Placental pathologic changes and perinatal outcomes in placenta previa
Placenta previa is a condition in which the placenta implants in the poorly vascularized lower uterine segment, which may result in inadequate uteroplacental perfusion, in turn, adversely affect the neonatal outcome. Abnormal placentation may also lead to severe postpartum hemorrhage as placenta sep...
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| Veröffentlicht in: | Placenta (Eastbourne) 2018-03, Vol.63, p.15-20 |
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| creator | Jung, Eun Jung Cho, Hwa Jin Byun, Jung Mi Jeong, Dae Hoon Lee, Kyung Bok Sung, Moon Su Kim, Ki Tae Kim, Young Nam |
| description | Placenta previa is a condition in which the placenta implants in the poorly vascularized lower uterine segment, which may result in inadequate uteroplacental perfusion, in turn, adversely affect the neonatal outcome. Abnormal placentation may also lead to severe postpartum hemorrhage as placenta separation proceeds. We aimed to evaluate the differences in placental histopathology and perinatal outcomes in pregnancies complicated with placenta previa and controls.
We undertook a retrospective case-control study of 93 pregnancies with placenta previa and 81 controls between 2011 and 2017.
Gross findings of the placenta showed that the placentas in placenta previa had significantly higher mean large chorionic plate diameters (18.5 ± 3.2 vs 17.5 ± 2.6 cm, P = .0298), chorionic plate areas (218.4 ± 62.9 cm2 vs 198.7 ± 56.0 cm2, P = .0344), and marginal cord insertion (19.8% vs 8.6%, P = .0411) than control groups. Placental histopathological findings showed that placentas in placenta previa was significantly associated with maternal underperfusion, including villous infarction (50.5% vs 25.9%, P = .0009) and increased intervillous fibrin deposition (38.7% vs 7.4%, P |
| doi_str_mv | 10.1016/j.placenta.2017.12.016 |
| format | Article |
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We undertook a retrospective case-control study of 93 pregnancies with placenta previa and 81 controls between 2011 and 2017.
Gross findings of the placenta showed that the placentas in placenta previa had significantly higher mean large chorionic plate diameters (18.5 ± 3.2 vs 17.5 ± 2.6 cm, P = .0298), chorionic plate areas (218.4 ± 62.9 cm2 vs 198.7 ± 56.0 cm2, P = .0344), and marginal cord insertion (19.8% vs 8.6%, P = .0411) than control groups. Placental histopathological findings showed that placentas in placenta previa was significantly associated with maternal underperfusion, including villous infarction (50.5% vs 25.9%, P = .0009) and increased intervillous fibrin deposition (38.7% vs 7.4%, P < .0001). Also, women in the placenta previa group had a higher rate of abnormally invasive placenta and severe postpartum hemorrhage. However, placenta previa was not associated with the increased risk of neonatal mortality and morbidity.
Abnormal placentation into the poorly vascularized lower uterine segment induces compensatory placental growth and increased surface area in response to reduced placental perfusion, which was consistent with the histopathological findings of coagulative necrosis of chorionic villi and fibrin deposition in the intervillous space. The morphological changes occurring in placenta previa may have important roles in maintaining adequate uteroplacental-fetal perfusion, which may prevent adverse neonatal outcomes.
•Placentas in placenta previa induce compensatory placental growth in response to reduced placental perfusion.•Placenta previa is associated with the coagulative necrosis of chorionic villi and fibrin deposition intervillous space.•Placenta previa is not associated with the increased risk of neonatal mortality and morbidity.</description><identifier>ISSN: 0143-4004</identifier><identifier>EISSN: 1532-3102</identifier><identifier>DOI: 10.1016/j.placenta.2017.12.016</identifier><identifier>PMID: 29486851</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Abnormally invasive placenta ; Adult ; Case-Control Studies ; Chorion - pathology ; Chorionic plate area ; Female ; Humans ; Parturition ; Placenta - pathology ; Placenta previa ; Placenta Previa - pathology ; Postpartum hemorrhage ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Underperfusion</subject><ispartof>Placenta (Eastbourne), 2018-03, Vol.63, p.15-20</ispartof><rights>2017 Elsevier Ltd</rights><rights>Copyright © 2017 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-1a730935ae15baf08e251efdd0e073103114a8b339dc461122e4bc4318d06cb3</citedby><cites>FETCH-LOGICAL-c434t-1a730935ae15baf08e251efdd0e073103114a8b339dc461122e4bc4318d06cb3</cites><orcidid>0000-0003-0897-0039</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.placenta.2017.12.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29486851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, Eun Jung</creatorcontrib><creatorcontrib>Cho, Hwa Jin</creatorcontrib><creatorcontrib>Byun, Jung Mi</creatorcontrib><creatorcontrib>Jeong, Dae Hoon</creatorcontrib><creatorcontrib>Lee, Kyung Bok</creatorcontrib><creatorcontrib>Sung, Moon Su</creatorcontrib><creatorcontrib>Kim, Ki Tae</creatorcontrib><creatorcontrib>Kim, Young Nam</creatorcontrib><title>Placental pathologic changes and perinatal outcomes in placenta previa</title><title>Placenta (Eastbourne)</title><addtitle>Placenta</addtitle><description>Placenta previa is a condition in which the placenta implants in the poorly vascularized lower uterine segment, which may result in inadequate uteroplacental perfusion, in turn, adversely affect the neonatal outcome. Abnormal placentation may also lead to severe postpartum hemorrhage as placenta separation proceeds. We aimed to evaluate the differences in placental histopathology and perinatal outcomes in pregnancies complicated with placenta previa and controls.
We undertook a retrospective case-control study of 93 pregnancies with placenta previa and 81 controls between 2011 and 2017.
Gross findings of the placenta showed that the placentas in placenta previa had significantly higher mean large chorionic plate diameters (18.5 ± 3.2 vs 17.5 ± 2.6 cm, P = .0298), chorionic plate areas (218.4 ± 62.9 cm2 vs 198.7 ± 56.0 cm2, P = .0344), and marginal cord insertion (19.8% vs 8.6%, P = .0411) than control groups. Placental histopathological findings showed that placentas in placenta previa was significantly associated with maternal underperfusion, including villous infarction (50.5% vs 25.9%, P = .0009) and increased intervillous fibrin deposition (38.7% vs 7.4%, P < .0001). Also, women in the placenta previa group had a higher rate of abnormally invasive placenta and severe postpartum hemorrhage. However, placenta previa was not associated with the increased risk of neonatal mortality and morbidity.
Abnormal placentation into the poorly vascularized lower uterine segment induces compensatory placental growth and increased surface area in response to reduced placental perfusion, which was consistent with the histopathological findings of coagulative necrosis of chorionic villi and fibrin deposition in the intervillous space. The morphological changes occurring in placenta previa may have important roles in maintaining adequate uteroplacental-fetal perfusion, which may prevent adverse neonatal outcomes.
•Placentas in placenta previa induce compensatory placental growth in response to reduced placental perfusion.•Placenta previa is associated with the coagulative necrosis of chorionic villi and fibrin deposition intervillous space.•Placenta previa is not associated with the increased risk of neonatal mortality and morbidity.</description><subject>Abnormally invasive placenta</subject><subject>Adult</subject><subject>Case-Control Studies</subject><subject>Chorion - pathology</subject><subject>Chorionic plate area</subject><subject>Female</subject><subject>Humans</subject><subject>Parturition</subject><subject>Placenta - pathology</subject><subject>Placenta previa</subject><subject>Placenta Previa - pathology</subject><subject>Postpartum hemorrhage</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Retrospective Studies</subject><subject>Underperfusion</subject><issn>0143-4004</issn><issn>1532-3102</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtLAzEUhYMotlb_Qpmlmxlzk8yjO6VYFQq66D5kkjttyrxMZgr-e1PaunUVOHznnpxDyBxoAhSyp33S10pjO6iEUcgTYEmQr8gUUs5iDpRdkykFwWNBqZiQO-_3lNKFAHZLJmwhiqxIYUpWX-czddSrYdfV3dbqSO9Uu0UfqdZEPTrbqiPQjYPumiDbNrqkR73Dg1X35KZStceH8zsjm9XrZvkerz_fPpYv61gLLoYYVM7pgqcKIS1VRQtkKWBlDEWah09zAKGKkvOF0SIDYAxFGaxQGJrpks_I4-ls77rvEf0gG-s11rVqsRu9ZKEhgyzNs4BmJ1S7znuHleydbZT7kUDlcUK5l5cS8jihBCaDHIzzc8ZYNmj-bJfNAvB8AjAUPVh00muLrUZjHepBms7-l_ELDS2FVw</recordid><startdate>201803</startdate><enddate>201803</enddate><creator>Jung, Eun Jung</creator><creator>Cho, Hwa Jin</creator><creator>Byun, Jung Mi</creator><creator>Jeong, Dae Hoon</creator><creator>Lee, Kyung Bok</creator><creator>Sung, Moon Su</creator><creator>Kim, Ki Tae</creator><creator>Kim, Young Nam</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0897-0039</orcidid></search><sort><creationdate>201803</creationdate><title>Placental pathologic changes and perinatal outcomes in placenta previa</title><author>Jung, Eun Jung ; Cho, Hwa Jin ; Byun, Jung Mi ; Jeong, Dae Hoon ; Lee, Kyung Bok ; Sung, Moon Su ; Kim, Ki Tae ; Kim, Young Nam</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-1a730935ae15baf08e251efdd0e073103114a8b339dc461122e4bc4318d06cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abnormally invasive placenta</topic><topic>Adult</topic><topic>Case-Control Studies</topic><topic>Chorion - pathology</topic><topic>Chorionic plate area</topic><topic>Female</topic><topic>Humans</topic><topic>Parturition</topic><topic>Placenta - pathology</topic><topic>Placenta previa</topic><topic>Placenta Previa - pathology</topic><topic>Postpartum hemorrhage</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Retrospective Studies</topic><topic>Underperfusion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jung, Eun Jung</creatorcontrib><creatorcontrib>Cho, Hwa Jin</creatorcontrib><creatorcontrib>Byun, Jung Mi</creatorcontrib><creatorcontrib>Jeong, Dae Hoon</creatorcontrib><creatorcontrib>Lee, Kyung Bok</creatorcontrib><creatorcontrib>Sung, Moon Su</creatorcontrib><creatorcontrib>Kim, Ki Tae</creatorcontrib><creatorcontrib>Kim, Young Nam</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Placenta (Eastbourne)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jung, Eun Jung</au><au>Cho, Hwa Jin</au><au>Byun, Jung Mi</au><au>Jeong, Dae Hoon</au><au>Lee, Kyung Bok</au><au>Sung, Moon Su</au><au>Kim, Ki Tae</au><au>Kim, Young Nam</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Placental pathologic changes and perinatal outcomes in placenta previa</atitle><jtitle>Placenta (Eastbourne)</jtitle><addtitle>Placenta</addtitle><date>2018-03</date><risdate>2018</risdate><volume>63</volume><spage>15</spage><epage>20</epage><pages>15-20</pages><issn>0143-4004</issn><eissn>1532-3102</eissn><abstract>Placenta previa is a condition in which the placenta implants in the poorly vascularized lower uterine segment, which may result in inadequate uteroplacental perfusion, in turn, adversely affect the neonatal outcome. Abnormal placentation may also lead to severe postpartum hemorrhage as placenta separation proceeds. We aimed to evaluate the differences in placental histopathology and perinatal outcomes in pregnancies complicated with placenta previa and controls.
We undertook a retrospective case-control study of 93 pregnancies with placenta previa and 81 controls between 2011 and 2017.
Gross findings of the placenta showed that the placentas in placenta previa had significantly higher mean large chorionic plate diameters (18.5 ± 3.2 vs 17.5 ± 2.6 cm, P = .0298), chorionic plate areas (218.4 ± 62.9 cm2 vs 198.7 ± 56.0 cm2, P = .0344), and marginal cord insertion (19.8% vs 8.6%, P = .0411) than control groups. Placental histopathological findings showed that placentas in placenta previa was significantly associated with maternal underperfusion, including villous infarction (50.5% vs 25.9%, P = .0009) and increased intervillous fibrin deposition (38.7% vs 7.4%, P < .0001). Also, women in the placenta previa group had a higher rate of abnormally invasive placenta and severe postpartum hemorrhage. However, placenta previa was not associated with the increased risk of neonatal mortality and morbidity.
Abnormal placentation into the poorly vascularized lower uterine segment induces compensatory placental growth and increased surface area in response to reduced placental perfusion, which was consistent with the histopathological findings of coagulative necrosis of chorionic villi and fibrin deposition in the intervillous space. The morphological changes occurring in placenta previa may have important roles in maintaining adequate uteroplacental-fetal perfusion, which may prevent adverse neonatal outcomes.
•Placentas in placenta previa induce compensatory placental growth in response to reduced placental perfusion.•Placenta previa is associated with the coagulative necrosis of chorionic villi and fibrin deposition intervillous space.•Placenta previa is not associated with the increased risk of neonatal mortality and morbidity.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>29486851</pmid><doi>10.1016/j.placenta.2017.12.016</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-0897-0039</orcidid></addata></record> |
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| subjects | Abnormally invasive placenta Adult Case-Control Studies Chorion - pathology Chorionic plate area Female Humans Parturition Placenta - pathology Placenta previa Placenta Previa - pathology Postpartum hemorrhage Pregnancy Pregnancy Outcome Retrospective Studies Underperfusion |
| title | Placental pathologic changes and perinatal outcomes in placenta previa |
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