is seen only as a transient stage in several species of bats...... placental form is achieved developmentally should be considered when using placental structure to extrapolate evolution of placentation....

  1. Prevalence of antepartum hemorrhage in women with placenta previa: a systematic review and meta-analysis

    Science.gov (United States)

    Fan, Dazhi; Wu, Song; Liu, Li; Xia, Qing; Wang, Wen; Guo, Xiaoling; Liu, Zhengping

    2017-01-01

    Antepartum hemorrhage (APH) is an important cause of perinatal mortality and maternal morbidity in pregnant women with placenta previa in the world. However, the epidemiological characteristics are not completely understood. We performed an initial systematic review and meta-analysis to assess the prevalence of APH in pregnant women with placenta previa. It was totally performed following the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement. PubMed, Elsevier Science Direct, and the Cochrane Library were searched before April 2016. A meta-analysis with a random-effects model based on a proportions approach was performed to determine the prevalence. Stratified analyses, meta-regression method, and sensitivity analysis were utilized to analyze the heterogeneity. A total of 29 articles were included. The pooled overall prevalence of APH among pregnant women with placenta previa was 51.6% (95% CI 42.7–60.6) in a heterogeneous set of studies (I2 = 97.9). Correlation analysis found that there was a positive correlation between prevalence and percentage of multiparous (r = 0.534, P = 0.027) and a negative correlation between prevalence and survey year (r = −0.400, P = 0.031). In conclusion, the prevalence of APH was a high condition among pregnant women with placenta previa. PMID:28067303

  2. Identification and localization of netrin-4 and neogenin in human first trimester and term placenta.

    Science.gov (United States)

    Dakouane-Giudicelli, M; Duboucher, C; Fortemps, J; Salama, S; Brulé, A; Rozenberg, P; de Mazancourt, P

    2012-09-01

    We describe here for the first time the characterization of family member of netrins, netrin-4 and its receptor neogenin, during the development of the placenta. By using western blots and RT-PCR, we demonstrated the presence of netrin-4 and its receptor neogenin protein as well as their transcripts. Using immunohistochemistry, we studied the distribution of netrin-4 and neogenin in both the first trimester and term placenta. We observed staining of netrin-4 in villous and extravillous cytotrophoblasts, syncytiotrophoblast, and endothelial cells whereas staining in stromal cells was faint. In decidua, we observed netrin-4 labelling in glandular epithelial cells, perivascular decidualized cells, and endothelial cells. However, neogenin was absent in villous and extravillous cytotrophoblasts and was expressed only on syncytiotrophoblast and placental stromal cells in the first trimester and at term placenta. The pattern of distribution suggests that a functional netrin-4-neogenin pathway might be restricted to syncytiotrophoblasts, mesenchymal cells, and villous endothelial cells. This pathway function might vary with its localization in the placenta. It is possibly involved in angiogenesis, morphogenesis, and differentiation.

  3. Comparison of mesenchymal stem cells from human placenta and bone marrow

    Institute of Scientific and Technical Information of China (English)

    张毅; 李长东; 江小霞; 李荷莲; 唐佩弦; 毛宁

    2004-01-01

    Background Nowadays bone marrow represents the main source of mesenchymal stem cells (MSCs). We identified a new population of MSCs derived from human placenta and compared its biological characterization with bone marrow derived MSCs.Methods Mononucleated cells (MNC) were isolated from the human placenta tissue perfusate by density gradient fractionation. Individual colonies were selected and cultured in tissue dishes. At the same time, human bone marrow derived MSCs were identified. Culture-expanded cells were characterized by immune phenotyping and cultured under conditions promoting differetiation to osteoblasts or adipocytes. The hematopoietic cytokines were assayed using reverse transcriptase polymerase chain reaction (RT-PCR). Results Human placental MSCs exhibited fibroblastoid morphology. Flow cytometric analyses showed that the placental MSC were CD29, CD44, CD73, CD105, CD166, HLA-ABC positive; but were negative for CD34, CD45, and HLA-DR. Functionally, they could be induced into adipocytes or osteocytes. Moreover, several hematopoietic cytokine mRNA was found in placenta-derived MSCs by RT-PCR analysis, including IL-6, M-CSF, Flt3-ligand and SCF. These results were consistent with the properties of bone marrow derived MSCs.Conclusion These observations implicate the postpartum human placenta as an important and novel source of multipotent stem cells that could potentially be used for investigating mesenchymal differentiation and regulation of hematopoiesis.

  4. The Effects of the Hominis Placenta Herbal acupuncture on Sleep pattern disturbance

    Directory of Open Access Journals (Sweden)

    Youn Hyoun-min

    2005-02-01

    Full Text Available Objective : This study has been designed and performed to identify the effects of Hominis Placenta herbal acupuncture which is usually used in reducing sleep pattern disturbances. Methods : The study subjects studied included 48 patients who were admitted in hospital located in Pusan, and they were classified into 2 groups : 25 patients in the experimental group who injected Hominis Placenta herbal acupuncture and 23 patients in the control group who were treated by acupuncture. The both group injected on GB20, GB12 and HT7 for 5 days without medicine. The sleep pattern disturbance score was measured by using 15 questions according to Korean Sleep Scale A(Oh, Jin Joo. Song, Mi Soon. Kim, Shin Mi. 1998. Results & conclusions : The sleep pattern disturbance score of the experimental group who injected Hominis Placenta herbal acupuncture was significantly lower than that of the control group. (t= 7.00 p= .00 These results provided that Hominis Placenta herbal acupuncture of GB20, GB12 and HT7 was effective for relieving sleep pattern disturbances, it is need more sample's number and more treatmentt's duration.

  5. Role of Doppler US and MRI in diagnosis of placenta accreta

    African Journals Online (AJOL)

    Manal Hamisa

    2014-10-19

    Oct 19, 2014 ... outer uterine bulge causing from the mass effect of the ... careful attention to the placental–myometrial interface and .... Clinical history: a 38 year old female patient presented with pelvic pain and vaginal bleeding with a history of two cesarean ... was abnormal or interrupted, and confirmed to be placenta.

  6. Is endomyometrial injury during termination of pregnancy or curettage following miscarriage the precursor to placenta accreta?

    NARCIS (Netherlands)

    Beuker, JM; Erwich, JJHM; Khong, TY

    2005-01-01

    Aims: To determine the frequency with which myometrium is removed during vacuum terminations of pregnancy or dilatation and curettage after miscarriage, and to relate these findings to subsequent placenta accreta or its proxies. Methods: Archival tissues from vacuum termination of pregnancy or dilat

  7. The ABCG2 efflux transporter from rabbit placenta: Cloning and functional characterization.

    Science.gov (United States)

    Halwachs, Sandra; Kneuer, Carsten; Gohlsch, Katrin; Müller, Marian; Ritz, Vera; Honscha, Walther

    2016-02-01

    In human placenta, the ATP-binding cassette efflux transporter ABCG2 is highly expressed in syncytiotrophoblast cells and mediates cellular excretion of various drugs and toxins. Hence, physiological ABCG2 activity substantially contributes to the fetoprotective placenta barrier function during gestation. Developmental toxicity studies are often performed in rabbit. However, despite its toxicological relevance, there is no data so far on functional ABCG2 expression in this species. Therefore, we cloned ABCG2 from placenta tissues of chinchilla rabbit. Sequencing showed 84-86% amino acid sequence identity to the orthologues from man, rat and mouse. We transduced the rabbit ABCG2 clone (rbABCG2) in MDCKII cells and stable rbABCG2 gene and protein expression was shown by RT-PCR and Western blot analysis. The rbABCG2 efflux activity was demonstrated with the Hoechst H33342 assay using the specific ABCG2 inhibitor Ko143. We further tested the effect of established human ABCG2 (hABCG2) drug substrates including the antibiotic danofloxacin or the histamine H2-receptor antagonist cimetidine on H33342 accumulation in MDCKII-rbABCG2 or -hABCG2 cells. Human therapeutic plasma concentrations of all tested drugs caused a comparable competitive inhibition of H33342 excretion in both ABCG2 clones. Altogether, we first showed functional expression of the ABCG2 efflux transporter in rabbit placenta. Moreover, our data suggest a similar drug substrate spectrum of the rabbit and the human ABCG2 efflux transporter.

  8. Fetomaternal outcome in placenta previa - a retrospective study in teaching hospital

    Directory of Open Access Journals (Sweden)

    Manohar Rangaswamy

    2016-09-01

    Conclusions: Managing a case of placenta previa during pregnancy poses a great challenge to every obstetrician in present day obstetrics due its increased risk of maternal and perinatal complications. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3081-3084

  9. Velamentous and Furcate Cord Insertion with Placenta Accreta in an IVF Pregnancy with Unicornuate Uterus

    Directory of Open Access Journals (Sweden)

    Mehmet Tunç Canda

    2013-01-01

    Full Text Available Velamentous and furcate cord insertion with concomitant placenta accreta is a very rare and life-threatening event of pregnancy for both the mother and the fetus. Obstetricians should be cautious about umbilical cord insertion and placental adherence abnormalities in pregnancies conceived by assisted reproductive technologies (ART particularly in women with Müllerian anomalies.

  10. Behandling af placenta percreta kræver involvering af flere specialer

    DEFF Research Database (Denmark)

    Clausen, Caroline; Lönn, Lars; Albrechtsen, Charlotte Krebs;

    2011-01-01

    Placenta percreta is a rare life-threatening obstetrical condition, often resulting in severe haemorrhage and hysterectomy. The incidence seems to be increasing, probably secondary to the increase in caesarean section rates. We present a protocol for an elective multidisciplinary approach...

  11. Structuro-functional changes in the placenta as a result of exposure to atmospheric pollutants

    Energy Technology Data Exchange (ETDEWEB)

    Bonashevskaia, T.I.; Lamentova, T.G.; Shmakov, G.S.; Nikolaeva, E.G.; Suslova, V.M.

    1985-02-01

    Under the influence of atmospheric pollutions certain structural-functional changes take place in placenta: terminal villi per stipulated square unite, villi with desquamated epithelium, with dilated vessels, with deposition of fibrinoid masses, with plasmodial buds increase in number; section area occupied by epithelial layer decreases; RNA concentration and histoenzymatic activity change in the latter.

  12. Cow placenta extract promotes murine hair growth through enhancing the insulin - like growth factor-1

    Directory of Open Access Journals (Sweden)

    Dongliang Zhang

    2011-01-01

    Full Text Available Background: Hair loss is seen as an irreversible process. Most research concentrates on how to elongate the anagen, reduce the negative factors of obstructing hair growth and improve the hair number and size. Aim: In our experiment, we tried to prove that the cow placenta extract can promote hair growth by elongating hair shaft and increasing hair follicle number. Materials and Methods: Cow placenta extract (CPE, water and minoxidil applied separately on the back of depilated B57CL/6 mice for the case, negative and positive control respectively. We checked the proliferation of cells which are resident in hair sheath, and the expression of a few growth factors which stimulate hair growth. Results: Result shows that placenta extract more efficiently accelerates cell division and growth factor expression, by raising the insulin-like growth factor (IGF-1 mRNA and protein level to increase HF size and hair length. Conclusions: The extract is not a purified product; so, it is less effective than minoxidil, which is approved by the US FDA for the treatment of male pattern baldness. If refinement is done, the placenta extract would be a good candidate medicine for hair loss.

  13. The evolution of the placenta drives a shift in sexual selection in livebearing fish

    NARCIS (Netherlands)

    Pollux, B.J.A.; Meredith, R.W.; Springer, M.S.; Garland, T.; Reznick, D.N.

    2014-01-01

    The evolution of the placenta from a non-placental ancestor causes a shift of maternal investment from pre- to post-fertilization, creating a venue for parent–offspring conflicts during pregnancy1, 2, 3, 4. Theory predicts that the rise of these conflicts should drive a shift from a reliance on

  14. Enantiomeric ratios as an indicator of exposure processes for persistent pollutants in human placentas

    DEFF Research Database (Denmark)

    Shen, Heqing; Virtanen, H E; Main, Katharina M

    2006-01-01

    The enantiomeric ratios (ER) of alpha-HCH and o,p'-DDT ((+)-isomer concentration/(-)-isomer concentration) and o,p'-DDD (first eluting enantiomer/second enantiomer) were investigated in 112 human placentas from Finnish boys collected 1997-2001. Both o,p'-DDD and alpha-HCH showed changes in their ER...

  15. Human Oocyte-Derived Methylation Differences Persist in the Placenta Revealing Widespread Transient Imprinting.

    Directory of Open Access Journals (Sweden)

    Marta Sanchez-Delgado

    2016-11-01

    Full Text Available Thousands of regions in gametes have opposing methylation profiles that are largely resolved during the post-fertilization epigenetic reprogramming. However some specific sequences associated with imprinted loci survive this demethylation process. Here we present the data describing the fate of germline-derived methylation in humans. With the exception of a few known paternally methylated germline differentially methylated regions (DMRs associated with known imprinted domains, we demonstrate that sperm-derived methylation is reprogrammed by the blastocyst stage of development. In contrast a large number of oocyte-derived methylation differences survive to the blastocyst stage and uniquely persist as transiently methylated DMRs only in the placenta. Furthermore, we demonstrate that this phenomenon is exclusive to primates, since no placenta-specific maternal methylation was observed in mouse. Utilizing single cell RNA-seq datasets from human preimplantation embryos we show that following embryonic genome activation the maternally methylated transient DMRs can orchestrate imprinted expression. However despite showing widespread imprinted expression of genes in placenta, allele-specific transcriptional profiling revealed that not all placenta-specific DMRs coordinate imprinted expression and that this maternal methylation may be absent in a minority of samples, suggestive of polymorphic imprinted methylation.

  16. Proteomic analysis of the alteration of protein expression in the placenta of Down syndrome

    Institute of Scientific and Technical Information of China (English)

    SUN Cheng-juan; YAN Li-yu; WANG Wei; YU Song; WANG Xin; ZHANG Wei-yuan

    2011-01-01

    Background Down syndrome (DS) is the most common form of human aneuploidy,and there is no effective therapy for the chromosomal abnormalities.We aimed to unravel the molecular mechanisms underlying DS and to provide clues to prenatal screening.Methods A series of proteomics-based experiments was conducted using 19 patients with DS fetuses and 17 normal pregnancies.The proteome of placenta was investigated as displayed by two-dimensional difference gel electrophoresis (2D-DIGE),and comparisons were made between placentas that developed under DS and normal pregnancy conditions.Multivariate analysis of the resulting protein patterns revealed DS-specific protein expression.Matrix-assisted laser desorption/ionization (MALDI) time-of-flight/time-of-flight (TOF/TOF) high-resolution tandem mass spectrometer (MS)-based identification was successful for 12 out of 17 selected protein spots.Results Among those,three proteins involved in the resist of reactive oxygen species (ROS) and neurogenesis were more abundant in the DS placenta (superoxide dismutase 1,endoplasmic reticulum protein 29 and heat shock protein beta-1),while peroxiredoxin-6 involved in cell defense mechanism against ROS was expressed at a higher level in the normal pregnancies.Conclusion Knowledge of the DS placenta proteome emphasizes the role of proteins involved in anti-oxidation during DS,and may form the basis of a potential approach to minimize the incidence of DS in the clinical setting.

  17. How Prenatal Depression, Anxiety, and Stress May Affect Child Outcome: The Placenta and Child Development

    Science.gov (United States)

    Glover, Vivette; O'Connor, T. G.; O'Donnell, K.; Capron, Lauren

    2014-01-01

    There is good evidence that if a woman is depressed, anxious, or stressed while she is pregnant, then there is an increased risk that her child will have emotional, behavioral, or cognitive problems. Her own biology must cause these effects, but it is not known how. One important line of research suggests that the function of the placenta changes…

  18. Conventional MRI features for predicting the clinical outcome of patients with invasive placenta

    Science.gov (United States)

    Chen, Ting; Xu, Xiao-Quan; Shi, Hai-Bin; Yang, Zheng-Qiang; Zhou, Xin; Pan, Yi

    2017-01-01

    PURPOSE We aimed to evaluate whether morphologic magnetic resonance imaging (MRI) features could help to predict the maternal outcome after uterine artery embolization (UAE)-assisted cesarean section (CS) in patients with invasive placenta previa. METHODS We retrospectively reviewed the MRI data of 40 pregnant women who have undergone UAE-assisted cesarean section due to suspected high risk of massive hemorrhage caused by invasive placenta previa. Patients were divided into two groups based on the maternal outcome (good-outcome group: minor hemorrhage and uterus preserved; poor-outcome group: significant hemorrhage or emergency hysterectomy). Morphologic MRI features were compared between the two groups. Multivariate logistic regression analysis was used to identify the most valuable variables, and predictive value of the identified risk factor was determined. RESULTS Low signal intensity bands on T2-weighted imaging (P placenta percreta (P = 0.011), and placental cervical protrusion sign (P = 0.002) were more frequently observed in patients with poor outcome. Low signal intensity bands on T2-weighted imaging was the only significant predictor of poor maternal outcome in multivariate analysis (P = 0.020; odds ratio, 14.79), with 81.3% sensitivity and 84.3% specificity. CONCLUSION Low signal intensity bands on T2-weighted imaging might be a predictor of poor maternal outcome after UAE-assisted cesarean section in patients with invasive placenta previa. PMID:28345524

  19. The association of placenta previa and assisted reproductive techniques: a meta-analysis.

    Science.gov (United States)

    Karami, Manoochehr; Jenabi, Ensiyeh; Fereidooni, Bita

    2017-06-06

    Several epidemiological studies have determined that assisted reproductive techniques (ART) can increase the risk of placenta previa. To date, only a meta-analysis has been performed for assessing the relationship between placenta previa and ART. This meta-analysis was conducted to estimate the association between placenta previa and ART in singleton and twin pregnancies. A literature search was performed in major databases PubMed, Web of Science, and Scopus from the earliest possible year to April 2017. The heterogeneity across studies was explored by Q-test and I(2) statistic. The publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) and relative risk (RR) estimates with its 95% confidence intervals (CI) using a random-effects model. The literature search yielded 1529 publications until September 2016 with 1,388,592 participants. The overall estimate of OR was 2.67 (95%CI: 2.01, 3.34) and RR was 3.62 (95%CI: 0.21, 7.03) based on singleton pregnancies. The overall estimate of OR was 1.50 (95%CI: 1.26, 1.74) based on twin pregnancies. We showed based on odds ratio reports in observational studies that ART procedures are a risk factor for placenta previa.

  20. The effect of placenta previa on fetal growth and pregnancy outcome, in correlation with placental pathology.

    Science.gov (United States)

    Weiner, E; Miremberg, H; Grinstein, E; Mizrachi, Y; Schreiber, L; Bar, J; Kovo, M

    2016-12-01

    To compare the clinical characteristics and placental histopathology between pregnancies complicated by placenta previa and controls. Between 2009 and 2015, cesarean deliveries (CDs) of 119 pregnancies with placenta previa were identified from which maternal outcomes, neonatal outcomes and placental pathology were reviewed. Results were compared with CDs matched for maternal age and pregnancy complications (control group, n=119). Placental lesions were classified into maternal and fetal vascular supply lesions and inflammatory response. Composite neonatal outcome was defined as one or more of early neonatal complications. Small-for-gestational age (SGA) was defined as birth weight ⩽10th percentile. Placentas from the previa group had higher rates of weights previa group as compared with controls. After controlling for potential confounding bias using multivariable logistic regression models, placenta previa remained statistically significantly associated with placental maternal (adjusted odds ratio (aOR) 2.48, 95% confidence interval (CI) 1.2-4.9, P=0.009) and fetal (aOR 7.05, 95% CI 2.4-20.2, Pplacenta previa in the current study. These findings may suggest that abnormal placentation is accompanied by suboptimal implantation that interferes with fetal growth.

  1. Acute and massive bleeding from placenta previa and infants' brain damage.

    Science.gov (United States)

    Furuta, Ken; Tokunaga, Shuichi; Furukawa, Seishi; Sameshima, Hiroshi

    2014-09-01

    Among the causes of third trimester bleeding, the impact of placenta previa on cerebral palsy is not well known. To clarify the effect of maternal bleeding from placenta previa on cerebral palsy, and in particular when and how it occurs. A descriptive study. Sixty infants born to mothers with placenta previa in our regional population-based study of 160,000 deliveries from 1998 to 2012. Premature deliveries occurring atplacenta accreta were excluded. Prevalence of cystic periventricular leukomalacia (PVL) and cerebral palsy (CP). Five infants had PVL and 4 of these infants developed CP (1/40,000 deliveries). Acute and massive bleeding (>500g within 8h) occurred at around 30-31 weeks of gestation, and was severe enough to deliver the fetus. None of the 5 infants with PVL underwent antenatal corticosteroid treatment, and 1 infant had mild neonatal hypocapnia with a PaCO2 placenta previa at around 30 weeks of gestation may be a risk factor for CP, and requires careful neonatal follow-up. The underlying process connecting massive placental bleeding and PVL requires further investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Factors related to the etiology of retained placenta in dairy cattle

    NARCIS (Netherlands)

    Joosten, I.; Eldik, P. van; Elving, L.; Mey, G.J.W. van der

    1987-01-01

    Birth records of 369 288 calvings of 160 188 Meuse-Rhine-Yssel cows were analysed to assess the influence of factors associated with retained placenta. Special emphasis was placed on the analysis of a subset containing data on births involving a single live calf and an easy or normal calving process

  3. A rare case of cervical fibroid presenting as retained placenta with postpartum hemorrhage

    Directory of Open Access Journals (Sweden)

    Meenakshi Chowdhury

    2015-04-01

    Full Text Available Fibroids during pregnancy are often asymptomatic but sometimes may lead to various complications and unusual presentations. We are reporting an unusual case of cervical fibroid during pregnancy that presented as retained placenta with postpartum hemorrhage following a full term normal vaginal delivery. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 505-507

  4. The role of autophagy in the placenta as a regulator of cell death.

    Science.gov (United States)

    Gong, Jin-Sung; Kim, Gi Jin

    2014-09-01

    The placenta is a temporary fetomaternal organ capable of supporting fetal growth and development during pregnancy. In particular, abnormal development and dysfunction of the placenta due to cha nges in the proliferation, differentiation, cell death, and invasion of trophoblasts induce several gynecological diseases as well as abnormal fetal development. Autophagy is a catalytic process that maintains cellular structures by recycling building blocks derived from damaged microorganelles or proteins resulting from digestion in lysosomes. Additionally, autophagy is necessary to maintain homeostasis during cellular growth, development, and differentiation, and to protect cells from nutritional deficiencies or factors related to metabolism inhibition. Induced autophagy by various environmental factors has a dual role: it facilitates cellular survival in normal conditions, but the cascade of cellular death is accelerated by over-activated autophagy. Therefore, cellular death by autophagy has been known as programmed cell death type II. Autophagy causes or inhibits cellular death via the other mechanism, apoptosis, which is programmed cell death type I. Recently, it has been reported that autophagy increases in placenta-related obstetrical diseases such as preeclampsia and intrauterine growth retardation, although the mechanisms are still unclear. In particular, abnormal autophagic mechanisms prevent trophoblast invasion and inhibit trophoblast functions. Therefore, the objectives of this review are to examine the characteristics and functions of autophagy and to investigate the role of autophagy in the placenta and the trophoblast as a regulator of cell death.

  5. Human Oocyte-Derived Methylation Differences Persist in the Placenta Revealing Widespread Transient Imprinting

    Science.gov (United States)

    Court, Franck; Martin-Trujillo, Alex; Tayama, Chiharu; Kondova, Ivanela; Bontrop, Ronald; Poo-Llanillo, Maria Eugenia; Nakabayashi, Kazuhiko; Simón, Carlos; Monk, David

    2016-01-01

    Thousands of regions in gametes have opposing methylation profiles that are largely resolved during the post-fertilization epigenetic reprogramming. However some specific sequences associated with imprinted loci survive this demethylation process. Here we present the data describing the fate of germline-derived methylation in humans. With the exception of a few known paternally methylated germline differentially methylated regions (DMRs) associated with known imprinted domains, we demonstrate that sperm-derived methylation is reprogrammed by the blastocyst stage of development. In contrast a large number of oocyte-derived methylation differences survive to the blastocyst stage and uniquely persist as transiently methylated DMRs only in the placenta. Furthermore, we demonstrate that this phenomenon is exclusive to primates, since no placenta-specific maternal methylation was observed in mouse. Utilizing single cell RNA-seq datasets from human preimplantation embryos we show that following embryonic genome activation the maternally methylated transient DMRs can orchestrate imprinted expression. However despite showing widespread imprinted expression of genes in placenta, allele-specific transcriptional profiling revealed that not all placenta-specific DMRs coordinate imprinted expression and that this maternal methylation may be absent in a minority of samples, suggestive of polymorphic imprinted methylation. PMID:27835649

  6. How Prenatal Depression, Anxiety, and Stress May Affect Child Outcome: The Placenta and Child Development

    Science.gov (United States)

    Glover, Vivette; O'Connor, T. G.; O'Donnell, K.; Capron, Lauren

    2014-01-01

    There is good evidence that if a woman is depressed, anxious, or stressed while she is pregnant, then there is an increased risk that her child will have emotional, behavioral, or cognitive problems. Her own biology must cause these effects, but it is not known how. One important line of research suggests that the function of the placenta changes…

  7. Smooth muscle tumor of the placenta - an entrapped maternal leiomyoma: a case report

    Directory of Open Access Journals (Sweden)

    Murtoniemi Katja

    2009-06-01

    Full Text Available Abstract Introduction Neoplasms of the placenta are uncommon. Tumors arising from the placental tissue include two distinct histological types: the benign vascular tumor, chorangioma, and very rarely, choriocarcinoma. Benign leiomyomas, in contrast, are very common tumors of the uterine wall and occur in 0.1% to 12.5% of all pregnant women. However, the incorporation of uterine leiomyoma into the placenta is exceptional and raises the question of its origin. This case is possibly the first report on this kind of a placental tumor which has been examined using both immunohistochemistry and chromosome analysis. Case presentation A 34-year-old G4P3 Caucasian woman was followed up antenatally because of a stillbirth in her previous pregnancy. At 36 weeks' gestation, a hypoechoic, 3.6 × 4.2 cm rounded mass was noted within the placenta on ultrasound examination. Histologically, the tumor was a benign leiomyoma and this finding was supported by immunohistochemistry. The newborn infant was male. Chromosomes of the neoplasm were studied by the fluorescence in situ hybridization technique and the tumor was found to carry XX chromosomes. Conclusion A rare benign smooth muscle neoplasm involving the placental parenchyma is presented. The tumor was a uterine leiomyoma of maternal origin, which had become entrapped by the placenta. This case report is of interest to the clinical specialty of obstetrics and gynecology and will advance our knowledge of the etiology of placental tumors.

  8. Tolerância da placenta à parada circulatória umbilical normotérmica Tolerance of placenta to normothermic umbilical circulatory arrest

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    Renato S Assad

    1992-09-01

    Full Text Available O aumento da resistência vascular placentáriae distúrbios de trocas gasosas freqüentemente ocorrem após a circulação extracorpórea (CEC fetal. A utilização de um circuito convencional de CEC que exclua a placenta da circulação através do clampeamento temporário do cordão umbilical pode proteger a vasculatura placentária dos estímulos que levam ao aumento da resistência vascular. Para avaliar a tolerância placentária à parada normotérmica do fluxo sangüíneo umbílico-placentário, 9 placentas de ovelhas isoladas in-situ, foram colocadas em CEC através da canulação dos vasos umbilicais, com fluxo médio de artéria umbilical de 214 ml/min/kg. Após 30 minutos de estabelecimento da CEC, a circulação placentária foi interrompida por 30 minutos, simulando o clapeamento do cordão umbilical durante a CEC fetal total. Posteriormente, a circulação placentária foi restabelecida aos valores basais. A troca de gases placentária, o fluxo sangüíneo e a resistência vascular materno-placentários foram avaliados antes e depois da parada circulatória. Não houve diferença estatisticamente significante entre os gradientes transplacentários de pO2 e pCO2, indicando que a interrupção do fluxo sangüíneo placentário por 30 minutos, em condições normotérmicas, não afeta a função placentária. Este modelo sugere um método alternativo para a aplicação clínica da CEC fetal, através da exclusão da circulação umbílico-placentária durante a CEC fetal, eliminandose, assim, os efeitos deletérios da CEC nas trocas gasosas placentárias.Elevation of placental vascular resistance (PVR and depression of fetal gas exchange occurs after fetal cardiopulmonary bypass (CPB. Excluding the placenta from the CPB circuit may protect the placental vasculature from the unwanted stimuli which lead to elevated PVR. To evaluate this approach, 9 isolated in-situ sheep placentas were placed on CPB by cannulating the umbilical vessels

  9. Content and balance of trace elements in placenta on different stages of gestation

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    I. I. Shkolna

    2017-02-01

    Full Text Available Functional status of placenta, which provides nutrients to the fetus, plays an important role in miscarriage. The aim to investigate content and balance of trace elements (Fe, Cu, Co, Zn, Mg, Mn in placenta in different terms of gestation. Materials and methods. We studied content and balance of essential trace elements (Fe, Cu, Co, Zn, Mg, Mn in placenta of 52 women which born babies in different terms of gestation. The content of micronutrients studied using atomic absorption spectrophotometer C-115 MI. Results. We established average content and ratio of essential trace elements in placenta of women which born babies on 24-28, 29-31, 32-36 and 37-41 week of gestation. Conclusions. Intensive processes of accumulation and transport of essential trace elements took place in placenta during gestation. It was noted that the content of Fe, Cu and Zn was increased during gestation process and reached maximum level on 29-31 week of gestation. Mn content reached maximum level on 32-36 weeks. Indicators of Co in placenta gradually increased from 24-28 week of gestation and Mg level by contrast reduced. In addition, we investigated the ratio of essential trace elements in placenta, which showed that in pairs Fe/Co, Cu/Co, Zn/Mn and Mg/Mn we observed a significant decreasing of indicators (p<0.05 from 24 to 36 week of gestation, and in pairs Fe/Mg, Cu/Zn, Cu/Mg and Co/Mg - significant increasing of indicators during gestational process. Also we found a positive correlation between Cu and Mn (rxy=0.5732, p<0.05 at 24-28 weeks of gestation, Mg and Mn (rxy=0.5855, p<0.05 on 32-36 weeks, Mg and Mn on 29-31 weeks (rxy=0.8272, p<0.01 and Zn and Mn on 32-36 week of gestation (rxy=0.8097, p<0.05. So, features of transport and deposition of essential trace elements require further research.

  10. Paraoxonase 2 protein is spatially expressed in the human placenta and selectively reduced in labour.

    Science.gov (United States)

    Alwarfaly, Samy; Abdulsid, Akrem; Hanretty, Kevin; Lyall, Fiona

    2014-01-01

    Humans parturition involves interaction of hormonal, neurological, mechanical stretch and inflammatory pathways and the placenta plays a crucial role. The paraoxonases (PONs 1-3) protect against oxidative damage and lipid peroxidation, modulation of endoplasmic reticulum stress and regulation of apoptosis. Nothing is known about the role of PON2 in the placenta and labour. Since PON2 plays a role in oxidative stress and inflammation, both features of labour, we hypothesised that placental PON2 expression would alter during labour. PON2 was examined in placentas obtained from women who delivered by cesarean section and were not in labour and compared to the equivalent zone of placentas obtained from women who delivered vaginally following an uncomplicated labour. Samples were obtained from 12 sites within each placenta: 4 equally spaced apart pieces were sampled from the inner, middle and outer placental regions. PON2 expression was investigated by Western blotting and real time PCR. Two PON2 forms, one at 62 kDa and one at 43 kDa were found in all samples. No difference in protein expression of either isoform was found between the three sites in either the labour or non-labour group. At the middle site there was a highly significant decrease in PON2 expression in the labour group when compared to the non-labour group for both the 62 kDa form (p = 0.02) and the 43 kDa form (p = 0.006). No spatial differences were found within placentas at the mRNA level in either labour or non-labour. There was, paradoxically, an increase in PON2 mRNA in the labour group at the middle site only. This is the first report to describe changes in PON2 in the placenta in labour. The physiological and pathological significance of these remains to be elucidated but since PON2 is anti-inflammatory further studies are warranted to understand its role.

  11. Clinical analysis of 17 cases of placenta previa with placenta accreta%前置胎盘合并胎盘植入17例临床分析

    Institute of Scientific and Technical Information of China (English)

    游一平; 雷莹娟

    2005-01-01

    目的探讨前置胎盘合并胎盘植入的高危因素及处理方法.方法回顾性分析我院2000年1月~2004年11月住院治疗的139例前置胎盘,其中合并胎盘植入17例.结果前置胎盘合并胎盘植入发生率12.23%;很少发生产前出血的中央型前置胎盘多有胎盘植入;胎盘植入组即使产前出血,其次数及出血量较无胎盘植入者低.结论对不发生或极少发生产前出血,有多次孕产史的中央型前置胎盘,要考虑胎盘植入.浆膜面全肌层缝扎止血法可成功保留子宫,值得推广应用.%[Objective] To explore the high risk factors and management of placenta previa complicated with placenta accreta. [Method] Retrospectively analyzed all the 139 cases of placenta previa hospitalized in the hospital from 2000 January to 2004 November, of which 17 cases complicated with placenta accreta. [Result] The incidence rate of placenta previa with placenta aacreta was 12.23%; the patient with central placenta previa who seldom occurred antepartum hemorrhage was complicated with placenta accreta; and even if antepartum hemorrhage happened in the group of placenta accreta, the times and quantity of henorrhage were lower than non-placenta accreta group. [Conclusion] When there is no or little hemorrhage during third trimester in patients with central placenta previa and many parities, placenta accreta must be considered. Transfixion hemostasis of all muscular layer through serous membrane can reserve uterus successfully and it is worth generalizing.

  12. 凶险型前置胎盘并发胎盘植入33例临床治疗探讨%Clinical analysis on 33 cases of pernicious placenta previa with placenta accreta

    Institute of Scientific and Technical Information of China (English)

    田宁; 范玲

    2014-01-01

    T he aim is to study the perioperative management .We analyze the clinical complications of pernicious placenta previa complicated with placenta accrete ,taking totally 33 patients of pernicious placenta previa complicated with placenta accrete ,who had admitted to our hospital from January 2009 to December 2013 ,as the samples ,and summarize the clinical complications of the disease and perioperative management . T he results show that the incidence rate of pernicious placenta previa complicated with placenta accreta was 21 .15% .All patients of pernicious placenta previa complicated with placenta accrete were treated by operation ,and the uterus resection rate was 24 .24% (8/33) . T hus the patients of pernicious placenta previa should alert complicated placenta accrete .T he uterus resection rate increases for cases of pernicious placenta previa complicated with placenta accreta ,so they should be given adequate preoperative preparation ,the intraoperative bleeding should combine a variety of methods to control bleeding ,timely hysterectomy was necessary when the treatment was ineffective .%为了分析凶险型前置胎盘并发胎盘植入的临床并发症,探讨其围术期处理,选择首都医科大学附属北京妇产医院2009年1月-2013年12月确诊为凶险型前置胎盘合并胎盘植入的33例病例,研究该疾病的临床并发症和围术期处理.结果显示,凶险型前置胎盘并发胎盘植入发生率为21.15%,所有病例均采用手术终止妊娠,其中子宫切除率为24.24%(8/33).认为凶险型前置胎盘患者应警惕并发胎盘植入,凶险型前置胎盘合并胎盘植入的子宫切除率高,应进行充分的术前准备,术中需要结合多种止血方法控制出血,止血无效者需适时切除子宫.

  13. 凶险型前置胎盘并发胎盘植入的临床分析%Clinical analysis of pernicious placenta previa complicated with placenta accreta

    Institute of Scientific and Technical Information of China (English)

    黄莺; 孙海燕; 隋霜

    2012-01-01

    目的 探讨凶险型前置胎盘并发胎盘植入的高危因素及围产期处理.方法 回顾性分析188例凶险型前置胎盘患者的临床资料.结果 凶险型前置胎盘并发胎盘植入发生率为21.80%(41/188).凶险型前置胎盘并发胎盘植入的高危因素包括:孕妇高龄、流产次数≥2次、剖宫产2次.所有凶险型前置胎盘并发胎盘植入者均采用手术治疗,其中子宫切除率为26.82% (11/41),未并发胎盘植入者子宫切除率为0.96% (8/147),差异有统计学意义(χ2=16.141,P<0.01).结论 对高龄、有多次剖宫产史或多次流产史的凶险型前置胎盘患者应警惕并发胎盘植入,前置胎盘并发胎盘植入的子宫切除率增高.%Objective To investigate the high risk factors and perinatal management of pernicious placenta previa complicated with placenta accreta. Methods The data of 188 cases of patients with pernicious placenta previa was retrospectively analyzed. Results The incidence rate of pernicious placenta previa complicated with placenta accreta was 21. 8% ( 41/188 ), and the high risk factors of it included maternal advanced age, abortion frequency ≥2 and 2 times of cesarean section. All cases of pernicious placenta previa complicated with placenta accreta were treated by operation, and the uterus resection rate was 26. 82% ( 11/41 ). The uterus resection rate of cases without placenta accreta was 0. 96% ( 8/147 ). The difference was statistically significant (X2 = 16. 141, P < 0. 01 ). Conclusion Patients of pernicious placenta previa with advanced age, history of several times of cesarean section and abortion should alert complicated placenta accrete. The uterus resection rate increases for cases of placenta previa complicated with placenta accreta.

  14. Role of mouse Wdr13 in placental growth; a genetic evidence for lifetime body weight determination by placenta during development.

    Science.gov (United States)

    Singh, Vijay Pratap; Alex, Jomini Liza; Lakshmi, B Jyothi; Sailasree, S Purnima; Raj, T Avinash; Kumar, Satish

    2015-08-26

    Placental development is essential for implantation and growth of foetus in the uterus of eutherian mammals. Numerous growth factors are responsible for placental development and cell lineage differentiation. Gene knockout mice have shown role of various genes in the placenta. Here using Wdr13 knockout mice, we show that this gene is important for proper placental development. Wdr13, a X-linked gene, expresses in multiple trophoblast cell types of placenta and the mutant placenta had reduced size after 17.5 dpc due to reduction of junctional zone (JZ) and labyrinth zone (LZ). We observed reduction in levels of angiopoietin-2 and cd44 mRNA in Wdr13 mutant placenta as compared to that in the wild type. Our findings show that Wdr13 is required for normal placental development and cell differentiation. Wdr13 heterozygous female placenta when the mutant allele was of maternal origin showed similar defects as those in case of Wdr13 null placenta. Using two types of heterozygous females carrying either maternally and paternally derived mutant Wdr13 allele we provide genetic evidence that development of placenta determines body weight of mice for the entire life.

  15. Novel MRI finding for diagnosis of invasive placenta praevia: evaluation of findings for 65 patients using clinical and histopathological correlations

    Energy Technology Data Exchange (ETDEWEB)

    Ueno, Yoshiko; Kitajima, Kazuhiro; Maeda, Tetsuo; Suenaga, Yuko; Takahashi, Satoru; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Kawakami, Fumi [Kobe University Graduate School of Medicine, Department of Pathology, Kobe (Japan); Matsuoka, Shozo; Tanimura, Kenji; Yamada, Hideto [Kobe University Graduate School of Medicine, Department of Obstetrics and Gynaecology, Kobe (Japan); Ohno, Yoshiharu [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Kobe University Graduate School of Medicine, Advanced Biomedical Imaging Research, Kobe (Japan)

    2014-04-15

    To review established magnetic resonance (MR) criteria and describe a new MR finding for the diagnosis of invasive placenta praevia. A retrospective review of prenatal MRI examinations of 65 patients (median age: 35 years) who underwent MR for the screening of invasive placenta praevia. All MRIs were performed on a 1.5-T unit, including axial, coronal and sagittal T2-weighted half-Fourier single-shot turbo spin echo imaging. Fifteen patients were diagnosed with invasive placenta praevia. Two experienced radiologists reviewed the MR images and evaluated a total of six MRI features of the placenta, including our novel finding of the placental protrusion into the internal os (placental protrusion sign). Inter-rater reliability was assessed by using kappa statistics. Features with a kappa statistic >0.40 were evaluated using Fisher's two-sided exact test for comparison of their capabilities for placental invasion assessment. Interobserver reliability was moderate or better for the intraplacental T2 dark band, intraplacental abnormal vascularity, uterine bulging, heterogeneous placenta and placental protrusion sign. Fisher's two-sided exact test results showed all these features were significantly associated with invasive placenta praevia. The novel MRI finding of a placental protrusion sign is a useful addition to the established MRI findings for the diagnosis of invasive placenta praevia. (orig.)

  16. A Standardized Approach for Transfusion Medicine Support in Patients With Morbidly Adherent Placenta.

    Science.gov (United States)

    Panigrahi, Anil K; Yeaton-Massey, Amanda; Bakhtary, Sara; Andrews, Jennifer; Lyell, Deirdre J; Butwick, Alexander J; Goodnough, Lawrence Tim

    2017-08-01

    The incidence of placenta accreta (PA) has increased from 0.8 to 3.0 in 1000 pregnancies, driven by increased rates of cesarean deliveries (32.2% in 2014) of births in the United States. The average blood loss for a delivery complicated by PA ranges from 2000 to 5000 mL, frequently requiring substantial transfusion medicine support. We report our own institutional multidisciplinary approach for managing such patients, along with transfusion medicine outcomes, in this setting over a 5-year period. We reviewed records for patients referred to our program in placental disorders from July 1, 2009, to July 1, 2014. A placental disorders preoperative checklist was implemented to ensure optimal management of patients with peripartum hemorrhage. Of 136 patients whose placentas were reviewed postpartum, 21 had PA, 39 had microscopic PA, 17 had increta, 17 had percreta, and 42 had no accreta (of which 11 had placenta previa). For each subtype, the percentage of patients receiving blood products were 71% (PA), 28% (microscopic PA), 82% (increta), 82% (percreta), and 19% (no accreta). Among patients with PA or variants, 89% of patients with PA or variants underwent postpartum hysterectomy, compared to only 5% of patients with no or microscopic PA. Based on our experience and on the findings of our retrospective analysis, patients presenting with either antepartum radiological evidence or clinical suspicion of morbidly adherent placenta will benefit from a standardized protocol for clinical management, including transfusion medicine support. We found that massive hemorrhage is predictable when abnormal placentation is identified predelivery and that blood product support is substantial regardless of the degree of placental invasiveness. The protocol at our institution provides immediate access to sufficient volumes and types of blood products at delivery for patients at highest risk for life-threatening obstetric hemorrhage. Therefore, for patients with a diagnosis of morbidly

  17. Comparative proteomics analysis of placenta from pregnant women with intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Zhang, Ting; Guo, Yueshuai; Guo, Xuejiang; Zhou, Tao; Chen, Daozhen; Xiang, Jingying; Zhou, Zuomin

    2013-01-01

    Intrahepatic cholestasis of pregnancy (ICP) usually occurs in the third trimester and associated with increased risks in fetal complications. Currently, the exact cause of this disease is unknown. In this study we aim to investigate the potential proteins in placenta, which may participate in the molecular mechanisms of ICP-related fetal complications using iTRAQ-based proteomics approach. The iTRAQ analysis combined with liquid chromatography-tandem mass spectrometry (LC-MS/MS) was performed to separate differentially expressed placental proteins from 4 pregnant women with ICP and 4 healthy pregnant women. Bioinformatics analysis was used to find the relative processes that these differentially expressed proteins were involved in. Three apoptosis related proteins ERp29, PRDX6 and MPO that resulted from iTRAQ-based proteomics were further verified in placenta by Western blotting and immunohistochemistry. Placental apoptosis was also detected by TUNEL assay. Proteomics results showed there were 38 differentially expressed proteins from pregnant women with ICP and healthy pregnant women, 29 were upregulated and 9 were downregulated in placenta from pregnant women with ICP. Bioinformatics analysis showed most of the identified proteins was functionally related to specific cell processes, including apoptosis, oxidative stress, lipid metabolism. The expression levels of ERp29, PRDX6 and MPO were consistent with the proteomics data. The apoptosis index in placenta from ICP patients was significantly increased. This preliminary work provides a better understanding of the proteomic alterations of placenta from pregnant women with ICP and may provide us some new insights into the pathophysiology and potential novel treatment targets for ICP.

  18. Comparative proteomics analysis of placenta from pregnant women with intrahepatic cholestasis of pregnancy.

    Directory of Open Access Journals (Sweden)

    Ting Zhang

    Full Text Available INTRODUCTION: Intrahepatic cholestasis of pregnancy (ICP usually occurs in the third trimester and associated with increased risks in fetal complications. Currently, the exact cause of this disease is unknown. In this study we aim to investigate the potential proteins in placenta, which may participate in the molecular mechanisms of ICP-related fetal complications using iTRAQ-based proteomics approach. METHODS: The iTRAQ analysis combined with liquid chromatography-tandem mass spectrometry (LC-MS/MS was performed to separate differentially expressed placental proteins from 4 pregnant women with ICP and 4 healthy pregnant women. Bioinformatics analysis was used to find the relative processes that these differentially expressed proteins were involved in. Three apoptosis related proteins ERp29, PRDX6 and MPO that resulted from iTRAQ-based proteomics were further verified in placenta by Western blotting and immunohistochemistry. Placental apoptosis was also detected by TUNEL assay. RESULTS: Proteomics results showed there were 38 differentially expressed proteins from pregnant women with ICP and healthy pregnant women, 29 were upregulated and 9 were downregulated in placenta from pregnant women with ICP. Bioinformatics analysis showed most of the identified proteins was functionally related to specific cell processes, including apoptosis, oxidative stress, lipid metabolism. The expression levels of ERp29, PRDX6 and MPO were consistent with the proteomics data. The apoptosis index in placenta from ICP patients was significantly increased. CONCLUSION: This preliminary work provides a better understanding of the proteomic alterations of placenta from pregnant women with ICP and may provide us some new insights into the pathophysiology and potential novel treatment targets for ICP.

  19. In vitro and in vivo human herpesvirus 8 infection of placenta.

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    Mariantonietta Di Stefano

    Full Text Available Herpesvirus infection of placenta may be harmful in pregnancy leading to disorders in fetal growth, premature delivery, miscarriage, or major congenital abnormalities. Although a correlation between human herpesvirus 8 (HHV-8 infection and abortion or low birth weight in children has been suggested, and rare cases of in utero or perinatal HHV-8 transmission have been documented, no direct evidence of HHV-8 infection of placenta has yet been reported. The aim of this study was to evaluate the in vitro and in vivo susceptibility of placental cells to HHV-8 infection. Short-term infection assays were performed on placental chorionic villi isolated from term placentae. Qualitative and quantitative HHV-8 detection were performed by PCR and real-time PCR, and HHV-8 proteins were analyzed by immunohistochemistry. Term placenta samples from HHV-8-seropositive women were analyzed for the presence of HHV-8 DNA and antigens. In vitro infected histocultures showed increasing amounts of HHV-8 DNA in tissues and supernatants; cyto- and syncitiotrophoblasts, as well as endothelial cells, expressed latent and lytic viral antigens. Increased apoptotic phenomena were visualized by the terminal deoxynucleotidyl transferase-mediated deoxyuridine nick end-labeling method in infected histocultures. Ex vivo, HHV-8 DNA and a latent viral antigen were detected in placenta samples from HHV-8-seropositive women. These findings demonstrate that HHV-8, like other human herpesviruses, may infect placental cells in vitro and in vivo, thus providing evidence that this phenomenon might influence vertical transmission and pregnancy outcome in HHV-8-infected women.

  20. Retained placenta of dairy cows associated with managemental factors in Rajshahi, Bangladesh

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    K. M. Mozaffor Hossain

    2013-08-01

    Full Text Available Aim: The incidence of retained placenta of dairy cows in relation to individual animal level and farm management factors such as farm type, farm size, housing system, floor type, feed quality, time of parturition, farming experience of farmer and delivery pattern of cows was determined. Materials and Methods: A total 1205 parturated dairy cows conducted in nine upazilas and four Metro Thana of Rajshahi district during July 2010 to June 2011for attainment of the result. Individual animal and farm management factors associated with retained placenta were recorded in a structured questionnaire through face-to-face farmer's interview and reviewing farm records. The raw data were compiled and statistical SPSS program to analyze to obtained result. Results: The overall incidence of retained placenta was 13.4%. The incidence was significantly higher in Local × Sahiwal genotype (4.6% and late delivery (longer gestation period (80% than their counter groups (p<0.05. The large farm (6.0% had higher incidence and had no significant effect than medium and individual household. Similarly animals housed in Tin shed building with poor ventilation facilities (6.6%, animal housed in unscientific concrete floor (6.8%, animals mostly grassed along with small amount of straw supplied (5.4% and a farmer had less than one year farming experience (5.3% had not significant statistically show higher incidence of retained placenta. Conclusion: The local genotype; mini farm; supplied better feed quality; vast farming experience of farmer and normal delivery with eutocia had less chance of retained placenta of dairy cows. [Vet World 2013; 6(4.000: 180-184

  1. Placenta previa and pre-eclampsia: analyses of 1645 cases at Medani Maternity Hospital, Sudan

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    Ishag eAdam

    2013-02-01

    Full Text Available A retrospective case- control study was conducted to investigate the risk factors for pre-eclampsia -including the protective effect of placenta previa -at Medani Maternity Hospital, Sudan. Medical files of the patients during the period 2003 to 2010 were reviewed for age, parity, education level, prenatal care, placenta previa and hemoglobin level. Women with pre-eclampsia were the cases, and women with normal pregnancy were the controls. There were 54339 singleton deliveries and 1765 women with pre-eclampsia in the hospital, giving the incidence of pre-eclampsia of 3.2%. The risk factors for pre-eclampsia were; women with age > 35 year (OR= 1.4, 95% CI: 1.1-1.8, primiparity (OR = 3.3, 95% CI: 2.7–4.0, para > 5 (OR= 3.1, 95% CI: 2.4–4.0 and anemia (OR= 3.3, 95% CI: 2.8–3.9. The risk of pre-eclampsia was inversely increased with education level and prenatal care attendance. The prevalence of placenta previa was 0(0% and 55 (3.3%, P< 0.001 in pre-eclamptic and control women, respectively. Placenta previa was a significant protective factor of pre-eclampsia (OR= 0.3, 95% CI: 0.1–0.7. Although, the socio-demographic risk factors for pre-eclampsia observed among women at Medani hospital were similar to those found in other settings; placenta previa was associated with decreased incidence of pre-eclampsia.

  2. Differential methylation of genes associated with cell adhesion in preeclamptic placentas.

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    Lauren Anton

    Full Text Available Preeclampsia (PE, a hypertensive disorder of pregnancy, is hypothesized to be associated with, if not mechanistically related to abnormal placental function. However, the exact mechanisms regulating the pathogenesis of PE remain unclear. While many studies have investigated changes in gene expression in the PE placenta, the role of epigenetics in PE associated placental dysfunction remains unclear. Using the genome-wide Illumina Infinium Methylation 450 BeadChip array, we analyzed gene-specific alterations in DNA methylation in placental biopsies collected from normal pregnant women delivering at term (n = 14, with term PE (≥37 weeks; n = 19 or with preterm PE (5% methylation difference. Functional annotation of the differentially methylated genes in preterm PE placentas revealed a 32 gene cluster in the cadherin and cell adhesion functional groups (Benjamini p<0.00001. Hypermethylation of CDH11 (p = 0.0143, COL5A1 (p = 0.0127 and TNF (p = 0.0098 and hypomethylation of NCAM1 (p = 0.0158 was associated with altered mRNA expression in preterm PE placentas. Demethylation of first trimester extravillous trophoblast cells resulted in altered CDH11 (p = 0.0087, COL5A1 (p = 0.0043, NCAM1 (p = 0.0260 and TNF (p = 0.0022 mRNA expression. These studies demonstrate aberrant methylation, correlating with disease severity, in PE placentas. Furthermore, we provide evidence that disruption of gene-specific methylation in preterm PE placentas and first trimester trophoblasts is significantly associated with altered gene expression demonstrating that epigenetic modifications early in pregnancy can have effects on trophoblast function contributing to PE.

  3. Oxygenation of the placenta and its role in pre-eclampsia.

    Science.gov (United States)

    Huppertz, Berthold

    2014-07-01

    Proper oxygenation of the placenta and hence the embryo/fetus is essential for a successful pregnancy. During the first trimester of pregnancy the partial pressure of oxygen in the placenta and the embryo is very low and does not exceed 20mmHg. At the end of the first trimester maternal blood flow towards the placenta is established leading to a sudden increase in placental oxygenation to about 50-60mmHg. This level of oxygenation is keptuntil delivery. One of the numerous hypotheses to describe the etiology of preeclampsia, which is still the most cited hypothesis today, is based on a failure of extravillous trophoblast to invade the uterine spiral arteries in the placental bed. This in turn is believed to result in placental hypoxia and subsequently to damage of the villous trophoblast. Following this hypothesis, there is a series of events following these hypoxic conditions of the placenta. There is a large number of articles published that have investigated the effect of different oxygen concentrations on the phenotype of trophoblasts in vitro and have used this data to corroborate the hypothesis above. Unfortunately, one important aspect has not been addressed until recently: What is the placental oxygen concentration in placental pathologies such as preeclampsia in vivo? All studies that have tried to elucidate the placental oxygen concentration have done this indirectly, since direct measurements of placental oxygen in the third trimester of pregnancy have been defined as unethical. Not a single of such studies has revealed that oxygenation of the placenta in pregnancy pathologies is decreased. At the same time a number of studies have shown that in intra-uterine growth restriction (IUGR) placental oxygenation is increased rather than decreased. This has been shown to be true in the presence and absence of preeclampsia. This data clearly disprove the above hypothesis and should open our minds to decipherthe realcauses of preeclampsia.

  4. Efficacy of ozone and other treatment modalities for retained placenta in dairy cows.

    Science.gov (United States)

    Zobel, R; Tkalčić, S

    2013-02-01

    Retained placenta is a worldwide recognized clinical condition in puerperal cows, which can significantly affect their health and fertility. Available treatment modalities are often of questionable efficacy or associated with time constraints, practicality or monetary considerations for their wide application in a routine dairy practice. The objective of this study was to compare and assess the efficacy of different treatment options, including a novel ozone treatment, for the retained placenta. Two hundred cows diagnosed with retained placenta were divided into five treatment groups, each receiving a different treatment option. Group A (n = 40) was given a combination treatment of intrauterine ozone and parenteral cephalexin; group B (n = 40) was given intrauterine ozone; group C (n = 40) was given a combination of parenteral cephalexin and intrauterine antibiotic tablets; group D (n = 40) was given only parenteral cephalexin and group E (n = 40) was given parenteral prostaglandins in 11-day intervals. The control group (group Z, n = 200) included cows that gave birth without assistance and were not diagnosed with a retained placenta. The ozone treatment (groups A and B) was found to be the most effective modality resulting in the shortest period of days open, the smallest number of artificial inseminations until pregnancy, the smallest number of animals diagnosed with fever within 10 days post-calving, the highest percentage of animals pregnant within 200 days after calving and the smallest number of animals culled because of infertility, when compared to the other treatment groups. The intrauterine ozone flush therefore has a potential as an efficacious and cost-effective treatment option for retained placenta, with an overall positive effect on puerperal health and fertility in cows.

  5. Relation between Birth Weight and Intraoperative Hemorrhage during Cesarean Section in Pregnancy with Placenta Previa.

    Science.gov (United States)

    Soyama, Hiroaki; Miyamoto, Morikazu; Ishibashi, Hiroki; Takano, Masashi; Sasa, Hidenori; Furuya, Kenichi

    2016-01-01

    Placenta previa, one of the most severe obstetric complications, carries an increased risk of intraoperative massive hemorrhage. Several risk factors for intraoperative hemorrhage have been identified to date. However, the correlation between birth weight and intraoperative hemorrhage has not been investigated. Here we estimate the correlation between birth weight and the occurrence of intraoperative massive hemorrhage in placenta previa. We included all 256 singleton pregnancies delivered via cesarean section at our hospital because of placenta previa between 2003 and 2015. We calculated not only measured birth weights but also standard deviation values according to the Japanese standard growth curve to adjust for differences in gestational age. We assessed the correlation between birth weight and the occurrence of intraoperative massive hemorrhage (>1500 mL blood loss). Receiver operating characteristic curves were constructed to determine the cutoff value of intraoperative massive hemorrhage. Of 256 pregnant women with placenta previa, 96 (38%) developed intraoperative massive hemorrhage. Receiver-operating characteristic curves revealed that the area under the curve of the combination variables between the standard deviation of birth weight and intraoperative massive hemorrhage was 0.71. The cutoff value with a sensitivity of 81.3% and specificity of 55.6% was -0.33 standard deviation. The multivariate analysis revealed that a standard deviation of >-0.33 (odds ratio, 5.88; 95% confidence interval, 3.04-12.00), need for hemostatic procedures (odds ratio, 3.31; 95% confidence interval, 1.79-6.25), and placental adhesion (odds ratio, 12.68; 95% confidence interval, 2.85-92.13) were independent risk of intraoperative massive hemorrhage. In patients with placenta previa, a birth weight >-0.33 standard deviation was a significant risk indicator of massive hemorrhage during cesarean section. Based on this result, further studies are required to investigate whether

  6. The association between placenta previa and leukocyte and platelet indices - a case control study.

    Science.gov (United States)

    Ersoy, Ali O; Ozler, Sibel; Oztas, Efser; Ersoy, Ebru; Kirbas, Ayse; Danisman, Nuri

    2016-01-01

    Despite medical advances, rising awareness, and satisfactory care facilities, placenta previa (PP) remains a challenging clinical entity due to the risk of excessive obstetric hemorrhage. Etiological concerns gave way to life-saving concerns about the prediction of maternal outcomes due to hemorrhage. Our study aimed to detect an early predictive marker of placenta previa. Ninety-three pregnant patients diagnosed with PP and 247 controls were recruited for this retro-spective study. Platelet and leukocyte indices were compared between the two groups. The groups were similar with regard to age distribution (31.2 ± 5.1 years [mean ± SD] in the PP group and 31.7 ± 4.2 years in controls), body mass index (BMI) (27.7 ± 3.6 kg/m2 in the PP group and 27.4 ± 4.6 kg/m2 in controls), and most characteristics of the obstetric history. Total leukocyte count, neutrophil count, and neutrophil-to-lymphocyte ratio were significantly higher in the PP group. Mean platelet volume (MPV) and large platelet cell ratio (P-LCR) values were significantly lower in the PP group as compared to controls, with regard to third trimester values. However, patients who were diagnosed postnatally with placenta percreta had lower MPV and P-LCR values than other patients with PP. There were no statistically significant differences between the two groups as far as first trimester values were concerned. Platelet and leukocyte indices in the third trimester of pregnancy may be valuable predictors of placenta previa and placenta percreta. More comprehensive studies are needed to address this issue.

  7. Placenta Previa and Pre-Eclampsia: Analyses of 1645 Cases at Medani Maternity Hospital, Sudan

    Science.gov (United States)

    Adam, Ishag; Haggaz, AbdElrahium D.; Mirghani, Omer A.; Elhassan, Elhassan M.

    2013-01-01

    A retrospective case-control study was conducted to investigate the risk factors for pre-eclampsia – including the protective effect of placenta previa – at Medani Maternity Hospital, Sudan. Medical files of the patients during the period 2003–2010 were reviewed for age, parity, education level, prenatal care, placenta previa, and hemoglobin level. Women with pre-eclampsia were the cases, and women with normal pregnancy were the controls. There were 54,339 singleton deliveries and 1765 women with pre-eclampsia in the hospital, giving the incidence of pre-eclampsia of 3.2%. The risk factors for pre-eclampsia were; women with age >35 years (OR = 1.4, 95% CI: 1.1–1.8), primiparity (OR = 3.3, 95% CI: 2.7–4.0), para >5 (OR = 3.1, 95% CI: 2.4–4.0), and anemia (OR = 3.3, 95% CI: 2.8–3.9). The risk of pre-eclampsia was inversely increased with education level and prenatal care attendance. The prevalence of placenta previa was 0 (0%) and 55 (3.3%), P Placenta previa was a significant protective factor of pre-eclampsia (OR = 0.3, 95% CI: 0.1–0.7). Although, the socio-demographic risk factors for pre-eclampsia observed among women at Medani hospital were similar to those found in other settings; placenta previa was associated with decreased incidence of pre-eclampsia. PMID:23450096

  8. Oxidoreductases in early gestational monkey placenta during maternal malarial infection : histochemical localisation

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    Nishi Saxena , P.S.R. Murthy

    2007-06-01

    Full Text Available Background & objectives: Early gestational malaria is more deleterious than late gestational infection.Still the pathophysiology of maternofoetal organ—the placenta in malaria remains almost unexploredduring early gestation. Present study dealing with oxidoreductases in early gestational placenta duringmaternal malarial infection of Plasmodium cynomolgi bastianellii in rhesus monkeys was anticipatedto provide a better insight into the functional impairment of this organ leading to foetal abnormalities.Methods: Three control and four experimental monkeys (Macaca mulatta were quarantined for onemonth prior to experimentation. Experimental monkeys at 2–2½ months of gestation were inoculatedwith P. cynomolgi bastianellii. On attaining first peak of parasitaemia the placentae were collectedfrom anesthetised animals. The snap-frozen, cryostat sections were subjected to histochemicallocalisation for 3 (or 17 β-hydroxysteroid dehydrogenase (β-HSD [3 (or 17 β-hydroxysteroid:NAD (P+ oxidoreductase, EC 1.1.1.51 hydroxysteroid dehydrogenases] and NADPH-tetrazoliumreductase [NADPH : (acceptor oxidoreductase, EC 1.6.99.1 NADPH-TR]. Comparative microscopyof control and malaria infected placental sections was performed and analysed.Results: A localised decrease in both the enzymes was observed in syncytiotrophoblast layer ofmalaria infected monkey placenta. The areas showing morphological damage of syncytiotrophoblastwere also depicting gross reduction in NADPH-TR activity.Interpretation & conclusion: The altered enzymatic activities [3 (or 17 β-HSD and NADPH-TR] inmalaria infected early gestational monkey placenta have been discussed in the light of placentalfunction. It could be concluded by present studies that these alterations would affect the cellularmetabolism especially steroidogenesis and detoxification process which in turn would affect thenormal development of the foetus as well as maintenance of gestation.

  9. Efeitos da betametasona sobre os fetos e placentas da rata albina

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    Souza Eduardo de

    2001-01-01

    Full Text Available Objetivos: analisar os efeitos da betametasona sobre o binômio materno-fetal da rata albina. Métodos: utilizamos 60 ratas albinas prenhes divididas ao acaso em três grupos numericamente iguais. As ratas do grupo I foram tratadas com betametasona na dose de 1 mg/kg de peso em 0,5 ml de água destilada, por via intramuscular no 11º, 12º, 18º e 19º dia de prenhez; as do grupo II receberam 0,5 ml de água destilada, por via intramuscular no 11º, 12º, 18º e 19º dia de prenhez, e as do grupo III não receberam qualquer fármaco ou veículo. O ganho de peso das matrizes foi avaliado nos dias 0, 7, 14 e 20 de prenhez, sendo que no 20º dia todos os animais foram sacrificados por decapitação. Foram quantificados o número de implantações, de reabsorções, de fetos, de placentas, de malformações maiores, de mortalidade materna e fetal, assim como o peso dos fetos e das placentas. Resultados: nossos resultados revelaram que as matrizes tratadas com betametasona apresentaram menor ganho de peso. Quanto aos fetos e as placentas do grupo tratado, observamos que os pesos foram inferiores aos dos outros grupos. A média de peso dos fetos foi de 3,20 g contra 3,75 g no grupo controle. A média de peso das placentas foi de 0,36 g no grupo tratado com betametasona contra 0,48 g no grupo controle. Todas estas diferenças foram estatisticamente significantes. Conclusões: a betametasona apresenta efeito negativo sobre o ganho de peso das matrizes, fetos e placentas, quando administrada de forma repetitiva a partir da segunda metade da prenhez.

  10. In vivo quantification of {sup 18}F-Fdg uptake in human placenta during early pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Zanotti-Fregonara, P.; Jan, S.; Trebossen, R.; Maroy, R. [CEA, DSV, I2BM, SHFJ, F-91401 Orsay (France); Champion, C. [Univ Paul Verlaine Metz, Lab Phys Mol et Collis, Inst Phys, Metz (France); Hindie, E. [Hop St Antoine, AP-HP, F-75571 Paris (France); Hindie, E. [Univ Paris 07, IMDCT, IUH, Ecole Doctorale B2T, F-75221 Paris (France)

    2008-07-01

    {sup 18}F-FDG is the most widely used PET radiopharmaceutical. Nevertheless, no data for {sup 18}F-FDG uptake in the human placenta have been reported. We recently reported on embryo dosimetry in a woman who underwent an {sup 18}F-FDG PET/CT scan during early pregnancy. In the present work we attempt an in vivo quantification of the {sup 18}F-FDG uptake by the placenta. The 27-y-old woman received 320 MBq of {sup 18}F-FDG for a follow-up study for Hodgkin's lymphoma and was later discovered to be pregnant (embryo age 8 wk). Imaging started 1 h after injection. The maximum placental tissue uptake (SUVmax) was 2.5. This value was conservatively attributed to the entire placental volume, i.e., 45 mL, a value representative of the average dimensions of a normal placenta at 8 wk. On the basis of these measurements, placenta {sup 18}F-FDG uptake in our patient was 0.19% of the injected activity. A Monte Carlo simulation was used to derive the photon dose to the embryo from the placenta (0.022 * 10{sup -2} mGy per MBq of injected {sup 18}F-FDG) and from the surrounding amniotic fluid (0.017 * 10{sup -2} mGy MBq{sup -1}). This increases our previously calculated dose (3.3 * 10{sup -2} mGy MBq{sup -1}) by only a small fraction (1.18%), which does not justify modifying the previous estimate given the overall uncertainties. (authors)

  11. [Risk factors of pregnancy termination at second and third trimester in women with scarred uterus and placenta previa].

    Science.gov (United States)

    Tian, Ji-shun; Pan, Fei-xia; He, Sai-nan; Hu, Wen-sheng

    2015-05-01

    To investigate the risk factors of pregnancy termination at second and third trimester in women with scarred uterus and placenta previa. Clinical data of 24 pregnant women of second and third trimester with a scarred uterus and placenta previa,who requested termination in Women's Hospital Zhejiang University School of Medicine from July 2009 to June 2014, were retrospectively analyzed. The method of mifepristone combined with ethacridine lactate was adopted for all cases. Mifepristone combined with ethacridine lactate and uterine artery embolization were routinely given for patients with complete placenta previa. Cesarean section was performed for patients who failed to delivery or underwent massive vaginal bleeding before delivery. Age, gestational weeks, gravidity and parity, times of previous cesarean section, the interval from previous operation, the position and the type of placenta previa, placenta accretet, the indication and method of termination, postpartum hemorrhage, successful rate of labor induction, placental retention ratio and uterus rupture were documented. The successful rate of labor induction was 83.3%. The analysis showed that age, gestational weeks, gravidity and parity and times of previous cesarean section were not risk factors for failed labor induction, however the interval time from previous operation was related to induction failure (Pplacenta adhered to the antetheca of the uterus or placenta accrete increased risk to have cesarean section. There were no significant differences in postpartum hemorrhage, the successful rate of labor induction, placental retention ratio and the rate of uterine rupture between patients with uterine artery embolization and those without. The labor induction would be feasible for women with a scarred uterus and placenta previa in second and third-trimester pregnancy. The previous operation ≥ 13 years, the antetheca placenta or placenta accrete might increase the incidence of labor induction, while the

  12. Evaluation of “J”-shaped Uterine Incision during Caesarean Section in Patients with Placenta Previa:A Retrospective Study

    Institute of Scientific and Technical Information of China (English)

    邹丽; 钟少平; 赵茵; 朱剑文; 陈莉娟

    2010-01-01

    This study evaluated the efficacy and safety of "J"-shaped uterine incision for caesarean section for patients diagnosed with placenta previa.A total of 55 consecutive cases of placenta previa treated in Union Hospital were retrospectively analyzed over a period of two years and 10 months.The subjects were divided into two groups with respect to the uterine incision.Twenty-four pregnant women with placenta previa who were indicated for caesarean section underwent the procedure using a new "J"-shaped uterine...

  13. Adhering maternal platelets can contribute to the cytokine and chemokine cocktail released by human first trimester villous placenta.

    Science.gov (United States)

    Blaschitz, A; Siwetz, M; Schlenke, P; Gauster, M

    2015-11-01

    Placental villous explant culture has been increasingly recognized as suitable model to study secretion of inflammatory and immune modulating factors by human placenta. Most of these factors likely derive from the syncytiotrophoblast, whereas extraplacental sources such as maternal peripheral blood cells are rarely considered. Due to their small size and absence of a nucleus, platelets adhering to perivillous fibrinoid of normal placenta are frequently ignored in routine immunohistochemistry. Here we demonstrate adhering maternal platelets on first trimester placental villi after explant culture and point out that platelet-derived factors must be considered when analyzing the inflammatory secretion profile of human placenta.

  14. VEGF system expression by immunohistochemistry and real-time RT-PCR study on collared peccary placenta

    DEFF Research Database (Denmark)

    Santos, Tatiana C.; Oliveira, Moacir F.; Papa, Paula C.;

    2014-01-01

    in the placenta and uterus of the collared peccary in nonpregnant females in the luteal phase and throughout pregnancy (>35, 75, 115, and 135 days). The material was examined by immunohistochemistry and by real-time reverse transcription polymerase chain reaction. Intense positive immunolabeling was observed...... in late pregnancy. In the collared peccary, the expression of the VEGF-ligand receptor system was similar to that in porcine and ruminant placentas, suggesting that an epitheliochorial placenta has the same physiological and interhemal barrier during vascular gestational development. The expression...

  15. Clinical analysis of 120 cases of pernicious placenta previa with and without placenta accrete%植入性与非植入性凶险型前置胎盘120例临床分析

    Institute of Scientific and Technical Information of China (English)

    林莉; 郭晓辉; 胡芷洋

    2013-01-01

    目的 分析植入性凶险型前置胎盘对孕产妇的危害性,提高对植入性凶险型前置胎盘的认识和重视.方法 对25例植入性凶险型前置胎盘与95例非植入性前置胎盘的病例进行对比分析.结果 中央性前置胎盘合并植入者达43.8%,植入组产后出血率、产后出血量及子宫切除率与非植入组对比有显著性差异(P<0.01).结论 凶险型前置胎盘孕妇产前应明确有无胎盘植入,应做好术中及术后出血的抢救措施,以保证孕产妇生命安全.%Objective To analysis the complications of pernicious placenta previa with placenta accreta. Methods Retrospective analysis of pernicious placenta cases of previa with and without placenta accreta was performed. Results A total of 43. 8% total pernicious placenta previa cases were complicated with placenta accreta. Compared with non - accreta group, the accreta group had higher chance of postpartum hemorrhage, and risk of hysterectomy (P < 0.01). Conclusion The risk of placenta accreta should be considered in prenatal care for cases with pernicious placenta previa, and prophylaxic management is recommended to prevent hemorrhage.

  16. Cross Talk between Adipose Tissue and Placenta in Obese and Gestational Diabetes Mellitus Pregnancies via Exosomes

    Directory of Open Access Journals (Sweden)

    Nanthini Jayabalan

    2017-09-01

    Full Text Available Obesity is an important public health issue worldwide, where it is commonly associated with the development of metabolic disorders, especially insulin resistance (IR. Maternal obesity is associated with an increased risk of pregnancy complications, especially gestational diabetes mellitus (GDM. Metabolism is a vital process for energy production and the maintenance of essential cellular functions. Excess energy storage is predominantly regulated by the adipose tissue. Primarily made up of adipocytes, adipose tissue acts as the body’s major energy reservoir. The role of adipose tissue, however, is not restricted to a “bag of fat.” The adipose tissue is an endocrine organ, secreting various adipokines, enzymes, growth factors, and hormones that take part in glucose and lipid metabolism. In obesity, the greater portion of the adipose tissue comprises fat, and there is increased pro-inflammatory cytokine secretion, macrophage infiltration, and reduced insulin sensitivity. Obesity contributes to systemic IR and its associated metabolic complications. Similar to adipose tissue, the placenta is also an endocrine organ. During pregnancy, the placenta secretes various molecules to maintain pregnancy physiology. In addition, the placenta plays an important role in metabolism and exchange of nutrients between mother and fetus. Inflammation at the placenta may contribute to the severity of maternal IR and her likelihood of developing GDM and may also mediate the adverse consequences of obesity and GDM on the fetus. Interestingly, studies on maternal insulin sensitivity and secretion of placental hormones have not shown a positive correlation between these phenomena. Recently, a great interest in the field of extracellular vesicles (EVs has been observed in the literature. EVs are produced by a wide range of cells and are present in all biological fluids. EVs are involved in cell-to-cell communication. Recent evidence points to an association between

  17. Megalin Is Predominantly Observed in Vesicular Structures in First and Third Trimester Cytotrophoblasts of the Human Placenta

    DEFF Research Database (Denmark)

    Storm, Tina; Christensen, Erik I; Christensen, Julie Nelly

    2016-01-01

    The membrane receptor megalin is crucial for normal fetal development. Besides its expression in the developing fetus, megalin is also expressed in the human placenta. Similar to its established function in the kidney proximal tubules, placental megalin has been proposed to mediate uptake of vital...... nutrients. However, details of megalin expression, subcellular localization, and function in the human placenta remain to be established. By immunohistochemical analyses of first trimester and term human placenta, we showed that megalin is predominantly expressed in cytotrophoblasts, the highly...... clearly place placental megalin in the context of endocytosis and trafficking of ligands. However, due to the limited expression of megalin in syncytiotrophoblasts, especially in term placenta, it appears that the main role for placental megalin is not to mediate uptake of nutrients from the maternal...

  18. Transplantation of placenta-derived mesenchymal stem cell-induced neural stem cells to treat spinal cord injur y

    Institute of Scientific and Technical Information of China (English)

    Zhi Li; Wei Zhao; Wei Liu; Ye Zhou; Jingqiao Jia; Lifeng Yang

    2014-01-01

    Because of their strong proliferative capacity and multi-potency, placenta-derived mesenchymal stem cells have gained interest as a cell source in the ifeld of nerve damage repair. In the present study, human placenta-derived mesenchymal stem cells were induced to differentiate into neural stem cells, which were then transplanted into the spinal cord after local spinal cord injury in rats. The motor functional recovery and pathological changes in the injured spinal cord were observed for 3 successive weeks. The results showed that human placenta-derived mesenchymal stem cells can differentiate into neuron-like cells and that induced neural stem cells contribute to the resto-ration of injured spinal cord without causing transplant rejection. Thus, these cells promote the recovery of motor and sensory functions in a rat model of spinal cord injury. Therefore, human placenta-derived mesenchymal stem cells may be useful as seed cells during the repair of spinal cord injury.

  19. Temporary balloon occlusion of the internal iliac arteries to prevent massive hemorrhage during cesarean delivery among patients with placenta previa

    NARCIS (Netherlands)

    Broekman, Evelien A.; Versteeg, Henneke; Vos, Louwerens D.; Dijksterhuis, Marja G.; Papatsonis, Dimitri N.

    2015-01-01

    Objective To evaluate the effectiveness of temporary balloon occlusion of the internal iliac artery before uterine incision to prevent massive obstetric hemorrhage during cesarean delivery among patients with anterior placenta previa. Methods In a retrospective cohort study conducted at Amphia

  20. Effect of routine rapid insertion of Bakri balloon tamponade on reducing hemorrhage from placenta previa during and after cesarean section.

    Science.gov (United States)

    Soyama, Hiroaki; Miyamoto, Morikazu; Sasa, Hidenori; Ishibashi, Hiroki; Yoshida, Masashi; Nakatsuka, Masaya; Takano, Masashi; Furuya, Kenichi

    2017-06-24

    To evaluate the effectiveness of routine rapid insertion of a Bakri balloon during cesarean section for placenta previa based on a retrospective control study. Women with singleton pregnancies who underwent cesarean section for placenta previa at our institution between 2003 and 2016 were enrolled. Between 2015 and 2016, women who routinely underwent balloon tamponade during cesarean section were defined as the balloon group. Between 2003 and 2014, women who underwent no hemostatic procedures except balloon tamponade were defined as the non-balloon group. The clinical outcomes of the two groups were retrospectively analyzed. Of the 266 women with placenta previa, 50 were in the balloon group and 216 were in the non-balloon group. The bleeding amounts were significantly smaller in the balloon group than in the non-balloon group: intraoperative bleeding (991 vs. 1250 g, p placenta previa.

  1. The development of a dynamic model for microvascular research and practice using human placenta: a preliminary report.

    Science.gov (United States)

    Waterhouse, N; Moss, A L; Townsend, P L

    1985-07-01

    Human placenta has been investigated in an attempt to develop a non-animal model for microvascular research and practice, with a dynamic artificial circulation. Initial work has been encouraging and further development is in progress.

  2. Folate Transporters in Placentas from Preterm Newborns and Their Relation to Cord Blood Folate and Vitamin B12 Levels

    National Research Council Canada - National Science Library

    Castaño, Erika; Caviedes, Lorena; Hirsch, Sandra; Llanos, Miguel; Iñiguez, Germán; Ronco, Ana María

    2017-01-01

    ... (PT, 32-36 weeks, n = 51). Term placentas were used as controls (T, 37-41 weeks, n = 47). Folates and vitamin B12 levels were measured by electrochemiluminescence in umbilical cord blood of newborns...

  3. Micro- and Nano-vesicles from First Trimester Human Placentae Carry Flt-1 and Levels Are Increased in Severe Preeclampsia.

    Science.gov (United States)

    Tong, Mancy; Chen, Qi; James, Joanna L; Stone, Peter R; Chamley, Lawrence W

    2017-01-01

    Preeclampsia is a life-threatening hypertensive disease affecting 3-5% of pregnancies. While the pathogenesis of preeclampsia remains unclear, it is known that placenta-derived factors trigger the disease by activating maternal endothelial cells prior to the onset of clinical symptoms. Extracellular vesicles (EVs) of different sizes extruded by the placenta may be one factor. The truncated/secreted form of Flt-1 (sFlt-1) has also been implicated in the pathogenesis of preeclampsia. We investigated whether placental EV production is altered in preeclampsia such that they induce endothelial cell activation, and whether (s)Flt-1 is involved. Macro-, micro-, and nano-vesicles were collected from normal and preeclamptic (PE) placental explants, and separated by differential centrifugation. The number and size of micro- and nano-vesicles was measured by nanoparticle tracking analysis and their ability to activate endothelial cells was quantified by endothelial cell intercellular adhesion molecule 1 expression and monocyte adhesion. The levels of Flt-1 were measured by western blots and ELISA. PE placentae extruded significantly more micro- and nano-vesicles than control placentae and the extruded micro-vesicles were larger than those from control placentae. Micro- and nano-vesicles from both first trimester and term human placentae carried Flt-1 and levels were significantly increased in EVs from severe, but not mild, PE compared to normotensive placentae. All fractions of EVs from PE placentae activated endothelial cells, and for micro- and nano-vesicles, activation was reduced in the presence of exogenous vascular endothelial growth factor (VEGF), a Flt-1 neutralizing antibody, or by pre-treatment with VEGF. While EV-bound VEGF constituted over 20% of the total detected VEGF secreted by PE and normotensive placentae, EV-bound Flt-1 did not significantly contribute to the total level of sFlt-1/Flt-1 released by human third trimester placentae. Micro- and nano

  4. Analysis of Placental Growth Factor in Placentas of Normal Pregnant Women and Women with Hypertensive Disorders of Pregnancy

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    To investigate the expressions of placental growth factor (PLGF) in placenta with hypertensive disorders of pregnancy (HDP), 45 women with HDP and 20 normally pregnant women were studied. Among 45 women with HDP, there were 23 cases of severe preeclampsia and one case of eclampsia. The location and level of PLGF proteins was determined by immunohistochemistry and Western blot. The expression of PLGF mRNA in placenta was assessed by reverse transcriptionalpolymerase chain reaction (RT-PCR). The results showed that: (1) The distribution of PLGF in placenta with HDP was similar to normal one, which was mainly in the cytoplasm of villous syncytiotrophoblast and villous stroma; (2) The expression of PLGF protein was significantly decreased in placentas with mild and severe preeclampsia compared to the normal ones (0.3±0.4 vs 0.6± 0.4, 0.2±0.5 vs 0.6±0. 4, P<0.01). There were no differences between the gestational hypertension placenta and normal one (0.5±0.6 vs 0.6±0.4, P>0. 05); (3) The transcription levels of the PLGF mRNA in placentas with preeclampsia were significantly lower than in normal groups (3.33±0.39 vs4.87±0.60, 1.97±0.29 vs 4.87±0. 60, P<0.01), and no differences were found between the gestational hypertension placenta and normal groups. These findings suggest that the abnormal expression of PLGF in placentas is related to the pathogenesis of HDP.

  5. The Incidence of Postpartum Hemorrhage in Pregnant Women with Placenta Previa: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Fan, Dazhi; Xia, Qing; Liu, Li; Wu, Shuzhen; Tian, Guo; Wang, Wen; Wu, Song; Guo, Xiaoling; Liu, Zhengping

    2017-01-01

    The global burden of postpartum hemorrhage (PPH) in women with placenta previa is a major public health concern. Although there are different reports on the incidence of PPH in different countries, to date, no research has reviewed them. The aim of this study was to calculate the average point incidence of PPH in women with placenta previa. A systematic review and meta-analysis of observational studies estimating PPH in women with placenta previa was conducted through literature searches in four databases in Jul 2016. This study was totally conducted according to the MOOSE guidelines and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard. From 1148 obtained studies, 11 included in the meta-analysis, which involved 5146 unique pregnant women with placenta previa. The overall pooled incidence of PPH was 22.3% (95% CI 15.8-28.7%). In the subgroup, the prevalence was 27.4% in placenta previas, and was 14.5% in low-lying placenta previa; the highest prevalence was estimated in Northern America (26.3%, 95%CI 11.0-41.6%), followed by the Asia (20.7%, 95%CI 12.8-28.6%), Australia (19.2%, 95% CI 17.2-21.1%) and Europe (17.8%, 95% CI, 11.5%-24.0%). The summary estimate of the incidence of PPH among women with placenta previa was considerable in this systematic review. The results will be crucial in prevention, treatment, and identification of PPH among pregnant women with placenta previa and will be contributed to the planning and implantation of relevant public health strategies.

  6. Effects of iron polymaltose complex, ferrous fumarate and ferrous sulfate treatments in anemic pregnant rats, their fetuses and placentas.

    Science.gov (United States)

    Toblli, Jorge E; Cao, Gabriel; Oliveri, Leda; Angerosa, Margarita

    2013-06-01

    Although oral iron preparations are widely prescribed to prevent and to treat iron deficiency anemia in pregnancy, comparative data on their effects to the mother, fetus and placenta are limited. In this study, the effects of oral iron polymaltose complex (IPC), ferrous fumarate (FF) and ferrous sulfate (FS) were compared in anemic pregnant rats, their fetuses and placentas. Hematological variables and oxidative stress markers in the liver, heart and kidneys of the dams and fetuses as well as the markers for oxidative stress, inflammation and hypoxia in placentas were assessed. Pregnancy outcome was measured by number of fetuses, and by neonate and placental weight. All therapies were comparably effective in correcting anemia. FS and FF, but not IPC, resulted in liver damage in dams and oxidative stress in dams, fetuses and placentas. FS group presented the highest catalase and GPx levels in dams, fetuses and placentas. IPC, but not FF or FS, restored normal TNF-α and IL6 expression levels in placentas whereas FS-treated animals presented the highest cytokine levels, suggesting a local inflammatory reaction. Anemia-induced high levels of HIF-1α were partially lowered by IPC and FF but further elevated by FS. Most of the negative effects associated with IDA were resolved by IPC treatment. Especially FS treatment was found to elicit hepatic damage in the dams, oxidative stress in the dams, fetuses and placenta as well as inflammation and high levels of HIF-1α in the placenta. Pregnancy outcome of FFand FS-treated animals was worse than that of IPC-treated animals.

  7. Value of prenatal diagnosis of pernicious placenta previa with placenta accreta%胎盘植入合并凶险型前置胎盘的产前诊断及意义

    Institute of Scientific and Technical Information of China (English)

    陈旭日

    2015-01-01

    Objective To investigate the prenatal diagnosis of pernicious placenta previa with placenta increta. Methods Collecting the patients were treated in our hospital from June 2005 to October 2014 , 16 cases were placenta implantation and placenta previa, 34 cases were placenta implantation without placenta previa and 78 cases were placenta previa complicated with placenta accreta, a total of 128 cases of patients as the research object. Prenatal ultrasound diagnosis rate and ultrasonography characteristics were retrospective analized. Results The detection rate of placenta implantation of the combined group was significantly higher than combined group placenta previa (P<0.05); Detection rate with the dangerous type of placenta were higher than the common group significantly (P<0.01). In placenta previa, ratio of patients with an age of more than 35 years the proportion with placenta implantation and uterine cavity operation with more than 2 times compared with placent a accreta patients, the difference was statistically significant (P<0.01). Conclusion Prenatal ultrasound diagnosis of placenta previa complicated with placenta accrete has a positive meaning to decrease the mother and fetal death risk.%目的:探讨胎盘植入合并凶险型前置胎盘的产前诊断及其意义。方法选取2005年6月至2014年10月我院收治的16例胎盘植入合并凶险型前置胎盘、34例胎盘植入未合并凶险型前置胎盘以及78例凶险型前置胎盘未合并胎盘植入,总计128例患者作为研究对象,回顾性分析产前超声检查诊断检出率以及超声检查特点。结果合并前置胎盘组胎盘植入检出率明显高于未合并组,差异具有统计学意义(P<0.05);合并凶险型胎盘检出率较合并普通型组检出率高,差异具有统计学意义(P<0.01)。在凶险型前置胎盘中,合并胎盘植入的患者年龄≥35岁比例以及宫腔操作次数≥2次的比例较未合并胎盘植入患者高

  8. Associations between congenital cryptorchidism in newborn boys and levels of dioxins and PCBs in placenta

    DEFF Research Database (Denmark)

    Virtanen, H E; Koskenniemi, J J; Sundqvist, E

    2012-01-01

    In animal studies, exposure to dioxins has been associated with disrupted development of the male reproductive system, including testicular maldescent. Some polychlorinated biphenyls (PCBs) have also dioxin-like effects. In addition, one previous case-control study has reported an association...... between congenital cryptorchidism and colostrum PCB levels. We performed a case-control study to evaluate whether congenital cryptorchidism in boys was associated with increased levels of dioxins or PCBs in placenta reflecting foetal exposure. In addition, associations between placenta levels...... controls) and 168 Danish (39 cases, 129 controls)] were analysed for 17 toxic polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and 37 PCBs (including 12 dioxin-like PCBs). Infant serum samples taken at 3 months were analysed for reproductive hormones. No significant differences between cases...

  9. Application of fluorescent in situ hybridisation for demonstration of Coxiella burnetti in placentas from ruminant abortions

    DEFF Research Database (Denmark)

    Jensen, Tim Kåre; Montgomery, Donald L.; Jaeger, Paula T.;

    2007-01-01

    A fluorescent in situ hybridisation (FISH) assay targeting 16S ribosomal RNA was developed for detection of the zoonotic bacterium Coxiella burnetii in formalin-fixed, paraffin-embedded tissue, and applied on placentas from ruminant abortions. The applicability of the FISH assay was compared...... to immunohistochemistry (IHC) using human positive control serum in 12 cases of C burnetii-associated placentitis as well as 7 negative control tissue samples. In all 12 cases the bacterium was detected within trophoblasts as well as free in the placental debris by both FISH and IHC. Extensive and significant infection...... by C. burnetii was revealed in 10 of the cases, whereas a slighter and focal distribution of the bacterium was observed in two cases. 90 aborted placentas from Danish ruminants were investigated by FISH. C burnetii was detected in one bovine case only, representing the first confirmation of C burnetii...

  10. Expression and localization of the omega-3 fatty acid receptor GPR120 in human term placenta.

    Science.gov (United States)

    Lager, S; Ramirez, V I; Gaccioli, F; Jansson, T; Powell, T L

    2014-07-01

    Fatty acids can function as signaling molecules, acting through receptors in the cytosol or on the cell surface. G-Protein Receptor (GPR)120 is a membrane-bound receptor mediating anti-inflammatory and insulin-sensitizing effects of the omega-3 fatty acid docohexaenoic acid (DHA). GPR120 dysfunction is associated with obesity in humans. Cellular localization of GPR120 and the influence of maternal obesity on GPR120 protein expression in the placenta are unknown. Herein we demonstrate that GPR120 is predominantly expressed in the microvillous membrane (MVM) of human placenta and that the expression level of this receptor in MVM is not altered by maternal body mass index (BMI).

  11. A model for gas and nutrient exchange in the chorionic vasculature system of the mouse placenta

    Science.gov (United States)

    Mirbod, Parisa; Sled, John

    2015-11-01

    The aim of this study is to develop an analytical model for the oxygen and nutrient transport from the umbilical cord to the small villous capillaries. The nutrient and carbon dioxide removal from the fetal cotyledons in the mouse placental system has also been considered. This model describes the mass transfer between the fetal and the maternal red blood cells in the chorionic arterial vasculature system. The model reveals the detail fetal vasculature system and its geometry and the precise mechanisms of mass transfer through the placenta. The dimensions of the villous capillaries, the total length of the villous trees, the total villi surface area, and the total resistance to mass transport in the fetal villous trees has also been defined. This is the first effort to explain the reason why there are at least 7 lobules in the mouse placenta from the fluid dynamics point of view.

  12. [Imbalance of system of glutamin - glutamic acid in the placenta and amniotic fluid at placental insufficiency].

    Science.gov (United States)

    Pogorelova, T N; Gunko, V O; Linde, V A

    2014-01-01

    Metabolism of glutamine and glutamic acid has been investigated in the placenta and amniotic fluid under conditions of placental insufficiency. The development of placental insufficiency is characterized by the increased content of glutamic acid and a decrease of glutamine in both placenta and amniotic fluid. These changes changes were accompanied by changes in the activity of enzymes involved in the metabolism of these amino acids. There was a decrease in glutamate dehydrogenase activity and an increase in glutaminase activity with the simultaneous decrease of glutamine synthetase activity. The compensatory decrease in the activity of glutamine keto acid aminotransferase did not prevent a decrease in the glutamine level. The impairments in the system glutamic acid-glutamine were more pronounced during the development of premature labor.

  13. Stem villous arteries from the placentas of heavy smokers: functional and mechanical properties

    DEFF Research Database (Denmark)

    Clausen, Helle Vibeke; Jorgensen, J C; Ottesen, B

    1999-01-01

    arteries were mounted in small-vessel myographs. Circumference-tension relationships were established with 124 mmol/L potassium chloride. Concentration-response curves were obtained for endothelin 1, prostaglandin F2alpha, vasoactive intestinal peptide, corticotropin-releasing hormone, sodium nitroprusside......, and cadmium chloride. The effect of nitric oxide was examined with N omega-nitro-l -arginine. RESULTS: Stem villous arteries from the heavy smoking group developed a significantly lower tension than did those from nonsmokers at 6 of 9 steps of the circumference-tension experiment (P ...OBJECTIVE: The aim of the study was to compare the mechanical and functional properties of isolated small stem villous arteries from the placentas of women who smoked heavily (>/=15 cigarettes/d) during pregnancy with those from the placentas of nonsmokers. STUDY DESIGN: Isolated stem villous...

  14. Growth and development of the placenta in the capybara (Hydrochaeris hydrochaeris)

    DEFF Research Database (Denmark)

    Kanashiro, Claudia; Santos, Tatiana C; Miglino, Maria Angelica

    2009-01-01

    electron microscopy. RESULTS: At the limb bud stage, the placenta was a pad of trophoblast covered by a layer of mesoderm from which fetal vessels were beginning to penetrate at folds in the surface. By 70 days, the placenta comprised areas of labyrinth (lobes) separated by interlobular areas. Placental......, there was a prominent subplacenta comprising cellular and syncytial trophoblast with mesenchyme and associated blood vessels. At 90 days, differentiation was complete and similar to that seen in other hystricognath rodents. Overlap of fetal vessels and maternal blood lacunae was confirmed by latex injection...... of the vessels. At all stages extraplacental trophoblast was associated with the maternal arterial supply and consisted of cellular trophoblast and syncytial streamers derived from the subplacenta. CONCLUSION: All important characteristics of placental development and organization in the capybara resembled those...

  15. Morphological evaluation of the placenta and fetal membranes during canine pregnancy from early implantation to term.

    Science.gov (United States)

    Aralla, Marina; Groppetti, Debora; Caldarini, Laura; Cremonesi, Fausto; Arrighi, Silvana

    2013-08-01

    To describe the histological changes of fetal adnexa throughout the physiological pregnancy, canine samples were obtained during natural delivery and caesarean section, as well as during ovariohysterectomy performed at any stage of undesired pregnancies (N=12). The first period of pregnancy (multiple samples collected at 10, 12, 14 days) was consistent with pre- and peri-implantation events, i.e. apposition and initial invasion steps into the endometrium. The second period (multiple samples collected at 18, 38, 40, 45 days) was related to the development of extra-embryonic structures, placenta establishment and labyrinth formation. At the end of this period the maximum morphological complexity of the endotheliochorial placenta was achieved, characterized by complete erosion of the endometrial epithelium and underlying interstitium with exposure of maternal capillaries to the chorial cells. The third period of gestation (multiple samples collected at 50, 53, 57, 60, 63 days) was characterized by enhancement either of placental and extra-embryonic tissues.

  16. Proteome Differences in Placenta and Endometrium between Normal and Intrauterine Growth Restricted Pig Fetuses.

    Directory of Open Access Journals (Sweden)

    Fang Chen

    Full Text Available Uteroplacental tissue plays a key role in substance exchanges between maternal and fetal circulation, and, therefore, in the growth and development of fetuses. In this study, proteomics and western blotting were applied to investigate the changes of proteome in the placenta and endometrium of normal and intrauterine growth restriction (IUGR porcine fetuses during mid to late pregnancy (D60, 90, and 110 of gestation. Our results showed that proteins participating in cell structure, energy metabolism, stress response, cell turnover, as well as transport and metabolism of nutrients were differentially expressed in placenta and endometrium between normal and IUGR fetuses. Analysis of functions of these proteins suggests reductions in ATP production and nutrients transport, increases in oxidative stress and apoptosis, and impairment of cell metabolism in IUGR fetuses. Collectively, our findings aid in understanding of the mechanisms responsible for uteroplacental dysfunction in IUGR fetus, and are expected to provide new strategies to reduce fetal growth restriction in pigs and other mammals.

  17. Oxytocinase-immunohistochemical demonstration in the immature and term human placenta.

    Science.gov (United States)

    Small, C W; Watkins, W B

    1975-10-27

    Oxytocinase (cystine aminopeptidase) was purified from human retroplacental serum by a combination of fractional precipitation, hydroxylapatite chromatography and gel exlusion chromatography on Sephadex G-200. The purified enzyme possessed a specific activity of 980 mIU/mg using L-cystine-di-p-nitroanilide as substrate. This represented a 3200 fold concentration from the starting material in an overall yield of 12%. Antibodies against oxytocinase were raised in rabbits and the gamma-globulins fraction labelled with fluorescein isothiocyanate prior to its use in the immunofluorescence histochemical localization of the enzyme in human placental tissue. Oxytocinase was confined to the syncytiotrophoblastic cells of normal term, and immature placentas as well as in placentas from patients suffering from severe toxaemia. Specific immunofluorescence was also present in the outer margins of the chorion and to a lesser extent in the amnion.

  18. Saline obtaining and time standardization of prothrombin using thromboplastin of human placenta.

    Directory of Open Access Journals (Sweden)

    María de Jesús Sánchez Bouza

    2003-07-01

    Full Text Available Background: Determining prothombine ‘s time is an important lab test in the study of coagulation disorders. To develop this essay the main reactive was thromboplastin , a substance that is presented in tissue and that has been obtained habitually from the human brain or certain animals but its extraction in labs or its commercial acquisition is difficult at present. Objective: To obtain Thromboplastin throughout the extraction of human placenta and to standardise the determination of pro-time into the obtained reactive Method: Placenta from normal delivery was used from which thromboplastin was obtained using a saline extraction. The reactive was compared with thromboplastin from human brain from ¨Dr. Hermanos Ameijeiras¨ Hospital in Havana City in a group of patients with and without anticoagulant treatment . With the extracted thromplastin similar or compatible results were obtained than with the habitual reactives by using easier and cheaper process.

  19. MOUSE ANTIBODY RESPONSE FOLLOWING REPETITIVE INJECTIONS OF GAMMA-IRRADIATED HUMAN PLACENTA COLLAGENA

    Institute of Scientific and Technical Information of China (English)

    刘秉慈; MelvinSpira; 许增禄

    1994-01-01

    Injectable bovine collagen has been used clinically for years.But both the necessity of repeated injections to maintain corrections and the question of adverse allergic reactions developing from the use of a xenogenic collagen have been an area of serious concern.To overoome these adyerse effects,we have developed injectable collagen preparations from human placenta.Gamma irradiation was used for sterilization and crosslinking of the collagen.We observed the mouse immune respose to gamma-irradiated human placenta soluble and insoluble collagen follow-ing multiple injections.After six injections of these materials,no total IgG level increase was found,nor was anti-body specifically directed against human collagen found.Mouse antibody levels were also observed following Zyderm Ⅱ and Zyplast repetitive injections and follow-ing repetitive implantations of coated vicryl and chromic gut.No humoral immune response was found in this het-erologous type system.

  20. Novel expression and regulation of voltage-dependent potassium channels in placentas from women with preeclampsia.

    Science.gov (United States)

    Mistry, Hiten D; McCallum, Laura A; Kurlak, Lesia O; Greenwood, Iain A; Broughton Pipkin, Fiona; Tribe, Rachel M

    2011-09-01

    Preeclampsia is associated with structural/functional alterations in placental and maternal vasculature. Voltage-dependant potassium channels encoded by KCNQ1-5 genes have been detected in several types of blood vessels where they promote vascular relaxation. Voltage-dependant potassium channel function can be modulated by KCNE1-5-encoded accessory proteins. The aim of this study was to determine whether KCNQ and KCNE genes are differentially expressed in placentas from women with preeclampsia compared with normotensive controls and to examine any differences in those who delivered preterm (voltage-dependant potassium channels are expressed and markedly modulated in placentas from preeclamptic women. Differential expression of isoforms may lead to altered cell proliferation. The correlation between KCNQ3 and KCNE5 expression is indicative of a novel channel complex and warrants further investigation.