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Sample records for na placenta durante

  1. Evidence for active maternal-fetal transport of Na+ across the placenta of the anaesthetized rat.

    PubMed Central

    Stulc, J; Stulcová, B; Sibley, C P

    1993-01-01

    1. In order to investigate mechanisms of Na+ transfer, the unidirectional maternal-fetal clearance (Kmf) of 22Na+ and of 51Cr-EDTA (a marker of paracellular diffusion) was measured across the intact or umbilically or dually perfused placenta of the anaesthetized rat. 2. The Kmf of 22Na+ in the intact preparation (18.5 +/- 2.7 microliters min-1, mean +/- S.D., n = 105 placentas) exceeded that of 51Cr-EDTA in the same experiments (1.4 +/- 0.3 microliters min-1) by more than ten times, whereas the difference in their diffusion coefficients in water was only 2-fold. In the perfused preparations the difference in the Kmf values was 6-fold. 3. Assuming that a simple model of paracellular diffusion through wide pores was one component of transfer, the Kmf of 51Cr-EDTA and the diffusion coefficients were used to calculate a component of 22Na+ clearance (Kmf,residual) and of Na+ flux (Jmf,residual) across the perfused placentas which could not be accounted for by transfer through the paracellular route. 4. Kmf,residual of 22Na+ across the dually perfused placenta was significantly lower when temperature was reduced, the temperature quotient (Q10) of the transfer being about 2. Kmf,residual was also significantly lower when 0.1 mM ouabain was perfused on the fetal side. Jmf,residual exhibited saturation kinetics characterized by an apparent Michaelis constant (Km) of 90 mM. Kmf,residual was not influenced by 0.5 mM frusemide, 0.5 mM amiloride or by 0.5 mM hydrochlorothiazide administered to the maternal side. It was significantly increased by 1 mM alanine on the maternal side suggesting that the coupled transfer of Na+ and amino acids may contribute significantly to the maternal-fetal flux of Na+. 5. These observations suggest that most (80%) of the maternal-fetal flux of Na+ across the rat placenta is effected by active transcellular transport. This transport involves passive entry of Na+ into the trophoblast from the maternal side by a largely unknown saturable mechanism

  2. Heme oxygenase-1 promotes migration and β-epithelial Na+ channel expression in cytotrophoblasts and ischemic placentas.

    PubMed

    Warrington, Junie P; Coleman, Kayla; Skaggs, Courtney; Hosick, Peter A; George, Eric M; Stec, David E; Ryan, Michael J; Granger, Joey P; Drummond, Heather A

    2014-05-01

    Preeclampsia is thought to arise from inadequate cytotrophoblast migration and invasion of the maternal spiral arteries, resulting in placental ischemia and hypertension. Evidence suggests that altered expression of epithelial Na(+) channel (ENaC) proteins may be a contributing mechanism for impaired cytotrophoblast migration. ENaC activity is required for normal cytotrophoblast migration. Moreover, β-ENaC, the most robustly expressed placental ENaC message, is reduced in placentas from preeclamptic women. We recently demonstrated that heme oxygenase-1 (HO-1) protects against hypertension in a rat model of placental ischemia; however, whether HO-1 regulation of β-ENaC contributes to the beneficial effects of HO-1 is unknown. The purpose of this study was to determine whether β-ENaC mediates cytotrophoblast migration and whether HO-1 enhances ENaC-mediated migration. We showed that placental ischemia, induced by reducing uterine perfusion suppressed, and HO-1 induction restored, β-ENaC expression in ischemic placentas. Using an in vitro model, we found that HO-1 induction, using cobalt protoporphyrin, stimulates cytotrophoblast β-ENaC expression by 1.5- and 1.8-fold (10 and 50 μM). We then showed that silencing of β-ENaC in cultured cytotrophoblasts (BeWo cells), by expression of dominant-negative constructs, reduced migration to 56 ± 13% (P < 0.05) of control. Importantly, HO-1 induction enhanced migration (43 ± 5% of control, P < 0.05), but the enhanced migratory response was entirely blocked by ENaC inhibition with amiloride (10 μM). Taken together, our results suggest that β-ENaC mediates cytotrophoblast migration and increasing β-ENaC expression by HO-1 induction enhances migration. HO-1 regulation of cytotrophoblast β-ENaC expression and migration may be a potential therapeutic target in preeclamptic patients.

  3. Placenta abruptio

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000605.htm Placenta abruptio To use the sharing features on this page, please enable JavaScript. The placenta connects the fetus (unborn baby) to the mother's ...

  4. Placenta abruptio

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000901.htm Placenta abruption - definition To use the sharing features on this page, please enable JavaScript. The placenta is the organ that supplies food and oxygen ...

  5. Placenta previa

    PubMed Central

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

    2016-01-01

    Objectives: To review cases of placenta previa in the last 13 years in a tertiary teaching hospital to identify risk factors for maternal morbidity. Methods: 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. Results: 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. Conclusion: 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 <36 weeks, and estimated blood loss >2000 ml. PMID:27381536

  6. Morbidly adherent placenta.

    PubMed

    Abuhamad, Alfred

    2013-10-01

    Morbidly adherent placenta, which describes placenta accreta, increta, and percreta, implies an abnormal implantation of the placenta into the uterine wall. The incidence of placenta accreta has increased significantly over the past several decades, with the main risk factors include prior cesarean section and placental previa. Sonographic markers of placenta accreta can be present as early as the first trimester and include a low uterine implantation of a gestational sac, multiple vascular lacunae within the placenta, loss of the normal hypoechoic retroplacental zone, and abnormality of the uterine serosa-bladder interface, among others. Ultrasound has high sensitivity and specificity for the diagnosis of placenta accreta and MRI should be reserved for rare cases in which the ultrasound is non-diagnostic. The optimum time for planned delivery for a patient with placenta accreta is around 34-35 weeks following a course of corticosteroid injection. The successful management of placenta accreta includes a multidisciplinary care team approach with the successful management relying heavily on the prenatal diagnosis of this entity and preparing for the surgical management in a multidisciplinary approach by assuring the most skilled team is available for those patients.

  7. Placenta accreta following hysteroscopic myomectomy.

    PubMed

    Tanaka, Mie; Matsuzaki, Shinya; Matsuzaki, Satoko; Kakigano, Aiko; Kumasawa, Keiichi; Ueda, Yutaka; Endo, Masayuki; Kimura, Tadashi

    2016-06-01

    Hardly any report exists on the influence of hysteroscopic myomectomy on subsequent pregnancy. Placenta accreta is most often associated with placenta previa in women with multiple prior cesarean sections. We report the first case of placenta accreta without placenta previa during the first pregnancy subsequent to hysteroscopic myomectomy.

  8. Pseudotumors of the placenta.

    PubMed

    Bruner, Evelyn T

    2016-01-01

    The placenta is one of the most common gross pathology specimens encountered by surgical pathologists, yet primary tumors are exceptionally rare and even rarer are entities with the potential to mimic malignancy. There are many nonneoplasticmass forming lesions in the placenta that are important to be aware of as many of these can be associated with adverse outcomes in the mother and fetus. Also important are entities which may be observed microscopically in the placenta and potentially confused as a malignancy. Knowledge of these potential pitfalls is essential to avoid making an incorrect diagnosis and causing undue alarm.

  9. Steps of glucocorticoid action in normal and diabetic rat placenta.

    PubMed

    Heller, C L; Weisenberg, L S; Ortí, E; De Nicola, A F

    1988-07-01

    This investigation examined the effects of Streptozotocin diabetes in pregnancy on several parameters of glucocorticoid action in the rat placenta. Pregnant diabetic rats showed reduced body weight, increased adrenal weight and serum corticosterone concentrations. Glucocorticoid receptors in placental cytosol of labyrinthine zone, measured in the absence of MoO4Na2 were similar in control and diabetic rats, but after addition of MoO4Na2 receptor number were moderately, but significantly reduced in diabetic placentas (P less than 0.01). No changes in affinity were detected in saturation analysis. Furthermore, transformation of the receptor assessed by its capacity for binding to DNA-cellulose, was enhanced in diabetic animals, suggesting increased efficiency of the receptor-bound hormone. Since the function of the glucocorticoid receptor of rat placenta may be the inhibition of local progesterone production (Heller and De Nicola, J. steroid Biochem. 19 (1983) 1339-1343), we determined progesterone synthesis in vitro and found that diabetic placentas synthesized significantly less progesterone than control tissue (P less than 0.05). Lastly, we found that the metabolism of corticosterone to 11-dehydrocorticosterone, while declining in control placentas as pregnancy advanced, it was sustained in diabetic pregnancy. It is suggested that diabetic rat placentas showed increased activity towards the glucocorticoid receptor, resulting in reduction in progesterone synthesis and sustained catabolism of corticosterone. The latter may possibly constitute a compensatory mechanism to protect the fetal compartment from high levels of maternal glucocorticoids.

  10. The placenta in preeclampsia

    PubMed Central

    Roberts, James M.; Escudero, C.

    2012-01-01

    The root cause of preeclampsia is the placenta. Preeclampsia begins to abate with the delivery of the placenta and can occur in the absence of a fetus but with the presence of trophoblast tissue with hydatidiform moles. In view of this, study of the placenta should provide insight into the pathophysiology of preeclampsia. In this presentation we examine placental pathological and pathophysiological changes with preeclampsia and fetal growth restriction (FGR). It would seem that this comparison should be illuminating as both conditions are associated with similarly abnormal placentation yet only in preeclampsia is there a maternal pathophysiological syndrome. Similar insights about early and late onset preeclampsia should also be provided by such information. We report that the placental abnormalities in preeclampsia are what would be predicted in a setting of reduced perfusion and oxidative stress. However, the differences from FGR are inconsistent. The most striking differences between the two conditions are found in areas that have been the least studied. There are differences between the placental findings in early and late onset preeclampsia but whether these are qualitative, indicating different diseases, or simply quantitative differences within the same disease is difficult to determine. We attempt to decipher the true differences, seek an explanation for the disparate results and provide recommendations that we hope may help resolve these issues in future studies. PMID:22745921

  11. Adenyl cyclase in the human placenta.

    PubMed

    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.

  12. Differential expression of calcium transport channels in placenta primary cells and tissues derived from preeclamptic placenta.

    PubMed

    Yang, Hyun; Kim, Tae-Hee; An, Beum-Soo; Choi, Kyung-Chul; Lee, Hae-Hyeog; Kim, Jong-Min; Jeung, Eui-Bae

    2013-03-10

    Preeclampsia is a pregnancy-specific disease characterized by hypertension, proteinuria, and oxidative stress in the placenta. During the last trimester of gestation, calcium (Ca(2+)) transport from mother to fetus increases dramatically in response to the increased demand for Ca(2+) caused by bone mineralization in the fetus. Ca(2+) supplementation can significantly reduce the incidence and severity of preeclampsia or delay its onset. Ca(2+) transport channels (CTCs) include transient receptor potential vanilloid 6 (TRPV6), plasma membrane Ca(2+) ATPase (PMCA1), and Na(+)/Ca(2+) exchangers (NCKX3 or NCX1). We hypothesized that trans-placental Ca(2+) exchange in preeclamptic trophoblasts may be compensated for successful fetal bone mineralization. The roles of cell membrane channels (TRPV6, PMCA1, NCKX3 and NCX1) were examined in placental primary cells and in normotensive and preeclamptic placentas. The biomarker gene for preeclampsia, soluble fms-like tyrosine kinase-1 (sFLT1) or marker for oxygen-sensitive gene, hypoxia-sensitive inducible factor 1α (HIF-1α), were up-regulated in the preeclamptic placentas and hypoxic cells. The detection of sFLT1 and HIF-1α genes demonstrated that our experimental conditions were suitable to verify a preeclamptic condition. In women experiencing preterm labor, CTC expressions was found to be increased in the fetal and maternal regions of the preeclamptic placenta compared to the observed in normotensive placenta. During term labor, TRPV6 and PMCA1 were highly expressed in the fetal and maternal sections of preeclamptic placenta, while the expression of NCKX3 and NCX1 was reduced. In addition, the expression of CTCs was altered in hypoxia-stressed placental cells. Taken together, our findings demonstrated that the expression of CTCs was regulated by hypoxia stress in placenta tissues and cells, suggesting that our experimental in vitro hypoxic conditions were similar to those of preeclampsia. Furthermore, impaired Ca(2

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

    MedlinePlus

    ... 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 ...

  14. Placenta percreta and the urologist.

    PubMed

    Konijeti, Ramdev; Rajfer, Jacob; Askari, Asghar

    2009-01-01

    Placenta percreta, the rarest and most severe form of placenta accreta, can involve the urinary bladder. Because of its propensity for severe hemorrhage, it is a potentially life-threatening condition. Although commonly discovered at the time of delivery, antenatal diagnosis may be achieved with ultrasound, magnetic resonance imaging, and/or cystoscopy. Every attempt should be made to minimize potential for blood loss by avoiding removal of the placenta at the time of delivery and either performing a hysterectomy or using methotrexate therapy to ablate the residual placenta in the postpartum period. If hemorrhage does occur during delivery, immediate surgical removal of the uterus should be considered and, depending on the severity of the hemorrhage and the depth of invasion of the placenta into the bladder, excision and/or reconstruction of the bladder may be necessary.

  15. Placenta accreta and anesthesia: A multidisciplinary approach.

    PubMed

    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.

  16. Urological Manifestations of Placenta Percreta

    PubMed Central

    Ibrahim, Mina A.; Liu, Angela; Dalpiaz, Amanda; Schwamb, Richard; Warren, Kelly; Khan, Sardar A.

    2015-01-01

    Placenta percreta is a condition of pregnancy associated with abnormal decidua placenta. It is characterized by invasion of chorionic villi past the myometrium and serosa, towards urogenital organs. Complications include massive hemorrhage, bladder dysfunction, and severe infections during delivery. Reports suggest an increasing prevalence of this condition. From a urological perspective, this review suggests how early diagnostic modalities, effective treatment plans, and appropriate surgical methods may aid in decreasing the morbidity and mortality of placenta percreta. The importance of maintaining bladder integrity during hysterectomy is emphasized. PMID:26889119

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

    PubMed

    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.

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

    PubMed

    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 < 0.001), recurrent abortions (11% vs. 5%, p < 0.001). Patients with placenta previa had higher rates of vaginal bleeding in the second half of pregnancy (3% vs. 0%, p < 0.001), gestational diabetes (8% vs. 5.5%, p < 0.001), placental abruption (10% vs. 1%, p < 0.001), adherent placenta (4% vs. 0.5%, p < 0.001), preterm delivery (52% vs. 8%, p < 0.001), with a median gestational age of 36 vs. 39 weeks, p < 0.001. The composite outcome was significantly more prevalent in the placenta previa group (21% vs. 13%, p < 0,001). 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. Copyright © 2017. Published by Elsevier B.V.

  19. Heparin treatment in abruptio placentae

    PubMed Central

    Martin, T. R.; Read, H. C.; Fraser, M. E.

    1974-01-01

    Two cases of abruptio placentae with disseminated intravascular coagulation (DIC) were treated with heparin, and coagulation was monitored by thromboelastography as well as the usual hematology tests. The cases demonstrated the vagaries of DIC and both showed decreased overt hemorrhage after heparin treatment was started. Heparin may be indicated for the management of abruptio placentae where delivery is not imminent, where significant disseminated intravascular coagulation exists, and when adequate serial coagulation studies are available. ImagesFIG. 1 PMID:4829841

  20. Placenta accreta: adherent placenta due to Asherman syndrome

    PubMed Central

    Engelbrechtsen, Line; Langhoff-Roos, Jens; Kjer, Jens Joergen; Istre, Olav

    2015-01-01

    Key Clinical Message 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. PMID:25838908

  1. Interaction of Digibind with endogenous cardiotonic steroids from preeclamptic placentae

    PubMed Central

    Fedorova, Olga V.; Tapilskaya, Natalia I.; Bzhelyansky, Anton M.; Frolova, Elena V.; Nikitina, Elena R.; Reznik, Vitaly A.; Kashkin, Vladimir A.; Bagrov, Alexei Y.

    2009-01-01

    Background Preeclampsia (PE) is a major cause of maternal and fetal mortality, and its pathogenesis is not fully understood. Endogenous digitalis-like cardiotonic steroids (CTS) have been implicated in the pathophysiology of PE; this is illustrated by clinical observations that Digibind, a therapeutic digoxin antibody fragment which binds CTS, lowers blood pressure and reverses Na/K-ATPase inhibition in patients with PE. Recently we reported that plasma levels of marinobufagenin (MBG), a bufadienolide vasoconstrictor CTS, are increased four-fold in patients with severe PE. Methods In the present study, we compared levels of MBG in normal and PE placentae, as well as the interactions of Digibind and antibodies against MBG and ouabain with material purified from PE placentae using high-performance liquid chromatography (HPLC). Results Levels of endogenous MBG, but not that of endogenous ouabain, exhibited a four-fold elevation in PE placentae vs. normal placentae (13.6±2.5 and 48.6±7.0 nmoles/g tissue; P<0.01). The elution time of endogenous placental MBG-like immunoreactive material from reverse-phase HPLC column was identical to that of authentic MBG. A competitive immunoassay based on Digibind exhibited reactivity to HPLC fractions having retention times similar to that seen with MBG and other bufadienolides, but no to ouabain-like immunoreactive material. Conclusions Our results suggest that elevated levels of endogenous bufadienolide CTS represent a potential target for immunoneutralization in patients with PE. PMID:19927009

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

    PubMed

    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.

  3. The presence of xenobiotic transporters in rat placenta.

    PubMed

    Leazer, Tyra M; Klaassen, Curtis D

    2003-02-01

    Understanding the role of transporters in placental handling of xenobiotics across the maternal-fetal interface is essential to evaluate the pharmacological and toxicological potential of therapeutic agents, drugs of abuse, and other xenobiotics to which the mother is exposed during pregnancy. Therefore, the purpose of this study was to assess mRNA levels of various transporters in placenta and to compare these to levels in maternal liver and kidney, predominant organs of excretion, to determine which transporters are likely to have a role in xenobiotic transfer within the placenta. During late stage pregnancy, relative amounts of mRNA levels of 40 genes representing 11 families/group of transporters were assessed in placenta with respect to relative maternal liver and kidney mRNA levels. Members of the following transporter families were assessed: three multidrug resistance (Mdr), six multidrug resistance-associated protein (Mrp), eight organic anion-transporting polypeptide (Oatp), three organic anion transporters (Oat), five organic cation transporters (Oct), two bile acid transporters (Na(+)/taurocholate-cotransporting polypeptide and bile salt export protein), four metal (ZnT1, divalent metal transporter 1, Menkes and Wilsons), a prostaglandin, two peptide, two sterolin, and four nucleoside transporters. Of the 40 genes evaluated, 16 [Mdr1a and 1b, Mrp1 and 5, Oct3 and Octn1, Oatp3 and 12, four metal, a prostaglandin, AbcG8, equilibrative nucleoside transporter 1 (ENT1), and ENT2] were expressed in placenta at concentrations similar to or higher than in maternal liver and kidney. The abundance of these mRNA transcripts in placenta suggests a role for these transporters in placental transport of xenobiotics and supports their role in the transport of endogenous substances.

  4. Adenomyosis in pregnancy mimicking morbidly adherent placenta

    PubMed Central

    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

  5. Optimal transport and the placenta

    SciTech Connect

    Morgan, Simon; Xia, Qinglan; Salafia, Carolym

    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.

  6. Placenta accreta spectrum: accreta, increta, and percreta.

    PubMed

    Silver, Robert M; Barbour, Kelli D

    2015-06-01

    Placenta accreta can lead to hemorrhage, resulting in hysterectomy, blood transfusion, multiple organ failure, and death. Accreta has been increasing steadily in incidence owing to an increase in the cesarean delivery rate. Major risk factors are placenta previa in women with prior cesarean deliveries. Obstetric ultrasonography can be used to diagnose placenta accreta antenatally, which allows for scheduled delivery in a multidisciplinary center of excellence for accreta. Controversies exist regarding optimal management, including optimal timing of delivery, surgical approach, use of adjunctive measures, and conservative (uterine-sparing) therapy. We review the definition, risk factors, diagnosis, management, and controversies regarding placenta accreta.

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

    PubMed

    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 (p<0.01, odds ratio 15.6, 95%CI 2.1-114.6) was a single significant predictor of adherent placenta 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.

  8. Increased placental trophoblast inclusions in placenta accreta.

    PubMed

    Adler, E; Madankumar, R; Rosner, M; Reznik, S E

    2014-12-01

    Trophoblast inclusions (TIs) are often found in placentas of genetically abnormal gestations. Although best documented in placentas from molar pregnancies and chromosomal aneuploidy, TIs are also associated with more subtle genetic abnormalities, and possibly autism. Less than 3% of non-aneuploid, non-accreta placentas have TIs. We hypothesize that placental genetics may play a role in the development of placenta accreta and aim to study TIs as a potential surrogate indicator of abnormal placental genetics. Forty cases of placenta accreta in the third trimester were identified in a search of the medical records at one institution. Forty two third trimester control placentas were identified by a review of consecutively received single gestation placentas with no known genetic abnormalities and no diagnosis of placenta accreta. Forty percent of cases with placenta accreta demonstrated TIs compared to 2.4% of controls. More invasive placenta accretas (increta and percreta) were more likely to demonstrate TIs than accreta (47% versus 20%). Prior cesarean delivery was more likely in accreta patients than controls (67% versus 9.5%). Placenta accreta is thought to be the result of damage to the endometrium predisposing to abnormal decidualization and invasive trophoblast growth into the myometrium. However, the etiology of accreta is incompletely understood with accreta frequently occurring in women without predisposing factors and failing to occur in predisposed patients. This study has shown that TIs are present at increased rates in cases of PA. Further studies are needed to discern what underlying pathogenic mechanisms are in common between abnormal placentation and the formation of TIs. Published by Elsevier Ltd.

  9. Placenta percreta: methotrexate treatment and MRI findings.

    PubMed

    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.

  10. Bupropion metabolism by human placenta

    PubMed Central

    Wang, Xiaoming; Abdelrahman, Doaa R.; Zharikova, Olga L.; Patrikeeva, Svetlana L.; Hankins, Gary D.V.; Ahmed, Mahmoud S.; Nanovskaya, Tatiana N.

    2010-01-01

    Smoking during pregnancy is the largest modifiable risk factor for pregnancy-related morbidity and mortality. The success of bupropion for smoking cessation warrants its investigation for treatment of pregnant patients. Nevertheless, the use of bupropion for the treatment of pregnant smokers requires additional data on its biodisposition during pregnancy. Therefore, the aim of this investigation was to determine the metabolism of bupropion in placentas obtained from nonsmoking and smoking women, identify metabolites formed and the enzymes catalyzing their formation, as well as the kinetics of the reaction. Data obtained revealed that human placentas metabolized bupropion to hydroxybupropion, erythro- and threohydrobupropion. The rates for formation of erythro- and threohydrobupropion exceeded that for hydroxybupropion by several folds, were dependent on the concentration of bupropion and exhibited saturation kinetics with an apparent Km value of 40 μM. Human placental 11β-hydroxysteroid dehydrogenases were identified as the major carbonyl-reducing enzymes responsible for reduction of bupropion to threo- and erythrohydrobupropion in microsomal fractions. On the other hand, CYP2B6 was responsible for formation of OH-bupropion. These data suggest that both placental microsomal carbonyl-reducing and oxidizing enzymes are involved in metabolism of bupropion. PMID:20109440

  11. Regeneration of ascorbic acid in human placenta

    SciTech Connect

    Rose, R.C.; Bode, A.M. )

    1990-02-26

    The free radical scavenging function of ascorbic acid (AA) results in the formation of the oxidized form of the vitamin, dehydro-L-ascorbic acid (DHAA). The enzymatic reduction of DHAA may be an important means of recycling and conserving ascorbic acid in various tissues. The role of the human placenta in the enzymatic reduction of the potentially toxic oxidized form was examined in tissue homogenized in 50 mM MOPs buffer. Assay of DHAA, AA, DKG (diketogulonic acid) were made by HPLC and liquid scintillation counting. Activity of the placental factor in reducing DHAA was dependent on the presence of both NADPH and GSH. Activity was reduced 81% by incubation with 2% trypsin and was unaffected by BSA, glycerol, EtOH, or Na-AZIDE. Inhibition was observed with 10 mM EDTA and 0.2M KCI but not with 1 mM EDTA or 0.1 M KCI or less. Studies are underway to further purify and characterize the enzyme(s) responsible for the observed activity.

  12. Optimal management strategies for placenta accreta.

    PubMed

    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.

  13. Transport of calcium by the placenta of the rat.

    PubMed Central

    Stulc, J; Stulcová, B

    1986-01-01

    Transport of 45Ca and of radioactively labelled inert saccharides across the intact or perfused placenta was measured in the rat on day 21 of pregnancy, the day after mating being day 1. The values of permeability--surface area product (PS) of the intact placenta to radioactive mannitol, sucrose, raffinose, and methoxyinulin were approximately proportional to their diffusion coefficients in water. This suggests that diffusion of inert hydrophilic molecules across the rat placenta takes place through wide aqueous channels. Net flux of Ca from mother to fetus, estimated from the increase of the fetal Ca content between day 20 and day 21 is 100 +/- 4 nmol min-1 (the limits here and below are S.E. of means). The unidirectional maternal-fetal flux of Ca (Jmf) in non-anaesthetized animals, estimated from the flux of 45Ca, is 100 +/- 7 nmol min-1. The similarity of the two values suggests that the fetal-maternal flux (Jfm) is small The umbilical vascular bed of the rat placenta was perfused in situ with Krebs-dextran fluid. Jmf estimated from the transfer of 45Ca from maternal plasma to perfusate was 81 +/- 4 nmol min-1. PS of the perfused placenta to radioactive sucrose was 2.6 +/- 0.3 microliter min-1. Jmf decreased reversibly when the placenta was perfused with 0.5 mM-dinitrophenol or 1 mM-CN-, which is consistent with the presumed active nature of the maternal-fetal transport of Ca. Jmf did not decrease when the placenta was perfused with Na-free fluids (substitution with Tris, Li or sucrose), indicating that Na-Ca exchange across the fetal border of the placental trophoblast is not involved in maternal-fetal transport of Ca. Transport of 45Ca to the perfusate was reduced to about 60% when maternal plasma concentration of Ca was doubled. This suggests that the affinity of the maternal-fetal transport system to Ca is high. Jmf did not change when the umbilical concentration of Ca was varied between 0.1 and 3 mM. There thus seems to be no rapid feed-back between

  14. TPRV-1 expression in human preeclamptic placenta.

    PubMed

    Martínez, Nora; Abán, Cyntia E; Leguizamón, Gustavo F; Damiano, Alicia E; Farina, Mariana G

    2016-04-01

    Preeclampsia is a multisystem disorder unique to human pregnancy, characterized by abnormal placentation. Although its causes remain unclear, it is known that the expression of several transporters is altered. Transient receptor potential vanilloid 1 (TRPV-1) is a nonselective cation channel, present in human placenta. Here, we evaluated the expression of TRPV-1 in preeclamptic placentas. We observed a deregulation in TRPV-1 expression in these placentas which may explain the impaired Ca(2+) homeostasis found in preeclampsia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Autophagy in term normal human placentas.

    PubMed

    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.

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

    PubMed

    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.

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

    MedlinePlus

    ... pressure. High blood pressure can affect your placenta. Twin or other multiple pregnancy. If you're pregnant with more than one baby, you might be at increased risk of certain placental problems. Blood-clotting disorders. Any ...

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

    PubMed

    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.

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

    PubMed Central

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

    2015-01-01

    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-naı¨ve 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. PMID:25888622

  20. Genomic imprinting in the human placenta.

    PubMed

    Monk, David

    2015-10-01

    With the launch of the National Institute of Child Health and Human Development/National Institutes of Health Human Placenta Project, the anticipation is that this often-overlooked organ will be the subject of much intense research. Compared with somatic tissues, the cells of the placenta have a unique epigenetic profile that dictates its transcription patterns, which when disturbed may be associated with adverse pregnancy outcomes. One major class of genes that is dependent on strict epigenetic regulation in the placenta is subject to genomic imprinting, the parent-of-origin-dependent monoallelic gene expression. This review discusses the differences in allelic expression and epigenetic profiles of imprinted genes that are identified between different species, which reflect the continuous evolutionary adaption of this form of epigenetic regulation. These observations divulge that placenta-specific imprinted gene that is reliant on repressive histone signatures in mice are unlikely to be imprinted in humans, whereas intense methylation profiling in humans has uncovered numerous maternally methylated regions that are restricted to the placenta that are not conserved in mice. Imprinting has been proposed to be a mechanism that regulates parental resource allocation and ultimately can influence fetal growth, with the placenta being the key in this process. Furthermore, I discuss the developmental dynamics of both classic and transient placenta-specific imprinting and examine the evidence for an involvement of these genes in intrauterine growth restriction and placenta-associated complications. Finally, I focus on examples of genes that are regulated aberrantly in complicated pregnancies, emphasizing their application as pregnancy-related disease biomarkers to aid the diagnosis of at-risk pregnancies early in gestation.

  1. Colonization of second-trimester placenta parenchyma.

    PubMed

    Onderdonk, Andrew B; Hecht, Jonathan L; McElrath, Thomas F; Delaney, Mary L; Allred, Elizabeth N; Leviton, Alan

    2008-07-01

    The overtly healthy, nonpregnant uterus harbors bacteria, Mycoplasma and Ureaplasma. The extent of colonization remains elusive, as are relationships between isolated microorganisms, preterm labor and fetal inflammation. Biopsy specimens of chorion parenchyma from 1083 placentas delivered before the beginning of the 28th week of gestation were cultured, and the placentas were examined histologically. The frequencies of individual microorganisms and groups of microorganisms were evaluated in strata of processes leading to preterm delivery, routes of delivery, gestational age, and placenta morphology. Placentas delivered by cesarean section with preeclampsia had the lowest bacterial recovery rate (25%). Preterm labor had the highest rates, which decreased with increasing gestational age from 79% at 23 weeks to 43% at 27 weeks. The presence of microorganisms in placenta parenchyma was associated with the presence of neutrophils in the fetal stem vessels of the chorion or in the vessels of the umbilical cord. The high rate of colonization appears to coincide with phenomena associated with preterm delivery and gestational age. The presence of microorganisms within placenta parenchyma is biologically important.

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

    PubMed

    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.

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

    PubMed Central

    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

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

    PubMed

    Findeklee, S; Costa, S D

    2015-08-01

    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.

  5. [Management of placenta previa and accreta].

    PubMed

    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.

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

    PubMed

    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 < .001). The area under the receive operating characteristic curve was 0.72 for previous cesarean delivery alone, increasing to 0.77 with the combination of the mean PI and previous cesarean delivery (P = .047). This study suggests that the mean PI measured by uterine artery Doppler velocimetry is reduced in patients with 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.

  7. Toward an integrated evolutionary understanding of the mammalian placenta

    PubMed Central

    Wildman, Derek E.

    2012-01-01

    The placenta is fundamentally important for the success of pregnancy. Disruptions outside the normal range for placenta 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 placenta expressed and imprinted genes from a phylogenetically diverse range of species is appropriate for unraveling the conserved and derived aspects of placenta biology. PMID:21306776

  8. [Placenta percreta with bladder and rectum invasion].

    PubMed

    Tórrez-Morales, Froilán; Briones-Garduño, Jesús Carlos

    Placenta percreta may lead to massive obstetric haemorrhage, haemodynamic decompensation, and ultimately death. Total obstetric hysterectomy is universally accepted as treatment; however, the emergence of new techniques such as the uterine artery angioembolisation approach, and the use of chemotherapy agents such as methotrexate, are alternatives also described in the literature. A 28 year-old patient, in her fourth gestation, with a previous history of 2 vaginal and 1 caesarean birth 4, in her 28.4 week of pregnancy, by second trimester ultrasound, was diagnosed with placenta percreta with bladder and rectal invasion using magnetic resonance imaging. Multidisciplinary and sequential treatment included: Caesarean with placenta in situ, uterine artery embolisation immediately after caesarean, chemotherapy with methotrexate weekly for 4 doses, and finally obstetric hysterectomy after bilateral hypogastric artery ligation. The outcome was favourable and the patient was discharged in good general condition. The protocoled and sequential management including selective embolization immediately after caesarean section with placenta in situ, weekly chemotherapy with methotrexate and obstetric hysterectomy, preceded by bilateral ligation of the hypogastric arteries, is a therapeutic alternative to be considered in cases of placenta percreta. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  9. Drugs of abuse and human placenta

    PubMed Central

    Ganapathy, Vadivel

    2013-01-01

    Drugs of abuse such as cocaine and amphetamines, when used by pregnant women, exert deleterious effects on the fetus. These drugs produce their effects through inhibition of the serotonin transporter, norepinephrine transporter, and dopamine transporter. The inhibition can occur in the pregnant mother as well as in the fetus. These events contribute to the detrimental effects of these drugs on the fetus. However, the role of placenta, which serves as the link between the pregnant mother and the fetus, in the process remains understudied. It has been assumed that placenta did not play any direct role in the process except that it allowed the passage of these drugs from maternal circulation into fetal circulation. This was before the discovery that placenta expresses two of the three monoamine transporters. The serotonin transporter and the norepinephrine transporter are expressed on the maternal-facing side of the syncytiotrophoblast, thus exposed to the inhibitory actions of cocaine and amphetamines if present in maternal blood. Inhibition of these transporters in placenta could lead to elevation of serotonin and norepinephrine in the intervillous space that may cause uterine contraction and vasoconstriction, resulting in premature delivery, decreased placental blood flow, and intrauterine growth retardation. Thus, the placenta is actually a direct target for these abusable drugs. Since the placental serotonin transporter and norepinephrine transporter are also inhibited by many antidepressants, therapeutic use of these drugs in pregnant women may have similar detrimental effects on placental function and fetal growth and development. PMID:20932493

  10. Effect of Placenta Previa on Fetal Growth

    PubMed Central

    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 <10th percentile by the Alexander growth standard. Univariable, stratified and multivariable analyses were used to estimate the effect of 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

  11. REVIEW: GENETIC MANIPULATION OF THE RODENT PLACENTA

    PubMed Central

    Renaud, Stephen J.; Rumi, M.A. Karim; Soares, Michael J.

    2011-01-01

    The principal role of the placenta is the maintenance of pregnancy and promotion of fetal growth and viability. The use of transgenic rodents has greatly enhanced our understanding of placental development and function. However, embryonic lethality is often a confounding variable in determining whether a genetic modification adversely affected placental development. In these cases, it is beneficial to specifically manipulate the placental genome. The purpose of this review is to summarize available methodologies for specific genetic modification of the rodent placenta. By restricting genetic alterations to the trophoblast lineage, it is possible to gain a deeper understanding of placental development that perhaps will lead to gene-targeted therapies to rescue irregular placentation in transgenic animals or in women at high-risk for placenta-associated pregnancy complications. PMID:21256588

  12. Oxidative Stress in Placenta: Health and Diseases

    PubMed Central

    Wu, Fan; Tian, Fu-Ju; Lin, Yi

    2015-01-01

    During pregnancy, development of the placenta is interrelated with the oxygen concentration. Embryo development takes place in a low oxygen environment until the beginning of the second trimester when large amounts of oxygen are conveyed to meet the growth requirements. High metabolism and oxidative stress are common in the placenta. Reactive oxidative species sometimes harm placental development, but they are also reported to regulate gene transcription and downstream activities such as trophoblast proliferation, invasion, and angiogenesis. Autophagy and apoptosis are two crucial, interconnected processes in the placenta that are often influenced by oxidative stress. The proper interactions between them play an important role in placental homeostasis. However, an imbalance between the protective and destructive mechanisms of autophagy and apoptosis seems to be linked with pregnancy-related disorders such as miscarriage, preeclampsia, and intrauterine growth restriction. Thus, potential therapies to hold oxidative stress in leash, promote placentation, and avoid unwanted apoptosis are discussed. PMID:26693479

  13. Transcriptome landscape of the human placenta

    PubMed Central

    2012-01-01

    Background The placenta is a key component in understanding the physiological processes involved in pregnancy. Characterizing genes critical for placental function can serve as a basis for identifying mechanisms underlying both normal and pathologic pregnancies. Detailing the placental tissue transcriptome could provide a valuable resource for genomic studies related to placental disease. Results We have conducted a deep RNA sequencing (RNA-Seq) study on three tissue components (amnion, chorion, and decidua) of 5 human placentas from normal term pregnancies. We compared the placental RNA-Seq data to that of 16 other human tissues and observed a wide spectrum of transcriptome differences both between placenta and other human tissues and between distinct compartments of the placenta. Exon-level analysis of the RNA-Seq data revealed a large number of exons with differential splicing activities between placenta and other tissues, and 79% (27 out of 34) of the events selected for RT-PCR test were validated. The master splicing regulator ESRP1 is expressed at a proportionately higher level in amnion compared to all other analyzed human tissues, and there is a significant enrichment of ESRP1-regulated exons with tissue-specific splicing activities in amnion. This suggests an important role of alternative splicing in regulating gene function and activity in specific placental compartments. Importantly, genes with differential expression or splicing in the placenta are significantly enriched for genes implicated in placental abnormalities and preterm birth. In addition, we identified 604-1007 novel transcripts and 494-585 novel exons expressed in each of the three placental compartments. Conclusions Our data demonstrate unique aspects of gene expression and splicing in placental tissues that provide a basis for disease investigation related to disruption of these mechanisms. These data are publicly available providing the community with a rich resource for placental

  14. Evidence of Human Papillomavirus in the Placenta

    PubMed Central

    Weyn, Christine; Thomas, Dominique; Jani, Jacques; Guizani, Meriem; Donner, Cathérine; Van Rysselberge, Michel; Hans, Christine; Bossens, Michel; Englert, Yvon

    2011-01-01

    Human papillomavirus (HPV) is an epitheliotropic virus typically infecting keratinocytes but also possibly epithelial trophoblastic placental cells. In the present study, we set out to investigate whether HPV can be recovered from transabdominally obtained placental cells to avoid any confounding contamination by HPV-infected cervical cells. Thirty-five placental samples from women undergoing transabdominal chorionic villous sampling were analyzed, and we detected HPV-16 and HPV-62 in 2 placentas. This study suggests that HPV infection of the placenta can occur early in pregnancy. The overall clinical implication of these results remains to be elucidated. PMID:21208925

  15. Nitroglycerin for management of retained placenta.

    PubMed

    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

  16. Escalating placenta invasiveness: repeated placenta accreta at the limit of viability.

    PubMed

    Greenbaum, Shirley; Khashper, Alla; Leron, Elad; Ohana, Eric; Meirovitz, Mihai; Hershkovitz, Reli; Erez, Offer

    2016-01-01

    Placenta percreta is an obstetric condition in which the placenta invades through the myometrium. This is the most severe form of placenta accreta and may result in spontaneous uterine rupture, a rare complication that threatens the life of both mother and fetus. In this case report, we describe a 32-year-old woman in her fourth pregnancy, diagnosed with repeated placenta accreta, which was eventually complicated by spontaneous uterine rupture at 24 weeks' gestation. This patient had a history of abnormal placentation in prior pregnancies and previous uterine injuries. This case demonstrates a pattern of escalating placental invasiveness, and raises questions regarding the process of abnormal placentation and the manifestation of uterine rupture in scarred uteri.

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

    PubMed Central

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

    2014-01-01

    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. PMID:26199801

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

    PubMed

    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. Modeling Oxygen Transport in the Human Placenta

    NASA Astrophysics Data System (ADS)

    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.

  20. Placenta previa and maternal hemorrhagic morbidity.

    PubMed

    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.

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

    PubMed

    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, vessels, glands, membranes, and many others. It may be expected that in many cases the relevance of results obtained from human placenta will be higher than those from animal models due to species specificity of metabolism and placental structure. For practical and economical reasons, we propose to apply a battery of sequential experiments for analysis of potential toxicants. This should start with using cell lines, followed by testing placenta tissue explants and isolated placenta cells, and finally by application of single and dual side ex vivo placenta perfusion. With each of these steps, the relative workload increases while the number of feasible repeats decreases. Simultaneously, the predictive power enhances by increasing similarity with in vivo human conditions. Toxic effects may be detected by performing proliferation, vitality and cell death assays, analysis of protein and hormone expression, immunohistochemistry or testing functionality of signaling pathways, gene expression, transport mechanisms, and so on. When toxic effects appear at any step, the subsequent assays may be cancelled. Such a system may be useful to reduce costs and increase specificity in testing questionable toxicants. Nonetheless, it requires further standardization and end point definitions for better comparability of results from different toxicants and to estimate the respective in vivo translatability and predictive value.

  2. The Placenta in Toxicology. Part IV: Battery of Toxicological Test Systems Based on Human Placenta

    PubMed Central

    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, vessels, glands, membranes, and many others. It may be expected that in many cases the relevance of results obtained from human placenta will be higher than those from animal models due to species specificity of metabolism and placental structure. For practical and economical reasons, we propose to apply a battery of sequential experiments for analysis of potential toxicants. This should start with using cell lines, followed by testing placenta tissue explants and isolated placenta cells, and finally by application of single and dual side ex vivo placenta perfusion. With each of these steps, the relative workload increases while the number of feasible repeats decreases. Simultaneously, the predictive power enhances by increasing similarity with in vivo human conditions. Toxic effects may be detected by performing proliferation, vitality and cell death assays, analysis of protein and hormone expression, immunohistochemistry or testing functionality of signaling pathways, gene expression, transport mechanisms, and so on. When toxic effects appear at any step, the subsequent assays may be cancelled. Such a system may be useful to reduce costs and increase specificity in testing questionable toxicants. Nonetheless, it requires further standardization and end point definitions for better comparability of results from different toxicants and to estimate the respective in vivo translatability and predictive value. PMID:23548605

  3. Transcriptome profile of the human placenta.

    PubMed

    Majewska, Marta; Lipka, Aleksandra; Paukszto, Lukasz; Jastrzebski, Jan Pawel; Myszczynski, Kamil; Gowkielewicz, Marek; Jozwik, Marcin; Majewski, Mariusz Krzysztof

    2017-03-01

    The human placenta is a particular organ that inseparably binds the mother and the fetus. The proper development and survival of the conceptus relies on the essential interplay between maternal and fetal factors involved in cooperation within the placenta. In our study, high-throughput sequencing (RNA-seq) was applied to analyze the global transcriptome of the human placenta during uncomplicated pregnancies. The RNA-seq was utilized to identify the global pattern of the gene expression in placentas (N = 4) from women in single and twin pregnancies. During analyses, we obtained 228,044 transcripts. More than 91% of them were multi-exon, and among them 134 were potentially unknown protein coding genes. Expression levels (FPKM) were estimated for 38,948 transcriptional active regions, and more than 3000 of genes were expressed with FPKM >20 in each sample. Additionally, all unannotated transcripts with estimated FPKM values were localized on the human genome. Highly covered splice junctions unannotated in the human genome (6497) were identified, and among them 30 were novel. To gain a better understanding of the biological implications, the assembled transcripts were annotated with gene ontology (GO) terms. Single nucleotide variants were predicted for the transcripts assigned to each analyzed GO category. Our results may be useful for establishing a general pattern of the gene expression in the human placenta. Characterizing placental transcriptome, which is crucial for a pregnancy's outcome, can serve as a basis for identifying the mechanisms underlying physiological pregnancy, as well as may be useful for an early detection of the genomic defects.

  4. Placenta accreta as a cause of peripartum hysterectomy.

    PubMed

    Palova, E; Redecha, M; Malova, A; Hammerova, L; Kosibova, Z

    2016-01-01

    Our objective was to identify the risk factors associated with placenta accreta. Cases of peripartum hysterectomy at University Hospital of Bratislava were identified in the period from January 1st 2008 to December 31th 2013. Included were only those cases which had a histological evidence of placenta accreta. Fifty patients, who underwent peripartum hysterectomy were included in the study. Between 2008 and 2013 eight cases of placenta accreta were identified. Five (62.5 %) of these were suspected before delivery. The overall incidence of PA was 0.19 per 1000 deliveries. Median gestational age at delivery was 37 weeks (range 25-41 weeks). Six of eight (75 %) women with placenta accreta had a previous caesarean delivery or curettage. In 5 patients both placenta praevia and prior Caesarean delivery were present. Among the 50 women who underwent peripartum hysterectomy, 8 (16 %) were patients with both prenatally diagnosed placenta praevia and previous caesarean delivery, placenta accreta was suspected in 4 of these (50 %) compared with 10 of 42 (24 %) without this combination of risk factors. Those in whom placenta accreta was suspected were delivered earlier than 37 weeks of gestation and were less likely to have emergency delivery. Placenta accreta is the second most common indication for an emergency peripartum hysterectomy. There is a high suspicion of placenta accreta in patients with placenta praevia and after previous Caesarean section (Tab. 3, Ref. 17).

  5. Placenta Percreta Presenting with Delayed Haematuria

    PubMed Central

    Daga, Sudarshan Omprakash; Patwardhan, Sujata Kiran

    2015-01-01

    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. PMID:26816944

  6. Transfer of gangliosides across the human placenta.

    PubMed

    Mitchell, M D; Henare, K; Balakrishnan, B; Lowe, E; Fong, B Y; McJarrow, P

    2012-04-01

    Gangliosides are structural and functional glycosphingolipids, considered to have important roles in neuronal development in fetal and neonatal development and in memory formation. In this report, we have investigated the ability of bovine milk-derived gangliosides GM3 and GD3 to cross the human placenta. We have employed the ex-vivo model of dually-perfused isolated human placental lobules. There was significant uptake of both GD3 and GM3 from the maternal perfusate. There was significant increase of GM3 in the fetal side and a non-statistically significant trend for GD3 to increase on the fetal side. Hence an apparent preference for GM3 release into fetal circulation. We suggest that gangliosides consumed by the mother enter her circulation, can be transferred across the placenta and may be available to the developing fetus for building neural connections. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Multidisciplinary management of invasive placenta previa.

    PubMed

    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

    To assess the effectiveness of a multidisciplinary team approach to reduce severe maternal morbidity in women with invasive placenta previa. We conducted a prospective study of 33 women with placenta previa and increta-percreta (diagnosed by ultrasound and/or magnetic resonance imaging) delivering at Mount Sinai Hospital, Toronto, following the introduction in January 2008 of a team-based approach to women with this condition. We included women who delivered by June 2012. We reviewed antenatal outpatient and inpatient records for use of six pre-defined team components by the attending staff obstetrician: (1) antenatal maternal-fetal medicine consultation, (2) surgical gynaecology consultation, (3) antenatal MRI, (4) interventional radiology consultation and preoperative placement of balloon catheters in the anterior divisions of the internal iliac arteries, (5) pre-planned surgical date, and (6) surgery performed by members of the invasive placenta surgical team. Antenatal course, delivery, and postpartum details were recorded to derive a five-point composite severe maternal morbidity score based on the presence or absence of: (1) ICU admission following delivery, (2) transfusion > 2 units of blood, (3) general anaesthesia start or conversion, (4) operating time in highest quartile (> 125 minutes), and (5) significant postoperative complications (readmission, prolonged postpartum stay, and/or pulmonary embolism). All 33 women survived during this time period. Two thirds (22/33) had either five or six of the six components of multidisciplinary care. Increasing use of multidisciplinary team components was associated with a significant reduction in composite morbidity (R2 = 0.228, P = 0.005). Team-based assessment and management of women with invasive placenta previa is likely to improve maternal outcomes and should be encouraged on a regional basis.

  8. Paternally expressed genes predominate in the placenta.

    PubMed

    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.

  9. Automated vasculature extraction from placenta images

    NASA Astrophysics Data System (ADS)

    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.

  10. Magnetic resonance imaging of the normal placenta.

    PubMed

    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.

  11. [Analysis of 65 cases of abruptio placenta].

    PubMed

    Dong, J L; Fei, C

    1992-05-01

    From Jan 1, 1971 to Dec 12, 1990, 65 cases of abruptio placenta were admitted to our hospital. The incidence was 0.19%. Among them, thirty were complicated by pregnancy induced hypertension (46.2%). The perinatal fetal mortality was 19.7%; perinatal death occurred mostly in the premature group. All babies survived except two abnormalities. Cesarean section rate was 32.3%. All postpartum hemorrhage 29.2%. Couvelaire uterus 6.2%, were cured by conservative treatment. There was neither stillbirth nor newborn death in the thirty three cases treated expectant, but a newborn asphyxia rate of 6.1% and a cesarean section rate of 15.1%. Analysis showed that abruptio placentae should be suspected in cases with abnormal fetal heart rate of unknown cause accompanying signs of labor, premature labor of unknown cause, uterine tongue, ultrasonically visualized liquid from dark area behind the placenta, besides classical signs of abdominal pain and vaginal bleeding. Expectant treatment is appropriate if gestational age is small and no acute symptoms exists so as to minimize the perinatal mortality and cesarean section rate.

  12. Methadone metabolism by early gestational age placentas.

    PubMed

    Hieronymus, Todd Lewis; Nanovskaya, Tatiana N; Deshmukh, Sujal V; Vargas, Ricardo; Hankins, Gary D V; Ahmed, Mahmoud S

    2006-07-01

    The objective of this study was to identify the enzyme that metabolizes methadone in preterm placentas. Microsomal fractions were obtained from preterm (17 to 34 weeks) placentas (36 total; 12 per each gestational age group) and their activity in metabolizing methadone to 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) was determined. The enzyme catalyzing the reaction was identified by using chemical inhibitors selective for various cytochrome P450 isozymes and monoclonal antibodies raised against them. The metabolism of methadone by microsomes revealed saturation kinetics. Methadone was N-demethylated to EDDP by aromatase. The affinity of methadone to aromatase (apparent Km) did not change with gestation, but the activity of the enzyme (Vmax) increased and varied widely between individual placentas. Aromatase/CYP19 is the placental enzyme metabolizing methadone during pregnancy. The variability in enzyme activity among individuals should be reflected by the concentration of methadone in the fetal circulation and might be one of the factors affecting the incidence and intensity of neonatal abstinence syndrome.

  13. Anticoagulant prophylaxis for placenta mediated pregnancy complications.

    PubMed

    Rodger, Marc A

    2011-02-01

    Thrombophilias are not yet established as a cause of the placenta-mediated pregnancy complications (pregnancy loss, pre-eclampsia, small for gestational age and placental abruption). A thrombophilia may be only one of many factors that lead to development of these complications. Our recent large systematic review of prospective cohort studies highlight that the association between thrombophilia and placenta mediated pregnancy complications is far from proven. The small step of previously describing an association in case control studies has led a large number of clinicians and opinion leaders to take the large leap of accepting this relationship as being causal and potentially treatable with anticoagulant interventions. Furthermore, while data in women with prior severe pre-eclpamsia, abruption and small for gestational age births without thrombophilia suggests some promise for anticoagulant prophylaxis to prevent complications in subsequent pregnancies in these women, in the absence of large well done and generalisable "no intervention" controlled studies adopting anticoagulant prophylaxis to prevent these complications is premature. The absence of strong evidence, coupled with the small potential for harm from anticoagulant prophylaxis suggests that these drugs should be considered experimental in thrombophilic and non-thrombophilic women with prior placenta mediated pregnancy complications.

  14. Risk Factors of Neonatal Anemia in Placenta Previa

    PubMed Central

    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

  15. Risk factors of neonatal anemia in placenta previa.

    PubMed

    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.

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

    PubMed Central

    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 < 0.05. Results There was a significant reduction in total volume and volume density of fibrin deposits on the surface of chorionic villi (p < 0.05), and a significant increment in total volume and volume density of chorionic villous blood vessels in PP group in comparison with C group (p < 0.05). Conclusion Results showed that impairment in situation of implantation in PP can cause significant changes in the structure of placenta. These changes probably can be influential on the evolution and survival of fetus. PMID:25927025

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    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.

  20. Trophoblast debris extruded from preeclamptic placentae activates endothelial cells: a mechanism by which the placenta communicates with the maternal endothelium.

    PubMed

    Shen, F; Wei, J; Snowise, S; DeSousa, J; Stone, P; Viall, C; Chen, Q; Chamley, L

    2014-10-01

    Preeclampsia is characterized by maternal endothelial dysfunction. While the mechanisms leading to preeclampsia are unclear, a factor(s) from the placenta is responsible for triggering the disease. One placental factor implicated in triggering preeclampsia is trophoblast debris which may transmit pathogenic signals from the placenta to endothelial cells. In this study, we investigated whether trophoblast debris from preeclamptic placentae triggered endothelial cell activation. Trophoblast debris from preeclamptic or normotensive placentae, or trophoblast debris from normal placental explants that had been cultured with preeclamptic (n = 14) or normotensive sera (n = 14) was exposed to endothelial cells. Activation of the endothelial cells was quantified by cell surface ICAM-1 and U937 adhesion to endothelial cells. The levels of IL-1β, pro-caspase-1 and active caspase-1 in the trophoblast debris were measured. Compared to controls, the levels of ICAM-1 and U937 adhesion to endothelial cells were significantly increased following exposure of the endothelial cells to trophoblast debris from preeclamptic placentae or placentae treated with preeclamptic sera. The levels IL-1β, pro-caspase-1 and active caspase-1 were significantly increased in both trophoblast debris from preeclamptic placentae and placentae treated with preeclamptic sera. These results provide the first direct evidence that trophoblast debris produced from preeclamptic placentae or placentae treated with preeclamptic sera can activate the endothelium. Trophoblast debris from preeclamptic but not normotensive placentae can induce endothelial cell activation. This may be one mechanism by which the preeclamptic placenta communicates with the maternal endothelium to induce activation of the endothelium. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Reoccurrence of retained placenta at vaginal delivery: an observational study.

    PubMed

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

    2013-04-01

    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery. Nested cohort study. Department of Gynecology and Obstetrics, university-affiliated teaching hospital. 10 334 nulliparous singleton pregnancies who delivered vaginally at the hospital during 2000-2009. Data from a computerized database information system were used to identify 287 women who had an ICD-10 diagnosis of retained placenta and 572 randomly selected controls matched by the date of first delivery. At chart review the diagnosis was confirmed by: (1) excessive bleeding <30 minutes after delivery without placental separation, (2) placenta not separated 30 minutes after delivery or (3) confirmation of retained placental tissue >2 hours postpartum. Confirmation of the diagnosis and prevalence of retained placenta. Risk of reoccurrence in a subsequent vaginal delivery. The prevalence of retained placenta increased from 2.8 to 7.0% after confirmation according to the set criteria. Of the selected women, 48.4% had a subsequent vaginal delivery. Of these women, 25.3% (23/91) with a previous retained placenta and 5.3% (11/206) without previously retained placenta, experienced retained placenta in subsequent delivery. This corresponds to an adjusted odds ratio of 5.5 (95% confidence interval 2.6-12.7) in the multivariate analysis for recurrence of retained placenta in a subsequent vaginal delivery. The use of the ICD-10 diagnosis of retained placenta underestimated the prevalence. The risk of reoccurrence of retained placenta is significantly increased in a subsequent vaginal delivery. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  2. Placenta changes in pregnancy with gestational diabetes.

    PubMed

    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.

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

    PubMed

    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

  4. [Placenta percreta with bladder invasion. Case report].

    PubMed

    Torres Gómez, Luis Guillermo; Torres Farías, Emigdio; Rodríguez Sandoval, Rosa María

    2007-09-01

    We report a case of a 30-year-old woman, who had two previous caesarean sections, attended for the first time at 18 weeks of gestation. Pelvic ultrasonography and color Doppler imaging showed a placenta percreta invading the urinary bladder. A caesarean section was carried out at 27th week of gestation for preterm premature rupture of membranes. Placental tissue was firmly attached to the anterior surface of the bladder. A cesarean hysterectomy was performed with bilateral anterior internal iliac artery ligation before hysterectomy was finished. The bladder was repaired, leaving a suprapubic catheter.

  5. Circadian Kisspeptin expression in human term placenta.

    PubMed

    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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Do uterotonic drugs increase risk of abruptio placentae and eclampsia?

    PubMed

    Morikawa, Mamoru; Cho, Kazutoshi; Yamada, Takahiro; Yamada, Takashi; Sato, Shoji; Minakami, Hisanori

    2014-05-01

    To determine whether the use of uterotonics, including oxytocin and prostaglandins, increases the risk of abruptio placentae and eclampsia. A retrospective analysis was conducted among 260,174 Japanese women at term. Demographic characteristics were studied as possible candidates for risk factors of abruptio placentae and eclampsia using multivariate logistic regression analyses. A total of 1,058 (0.41 %) and 147 (0.06 %) women developed abruptio placentae and eclampsia, respectively. Abruptio placentae and eclampsia occurred in 177 (0.29 %) and 42 (0.07 %) of the 61,857 women treated with uterotonics, respectively. Multivariate regression analyses indicated that uterotonics did not increase risk of developing either abruptio placentae or eclampsia. Primiparity [odds ratio (95 % confidence interval) 1.41 (1.24-1.60)], age ≥35 years [1.17 (1.03-1.33)], and presence of hypertension [2.42 (1.93-3.03)] were significant independent risk factors for abruptio placentae, while advancing gestation [0.67 (0.63-0.71)] decreased risk of abruptio placentae. Primiparity [odds ratio (95 % confidence interval) 4.06 (2.49-6.63)], age <20 years [2.44 (1.07-5.58)], presence of hypertension [28.7 (20.5-40.1)], and advancing gestation [1.28 (1.11-1.47)] were significant independent risk factors for eclampsia. The use of uterotonics did not increase the risk of abruptio placentae and eclampsia.

  7. A comprehensive analysis of the human placenta transcriptome

    USDA-ARS?s Scientific Manuscript database

    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 ...

  8. [Massive hemorrhage during cesarean section for placenta accreta].

    PubMed

    Komura, Reiko; Mochida, Takashi; Imai, Hidekazu; Shibue, Chieko; Tobita, Toshiyuki; Baba, Hiroshi

    2009-02-01

    A 37-year-old multigravida presented at 37 weeks of gestation with low-lying placenta and highly suspected placenta accreta. The placenta adhered widely to the anterior wall of the uterus. Therefore, a longitudinal incision of the uterine corpus at the thinnest part of the placenta was made during surgery. Concurrent with the incision, rapid and massive hemorrhage occurred. After the delivery of the baby and confirmation of the placental adhesion, the hysterectomy was started promptly. The bladder adhered strongly to the uterus, and was injured during the dissection. The total volume of hemorrhage was estimated to be 24,480 ml (including amniotic fluid and urine). No arterial clamp for hemostasis was used during the procedure. The patient was discharged on the 12th postoperative day with no sequela. The pathological diagnosis was placenta percreta. Placenta accreta is a rare disease with a high mortality rate. The hemorrhage becomes difficult to control in case of injury of placenta accreta. The hysterectomy following cesarean section also becomes complicated. Bladder injury is one of the complications of the cesarean hysterectomy which makes the hemorrhage greader. In conclusion, when placenta accreta is suspected a strategy to minimize blood loss during surgery should be discussed by a multidisciplinary team.

  9. Vaginal delivery through annular placenta – case report

    PubMed Central

    Živković, Nikica; Krezo, Stipe; Matijević, Ratko; Živković, Krešimir

    2013-01-01

    Annular placenta is an extremely rare morphological type of human placenta. It is commonly related to placental vessel abnormalities frequently causing antenatal and postnatal hemorrhage and operative delivery. Gravida 4 para 1 had an uneventful course of pregnancy and normal vaginal delivery followed by moderate postpartum hemorrhage. Hemorrhage was found to be local in origin but the placenta was annular in shape and the newborn was delivered through one of the openings. Annular placenta was not recognized before delivery. Its implantation site was in the lower uterine segment but high enough to allow the passage of the fetus through its annular defect and vaginal birth. To our knowledge, this is a first report of annular placenta ending in normal vaginal delivery. PMID:23630149

  10. Placenta Imprinted Gene Expression Association of Infant Neurobehavior

    PubMed Central

    Marsit, Carmen J.; Lambertini, Luca; Maccani, Matthew A.; Koestler, Devin C.; Houseman, E. Andres; Padbury, James F.; Lester, Barry M.; Chen, Jia

    2011-01-01

    Objective To identify links between altered gene imprinting in the placenta and infant neurobehavioral profiles. Study design We used qRT-PCR to examine the expression of 22 imprinted candidate genes in a series of 106 term human primary placenta tissues and associated that expression with summary scores from the NICU Network Neurobehavioral Scales performed on the corresponding infants. Clustering of the expression data was used to define distinct classes of expression. Results Significant associations were identified between classes of expression and the NICU Network Neurobehavioral Scales quality of movement (P=0.02) and handling (P=0.006) scores. Multivariable regression demonstrated an independent effect of imprinted gene expression profile on these neurobehavioral scores after controlling for confounders. Conclusion These results suggest that alterations in imprinted gene expression in the placenta are associated with infant neurodevelopmental outcomes. Our results suggest a role for the placenta and genomic imprinting in the placenta beyond intrauterine growth regulation. PMID:22153677

  11. [Location of the placenta in pregnancy with previous caesarean section].

    PubMed

    Karagiozova, J; Ivanov, St; Masseva, A; Frandeva, B; Ibriam, I

    2014-01-01

    Previous Caesarean section (SC) is considered to be established predisposing factor for abnormal placentation. In this study we examined whether prior SC is a risk factor for low laying placenta. Retrospective documentation was studied of 171 pregnant women after a SC (test group) and of 150 pregnant women after a normal birth (control), and cases of hysterectomy after giving birth to five years. Pathological lying placenta have established at 1.34% in the test group versus 0.67% in controls (p - 0.058), i.e. no proven link between prior Cesarean section and location of the placenta in the lower uterine segment during the next pregnancy. The analysis of cases of postpartum hysterectomy is found that the combination of condition after Cesarean section, placenta praevia and placenta accreta is a risk factor for hysterectomy after childbirth.

  12. The Programming Power of the Placenta

    PubMed Central

    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

  13. The Programming Power of the Placenta.

    PubMed

    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.

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

    PubMed

    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. Copyright © 2011. Published by Elsevier Ltd.

  15. Quantitative morphology of the placenta. II. The growth of the placenta and the problem of postmaturity.

    PubMed

    Bouw, G M; Stolte, L A; Baak, J P; Oort, J

    1978-02-01

    The morphological changes in the placenta concomitant with the transition from maturity to postmaturity were investigated by stereology under early clamping of the umbilical cord. 37 placentas from nonpathological pregnancies delivered after a period of 224-303 days of amenorrhea were examined. It appeared that after 267-288 days of amenorrhea, 8 out of 9 placental components showed no further growth and even showed regression. Only the volume of the trophoblast continued to grow in postmaturity. It is suggested that during postmaturity the villous capacity to produce steroids is continuing at a normal rate (as judged by the increase of the volume of the trophoblast), whereas the capability to transfer is deteriorating (as testified by the decreasing surface of the trophoblast).

  16. Abnormal Labyrinthine Zone in the Hectd1-null Placenta

    PubMed Central

    Sarkar, Anjali A.; Sabatino, Julia A.; Sugrue, Kelsey F.; Zohn, Irene E.

    2016-01-01

    Introduction The labyrinthine zone of the placenta is where exchange of nutrients and waste occurs between maternal and fetal circulations. Proper development of the placental labyrinth is essential for successful growth of the developing fetus and abnormalities in placental development are associated with intrauterine growth restriction (IUGR), preeclampsia and fetal demise. Our previous studies demonstrate that Hectd1 is essential for development of the junctional and labyrinthine zones of the placenta. Here we further characterize labyrinthine zone defects in the Hectd1 mutant placenta. Methods The structure of the mutant placenta was compared to wildtype littermates using histological methods. The expression of cell type specific markers was examined by immunohistochemistry and in situ hybridization. Results Hectd1 is expressed in the labyrinthine zone throughout development and the protein is enriched in syncytiotrophoblast layer type I cells (SynT-I) and Sinusoidal Trophoblast Giant cells (S-TGCs) in the mature placenta. Mutation of Hectd1 results in pale placentas with frequent hemorrhages along with gross abnormalities in the structure of the labyrinthine zone including a smaller overall volume and a poorly elaborated fetal vasculature that contain fewer fetal blood cells. Examination of molecular markers of labyrinthine trophoblast cell types reveals increased Dlx3 positive cells and Syna positive SynT-I cells, along with decreased Hand1 and Ctsq positive sinusoidal trophoblast giant cells (S-TGCs). Discussion Together these defects indicate that Hectd1 is required for development of the labyrinthine zone or the mouse placenta. PMID:26907377

  17. Abnormal labyrinthine zone in the Hectd1-null placenta.

    PubMed

    Sarkar, Anjali A; Sabatino, Julia A; Sugrue, Kelsey F; Zohn, Irene E

    2016-02-01

    The labyrinthine zone of the placenta is where exchange of nutrients and waste occurs between maternal and fetal circulations. Proper development of the placental labyrinth is essential for successful growth of the developing fetus and abnormalities in placental development are associated with intrauterine growth restriction (IUGR), preeclampsia and fetal demise. Our previous studies demonstrate that Hectd1 is essential for development of the junctional and labyrinthine zones of the placenta. Here we further characterize labyrinthine zone defects in the Hectd1 mutant placenta. The structure of the mutant placenta was compared to wildtype littermates using histological methods. The expression of cell type specific markers was examined by immunohistochemistry and in situ hybridization. Hectd1 is expressed in the labyrinthine zone throughout development and the protein is enriched in syncytiotrophoblast layer type I cells (SynT-I) and Sinusoidal Trophoblast Giant cells (S-TGCs) in the mature placenta. Mutation of Hectd1 results in pale placentas with frequent hemorrhages along with gross abnormalities in the structure of the labyrinthine zone including a smaller overall volume and a poorly elaborated fetal vasculature that contain fewer fetal blood cells. Examination of molecular markers of labyrinthine trophoblast cell types reveals increased Dlx3 positive cells and Syna positive SynT-I cells, along with decreased Hand1 and Ctsq positive sinusoidal trophoblast giant cells (S-TGCs). Together these defects indicate that Hectd1 is required for development of the labyrinthine zonethe mouse placenta. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Superoxide dismutase activity in normal and preeclamptic placentas.

    PubMed

    Wiktor, H; Kankofer, M

    1998-12-01

    A deficiency in superoxide dismutase (SOD) activity in preeclamptic placentas can lead to an excess of superoxide radicals and may be responsible for the development and the severity of preeclampsia (PE). Our studies were undertaken in order to determine placental SOD activity and to investigate their association with the development and the severity of PE. The activity of SOD was determined using a spectrophotometric method in 22 placentas from normal term pregnancies (group K), 24 placentas from pregnancies complicated by severe PE (group PE), and 21 placentas from pregnancies complicated by severe PE and intrauterine growth retardation (IUGR) (group PEI). Mean activity of SOD (MSOD) in 45 preeclamptic placentas 3.89 +/- 1.32 (M +/- SD) was significantly lower (P = 0.008) as compared to MSOD in the group K (6.75 +/- 1.96). MSOD in the PEI group (3.5 +/- 1.29) was significantly lower (P = 0.03) as compared to MSOD in the group K. MSOD in the PE group (4.23 +/- 1.25) was lower than MSOD in the group K, but this difference was not statistically significant (P = 0.11). MSOD in the group PEI was lower as compared to MSOD in the PE group, however this difference was not statistically significant (P = 0.23). The studies revealed decreased SOD activity in preeclamptic placentas in comparison to normal placentas.

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

    PubMed

    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 < 0.001). However, 5 min Apgar score and perinatal mortality rates were comparable between the groups. Neonatal outcomes remained comparable between the groups in a sub-analysis of cesarean deliveries only. Although placenta previa pregnancies involve higher maternal morbidity rates, term offsprings are not at an increased risk for immediate adverse outcome.

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

    PubMed Central

    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

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

    PubMed

    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. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. The dysfunctional placenta epigenome: causes and consequences.

    PubMed

    Lee, Sue-Ann; Ding, Chunming

    2012-10-01

    The placenta is a fetal-maternal endocrine organ responsible for ensuring proper fetal development throughout pregnancy. Adverse insults to the intrauterine environment often lead to expression level changes in placental genes, many of which are epigenetically regulated by DNA methylation, histone modifications and ncRNA interference. These epigenetic alterations may cause placental dysfunction, resulting in offspring of low birthweight owing to adverse pregnancy complications such as intrauterine growth restriction. Numerous epidemiological studies have shown a strong correlation between low birthweight and increased risk of developing metabolic diseases and neurological imbalances in adulthood, and in subsequent generations, indicating that epigenetic regulation of gene expression can be propagated stably with long-term effects on health. This article provides an overview of the various environmental factors capable of inducing detrimental changes to the placental epigenome, as well as the corresponding mechanisms that prime the offspring for onset of disease later in life.

  3. Chorioallantoic placenta defects in cloned mice

    SciTech Connect

    Wakisaka-Saito, Noriko; Kohda, Takashi . E-mail: tkhoda.epgn@tmd.ac.jp; Inoue, Kimiko; Ogonuki, Narumi; Miki, Hiromi; Hikichi, Takafusa; Mizutani, Eiji; Wakayama, Teruhiko; Kaneko-Ishino, Tomoko; Ogura, Atsuo; Ishino, Fumitoshi

    2006-10-13

    Somatic cell nuclear transfer technology has been applied to produce live clones successfully in several mammalian species, but the success rates are very low. In mice, about half of the nuclear transfer embryos undergo implantation, but very few survive to term. We undertook detailed histological analyses of placentas from cloned mouse embryos generated from cumulus cells at 10.5 dpc of pregnancy, by which stage most clones have terminated their development. At 10.5 dpc, the extraembryonic tissues displayed several defined histological patterns, each reflecting their stage of developmental arrest. The most notable abnormality was the poor development of the spongiotrophoblast layer of diploid cells. This is in contrast to the placental hyperplasia frequently observed in somatic clones at 12.5 dpc or later stages. A variety of structural abnormalities were also observed in the embryos. Both placental and embryonic defects likely contribute to the low success rate of the mouse clones.

  4. Placenta hominis protects osteoporosis in ovariectomized rats.

    PubMed

    Chae, H J; Choi, K H; Chae, S W; Kim, H M; Shin, T K; Lee, G Y; Jeong, G S; Park, H R; Choi, H I; Kim, S B; Yoo, S K; Kim, H R

    2006-01-01

    In China, Japan, and Korea, placenta hominis extracts (PHEs) are used clinically for the treatment of osteoporosis. The anti-osteoporotic effect of PHEs was studied. The trabecular bone area and thickness in OVX rats decreased by 50% from those in sham-operated rats; these decreases were completely inhibited by administration of PHEs for 7 weeks. Osteoclast numbers and the osteoblast surface were enhanced in OVX rats, but PHEs had no effect on these phenomena. Serum phosphorus and alkaline phosphatase in OVX rats increased compared to those in sham-operated rats, but the increases were not affected by the administration of PHEs. Thyroxine (T4) level was stimulated in OVX rats. The extracts inhibited the T4 level in the OVX rats. These results strongly suggest that PHEs be effective in preventing the development of bone loss induced by OVX in rats.

  5. Tetany following resuscitation after abruptio placentae.

    PubMed

    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.

  6. Micronized progesterone reduces vasoconstriction in the placenta.

    PubMed

    Miller, Nathaniel R; Dolinsky, Brad M; Napolitano, Peter G

    2015-09-01

    To investigate if micronized progesterone (P4) has the ability to attenuate thromboxane mimetic U46619-mediated fetoplacental artery vasoconstriction. Paired cotyledons obtained from the same placenta of five-term subjects were analyzed. The fetal artery and maternal intervillous space of one cotyledon was infused with P4 while another cotyledon was infused with control perfusate. After 30 min, a bolus dose of U44619 was administered to both cotyledons. The change in the measured fetoplacental vascular pressure caused by bolus administration of U46619 was less in the cotyledons infused with P4 (p = 0.009). Continuous treatment with P4 significantly attenuates the U46619-mediated fetoplacental vasoconstriction.

  7. Oxygen metabolism in human placenta mitochondria.

    PubMed

    Bustamante, J; Ramírez-Vélez, R; Czerniczyniec, A; Cicerchia, D; Aguilar de Plata, A C; Lores-Arnaiz, S

    2014-12-01

    Due to the high metabolic demands of the placental tissue during gestation, we decide to analyzed the mitochondrial bioenergetic functions in the human term placenta. Different mitochondrial morphological parameters, membrane potential and cardiolipin content were determined by flow cytometry. Oxygen uptake, hydrogen peroxide production and cytochrome P450 content, were also measured. Some apoptotic mitochondrial proteins were also analyzed by western blot. Two isolated mitochondrial fractions were observed: large/heavy and small/light with different functional characteristics. Oxygen uptake showed a respiratory control (RC) of 3.4 ± 0.3 for the heavy mitochondria, and 1.1 ± 0.4 for light mitochondria, indicating a respiratory dysfunction in the light fraction. Good levels of polarization were detected in the heavy fraction, meanwhile the light population showed a collapsed ΔΨm. Increased levels of cytochrome P450, higher levels of hydrogen peroxide, and low cardiolipin content were described for the light fraction. Three pro-apoptotic proteins p53, Bax, and cytochrome c were found increased in the heavy mitochondrial fraction; and deficient in the light fraction. The heavy mitochondrial fraction showed an improved respiratory function. This mitochondrial fraction, being probably from cytotrophoblast cells showed higher content of proteins able to induce apoptosis, indicating that these cells can effectively execute an apoptotic program in the presence of a death stimulus. Meanwhile the light and small organelles probably from syncytiotrophoblast, with a low oxygen metabolism, low level of ΔΨm, and increased hydrogen peroxide production, may not actively perform an apoptotic process due to their deficient energetic level. This study contributes to the characterization of functional parameters of human placenta mitochondria in order to understand the oxygen metabolism during the physiological process of gestation.

  8. Effect of chlorpromazine on rat placenta development.

    PubMed

    Furukawa, Satoshi; Hayashi, Seigo; Abe, Masayoshi; Hagio, Souichiro; Irie, Kota; Kuroda, Yusuke; Ogawa, Izumi; Sugiyama, Akihiko

    2014-01-01

    We examined the sequential histopathological changes in the placentas from rats exposed to chlorpromazine. Chlorpromazine was intraperitoneally administered on GD 14 at 50 and 100 mg/kg and the placentas were sampled on GDs 14.5, 15, 17 and 21. The incidence of dams with complete fetal resorption was increased from GD 17 up to 20% at 50 mg/kg and 44.4% at 100 mg/kg. The embryo/fetal weights reduced on GDs 15 and 17 at 50 mg/kg and during GDs 15-21 at 100 mg/kg. The placental weights reduced on GD 17 at 50 mg/kg and during GDs 14.5-21 at 100 mg/kg. Histopathologically, in the labyrinth zone, apoptotic cells were scattered in the trophoblastic septa without inhibition of cell proliferation on GDs 14.5 and 15 at 50 and 100 mg/kg in a dose-dependent manner. A decrease in trophoblasts led to labyrinth zone hypoplasia. In the basal zone, apoptotic cells were scattered on GDs 14.5 and 15 at 100 mg/kg, and most of them appeared to be glycogen cells. A decrease in glycogen cells induced the delayed development of glycogen cell islands and the subsequent remaining glycogen cell islands, and led to the cystic degeneration of glycogen cells. In addition, failure of development of the glycogen cell islands led to the impaired interstitial invasion of the glycogen cells, and then metrial gland hypoplasia occurred. Copyright © 2013 Elsevier GmbH. All rights reserved.

  9. Protein Nitration in Placenta – Functional Significance

    PubMed Central

    Webster, RP; Roberts, VHJ; Myatt, L

    2009-01-01

    Crucial roles of the placenta are disrupted in early and mid-trimester pregnancy loss, preeclampsia, eclampsia and intrauterine growth restriction. The pathophysiology of these disorders includes a relative hypoxia of the placenta, ischemia/reperfusion injury, an inflammatory response and oxidative stress. Reactive oxygen species including nitric oxide (NO), carbon monoxide and superoxide have been shown to participate in trophoblast invasion, regulation of placental vascular reactivity and other events. Superoxide, which regulates expression of redox sensitive genes, has been implicated in up-regulation of transcription factors, antioxidant production, angiogenesis, proliferation and matrix remodeling. When superoxide and nitric oxide are present in abundance, their interaction yields peroxynitrite a potent pro-oxidant, but also alters levels of nitric oxide, which in turn affect physiological functions. The peroxynitrite anion is extremely unstable thus evidence of its formation in vivo has been indirect via the occurrence of nitrated moieties including nitrated lipids and nitrotyrosine residues in proteins. Formation of 3-nitrotyrosine (protein nitration) is a “molecular fingerprint” of peroxynitrite formation. Protein nitration has been widely reported in a number of pathological states associated with inflammation but is reported to occur in normal physiology and is thought of as a prevalent, functionally relevant post-translational modification of proteins. Nitration of proteins can give either no effect, a gain or a loss of function. Nitration of a range of placental proteins is found in normal pregnancy but increased in pathologic pregnancies. Evidence is presented for nitration of placental signal transduction enzymes and transporters. The targets and extent of nitration of enzymes, receptors, transporters and structural proteins may markedly influence placental cellular function in both physiologic and pathologic settings. PMID:18851882

  10. ABRUPTIO PLACENTAE IN THE BABOON (PAPIO SPP.)

    PubMed Central

    Schenone, M.; Schlabritz-Loutsevitch, N.; Zhang, J.; Samson, J.E.; Mari, G.; Ferry, R.J.; Hubbard, G.B.; Dick, E.J.

    2012-01-01

    Introduction Placental abruption is a serious condition that increases perinatal morbidity and mortality. Clinical prevention and treatment options are limited, especially in human preterm deliveries. Knowledge of the mechanisms that keep the placenta in place during pregnancy is critical for developing strategies for the prevention of abruption. Failure of physiological transformation of spiral arteries has been described as a major contributing factor of the placental abruption development. Baboons (Papio spp.) share striking similarities with humans in regard to placental structure, utero-placental blood flow, and fetal development; however, the mode of trophoblast invasion is shallow in baboons. This fact prompted the hypothesis that the incidence of placental abruption will be increased in baboons compared to humans. Material and methods Baboon placentas were collected between 2002 and 2008. Two independent veterinary pathologists evaluated the slides. A certified physician pathologist performed additional histology. Results Placental abruption was diagnosed in 22 baboons among 2,423 live births during the study period (0.9% prevalence). The most common clinical presentations were fetal demise and vaginal bleeding. The most common pathological findings were intraplacental hemorrhage with or without hematoma formation (86.4%). Other findings consisted of neutrophil infiltration (50%), decidual necrosis (22.7%), decidual vascular congestion and inflammation, villous congestion and retroplacental hemorrhage/hematoma (18.2%). These pathologic findings were the same for term and preterm deliveries. Conclusion This is the first systematic study of placental abruption in non-human primates, analyzing a large colony of baboons. Despite differences in trophoblast invasion, the clinical features observed in placental abruption affecting baboons resembled those reported in humans. The cluster of placental pathological findings in baboons also agreed with clinical reports

  11. Placenta previa: obstetric risk factors and pregnancy outcome.

    PubMed

    Sheiner, E; Shoham-Vardi, I; Hallak, M; Hershkowitz, R; Katz, M; Mazor, M

    2001-12-01

    To determine the incidence, obstetric risk factors and perinatal outcome of placenta previa. All singleton deliveries at our institution between 1990 and 1998 complicated with placenta previa were compared with those without placenta previa. Placenta previa complicated 0.38% (n = 298) of all singleton deliveries (n = 78 524). A back-step multiple logistic regression model found the following factors to be independently correlated with the occurrence of placenta previa: maternal age above 40 years (OR 3.1, 95% CI 2.0-4.9), infertility treatments (OR 3.1, 95% CI 1.8-5.6), a previous Cesarean section (OR 1.8, 95% CI 1.4-2.4), a history of habitual abortions (OR 1.3, 95% CI 1.3-2.7) and Jewish ethnicity (OR 1.3, 95% CI 1.1-1.8). Pregnancies complicated with placenta previa had significantly higher rates of second-trimester bleeding (OR 156.0, 95% CI 87.2-277.5), pathological presentations (OR 7.6, 95% CI 5.7-10.1), abruptio placentae (OR 13.1, 95% CI 8.2-20.7), congenital malformations (OR 2.6, 95% CI 1.5-4.2), perinatal mortality (OR 2.6, 95% CI 1.1-5.6), Cesarean delivery (OR 57.4, 95% CI 40.7-81.4), Apgar scores at 5 min lower than 7 (OR 4.4, 95% CI 2.3-8.3), placenta accreta (OR 3.6, 95% CI 1.1-9.9) postpartum hemorrhage (OR 3.8, 95% CI 1.2-10.5), postpartum anemia (OR 5.5, 95% CI 4.4-6.9) and delayed maternal and infant discharge from the hospital (OR 10.9, 95% CI 7.3-16.1) as compared to pregnancies without placenta previa. In a multivariable analysis investigating risk factors for perinatal mortality, the following were found to be independent significant factors: congenital malformations, placental abruption, pathological presentations and preterm delivery. In contrast, placenta previa and Cesarean section were found to be protective factors against the occurrence of perinatal mortality while controlling for confounders. Although an abnormal implantation per se was not an independent risk factor for perinatal mortality, placenta previa should be considered as a

  12. Conservative management of abnormally invasive placenta: four case reports.

    PubMed

    Ramoni, Angela; Strobl, Eva-Maria; Tiechl, Johanna; Ritter, Magdalena; Marth, Christian

    2013-04-01

    Prenatal diagnosis of placenta increta and percreta is essential to avoid potentially life-threatening hemorrhage by optimizing peripartal management. Invasive placentation presents significant challenges at cesarean section even for highly skilled surgeons. In the four cases of placenta increta/percreta presented here we tried to avoid hysterectomy by leaving the placenta behind and tried to accelerate regression of placental tissue by administering methotrexate. The outcome in each of the four women was different, but no major bleeding occurred in any of the cases. Close follow-up for many weeks is mandatory.

  13. Prevalence of placenta previa among deliveries in Mainland China

    PubMed Central

    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

  14. Trans fatty acid accumulation in the human placenta.

    PubMed

    Wada, Yoshiro; Yoshida-Yamamoto, Shumi; Wada, Yoshinao; Nakayama, Masahiro; Mitsuda, Nobuaki; Kitajima, Hiroyuki

    2017-03-01

    Trans fatty acid may impair fetal growth and infant neurodevelopment, but the quantity in a placenta and human tissues remains unknown. To address the issue, a simple and reliable method of quantification is needed. We established a method of quantifying trans-octadecenoic acids (trans-6,8,9,11 18:1 fatty acids, TOAs), a major component of trans fatty acid, in human tissue samples, and then determined the TOAs level in the placenta. Oleic acid (OA) (C18:1(9c)) was measured by isotope dilution gas chromatography-mass spectrometry, and the TOAs level was subsequently calculated based on the ratio of the peak areas for TOAs and OA (TOAs/OA) in the mass chromatogram. Lipids were extracted from 28 human placentas at different gestational ages from 28 to 41 weeks, and the TOAs and OA levels were measured. In method validation, the limit of detection for elaidic acid (trans-9,18:1 fatty acid), a major component of TOAs, was 0.57 ng, and linearity of calibration ranging from 7.7 to 68.0 μg/g placenta for TOAs. In human placenta analysis, the TOAs level was significantly higher in term (n = 15, 40.2 ± 9.7 μg/g placenta) than in preterm placentas (n = 13, 18.9 ± 7.4 μg/g placenta) (p < 0.001), while OA levels were similar in term (n = 15, 863 ± 132 μg/g placenta) and preterm (n = 13, 743 ± 283 μg/g placenta) placentas (p = 0.15). TOAs accumulate in the placenta as pregnancy progresses and have a fate different from that of OA in vivo. To our knowledge, this is the first report of TOA quantification in human tissue samples. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  15. Transplacental differences in Ca, Na, K, and electropotential in the guinea pig

    SciTech Connect

    Kelman, B.J.; Twardock, A.R.

    1983-07-01

    The fetal side of hemochorial placentas from guinea pigs between 58 and 62 days gestation were perfused in situ. Concurrent measurements were made of the clearances of radiocalcium and tritiated water from maternal to fetal circulation of the placenta, transplacental potential difference (TPD), maternal plasma and perfusate Ca, Na, and K concentrations, maternal blood pressure, gross permeability of albumin in the placenta, and net water movements. Movement of Ca from dam to fetus appeared to occur against an electrochemical gradient and was not associated with the movements of Na and K across the placenta. A negative correlation between perfusate Na and K concentrations, not dependent on maternal plasma Na and K concentrations and abolished by high concentrations of Ca in the fetal circulation of the placenta, strongly supports the concept of a Na-K exchange mechanism in the placenta directed so that K is moved against a concentration gradient towards the dam. There was no evidence that the TPD existed at the site of maternal-fetal exchange for Ca, Na, or K.

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

    PubMed

    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.

  17. Identification of ATP diphosphohydrolase activity in human term placenta using a novel assay for AMP.

    PubMed

    Papamarcaki, T; Tsolas, O

    1990-09-03

    Human term placenta contains an ATP diphosphohydrolase activity which hydrolyses ATP to ADP and inorganic phosphate and ADP to AMP and a second mole of inorganic phosphate. The activity has a pH optimum between 8.0 and 8.5. Magnesium or calcium ions are required for maximum activity. Other nucleoside phosphates, p-nitrophenyl phosphate or sodium pyrophosphate, are not hydrolysed. The activity is not due to ATPases, or to myokinase, as determined by the use of inhibitors. NaF and NaN3 were found to inhibit strongly the activity thus identifying it as an ATP diphosphohydrolase. A sensitive enzymatic assay for measurement of AMP, one of the products of the reaction, was established, based on the strong inhibition of muscle fructose 1,6-biphosphatase by AMP. The range of the assay was 0.05-0.8 microM AMP. ATP diphosphohydrolase was found to have a rate of AMP production from ADP twice the rate from ATP. Under the same conditions, the assay for Pi release, on the other hand, gave velocities similar to each other for the two substrates. The activity appears to be identical to the ADP-hydrolysing activity in placenta reported by others.

  18. Origin stories from a regional placenta tissue collection

    PubMed Central

    Fannin, Maria; Kent, Julie

    2015-01-01

    Twenty-three years ago when women and their children were recruited to a longitudinal genetic epidemiological study during pregnancy, placentas were collected at birth. This paper explores the history of a regional placenta biobank and contemporary understandings of its value for the constitution of a research population. We draw on interviews with some of the mothers and those responsible for the establishment and curation of the placenta collection in order to explore the significance and meaning of the collection for them. Given its capacity to stand in for the study cohort of mothers and children, we argue that the material significance of the placenta biobank as a research tool seems far less important than the work it does in constituting a population. The stories about this collection may be understood within the wider context of developments in biobanking and the bioeconomy. PMID:25745355

  19. Morbidly Adherent Placenta: Interprofessional Management Strategies for the Intrapartum Period.

    PubMed

    Baird, Suzanne McMurtry; Troiano, Nan H; Kennedy, Margaret Betsy Babb

    "Morbidly adherent placenta" is a term that describes the continuum of placenta accreta, increta, and percreta. The incidence of this type of abnormal placentation has increased significantly over recent decades. The reason is probably multifactorial but, partly, because of factors such as the increasing number of cesarean births. Women at greatest risk are those who have myometrial damage caused by a previous cesarean birth, with either anterior or posterior placenta previa overlying the uterine scar. This condition poses significant risks of morbidity and/or mortality to the pregnant woman and her fetus. A multidisciplinary approach to care throughout pregnancy is essential. This article describes the classification of morbidly adherent placenta, risk factors, methods of diagnosis, potential maternal and fetal complications, and intrapartum clinical management strategies to optimize outcomes.

  20. Increased glucocerebrosidase expression and activity in preeclamptic placenta.

    PubMed

    Jebbink, J M; Boot, R G; Keijser, R; Moerland, P D; Aten, J; Veenboer, G J M; van Wely, M; Buimer, M; Ver Loren van Themaat, E; Aerts, J M F G; van der Post, J A M; Afink, G B; Ris-Stalpers, C

    2015-02-01

    Lysosomal glucosidase beta acid (GBA) deficiency is inherent to Gaucher disease, Parkinsonism and Lewy-body dementia. Increased GBA expression has never been associated with human disease. We describe increased GBA expression and activity in placenta from preeclamptic pregnancies. 112 placenta biopsies were available for qPCR, analysis of GBA gene expression and activity. Microanalysis was performed on 20 placenta samples. Alternatively spliced placental GBA transcripts were cloned, expressed in HEK293 cells and analyzed by Western blot and activity assay. GBA is expressed in the syncytiotrophoblast layer of human placenta already at 5 weeks of gestation. We identified five novel GBA transcripts in placenta that enzymatically inactive when expressed in HEK293 cells. Both GBA RNA expression and enzymatic activity are upregulated in preeclamptic placenta. Microarray analysis of 20 placenta tissues identified 158 genes co-regulating with GBA expression and gene enrichment analysis highlights lysosomal function. In our micro-array data GBA expression does not correlate with FLT1 expression, currently the most powerful marker for preeclampsia. There are 89 transcripts that are negatively correlated with GBA expression of which BMP4 and TFEB are interesting as they are essential to early placenta function. Although very speculative, we hypothesize that increased GBA expression might relate to placentation through decreased BMP4 signaling or vascularization through downregulation of TFEB. Ceramide, the product of hydrolysis of glucosylceramide by GBA and involved in the regulation of cell differentiation, survival and apoptosis, is another putative candidate linking increased GBA activity to preeclampsia. Both pathways merit further investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Is epidural analgesia during labor related to retained placenta?

    PubMed

    Sarit, Avraham; Sokolov, Amit; Many, Ariel

    2016-05-01

    To explore the influence of epidural analgesia on the course of the third stage of labor and on the incidence of the complete retained placenta as well as retained parts of the placenta. This is a population-based cohort study in a tertiary medical center. We collected data from all 4227 spontaneous singleton vaginal deliveries during 6 months and compared the incidence of retained placenta in deliveries with epidural analgesia with those without analgesia. Multivariable logistic regression was used to control for possible confounders. More than two-thirds of the women (69.25%) used epidural analgesia during their delivery. A need for intervention due to placental disorder during the third stage of labor was noted in 4.2% of all deliveries. Epidural analgesia appeared to be significantly (P=0.028) related to placental disorders compared with no analgesia: 4.8% vs. 3%, respectively. Deliveries with manual interventions during the third stage, for either complete retained placenta or suspected retained parts of the placenta, were associated with the use of epidural analgesia (P=0.008), oxytocin (P=0.002) and older age at delivery (P=0.000), but when including all factors in a multivariable analysis, using a stepwise logistic regression, the factors that were independently associated with interventions for placental disruption during the third stage of delivery were previous cesarean section, oxytocin use and, marginally, older age. Complete retained placenta and retained parts of the placenta share the same risk factors. Epidural analgesia does not directly influence the incidence of complete retained placenta or retained parts, though clinically linked through increased oxytocin use. The factors that were independently associated with interventions for placental disruption during the third stage of delivery were previous cesarean section, oxytocin use and older age.

  2. Effect of Placenta Previa on Preeclampsia

    PubMed Central

    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

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

    PubMed

    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.

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

    PubMed

    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. © 2016 Japan Society of Obstetrics and Gynecology.

  5. Glucose transporters in the human placenta.

    PubMed

    Illsley, N P

    2000-01-01

    The availability of antibodies and cDNA probes specific for the various members of the facilitated-diffusion glucose transporter (GLUT) family has enabled researchers to obtain a much clearer picture of the mechanisms for placental uptake and transplacental transport of glucose. This review examines studies of human placental glucose transport with the aim of providing a model which describes the transporter isoforms present in the placenta, their cellular localization and functional significance. The GLUT1 glucose transporter, present on both the microvillous and basal membranes of the syncytial barrier, is the primary isoform involved in the transplacental movement of glucose. Although GLUT3 mRNA is widely distributed, GLUT3 protein is localized to the arterial component of the vascular endothelium, where it may play a role in enhancing transplacental glucose transport. This data is in contrast to the situation in other mammalian species, such as the mouse, rat and sheep, where GLUT3 protein is not only present in those epithelial cells which carry out transplacental transport but becomes an increasingly prominent isoform as gestation progresses. The asymmetric distribution of GLUT1 in the human syncytiotrophoblast (microvillous>basal) means that basal GLUT1 acts as the rate limiting step in transplacental transfer. Changes in basal GLUT1 therefore have the potential to cause alterations in transplacental transport of glucose. Although there appear to be no changes in syncytial GLUT1 expression in intrauterine growth retardation, in diabetic pregnancies increases in basal GLUT1 expression and activity have been observed, with significant consequences for the maternal-fetal flux of glucose. Little is known of glucose transporter regulation in the placenta save for the effects of hyper- and hypoglycemia. GLUT1 expression and activity appear to be inversely related to extracellular glucose concentration, however within the physiological range, GLUT1 expression is

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

    PubMed

    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 < .01). However, there was no statistically significant difference between SWE values of 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.

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

    PubMed

    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.

  8. Bidirectional transfer of methadone across human placenta.

    PubMed

    Nekhayeva, Ilona A; Nanovskaya, Tatiana N; Deshmukh, Sujal V; Zharikova, Olga L; Hankins, Gary D V; Ahmed, Mahmoud S

    2005-01-01

    Methadone maintenance programs are considered the standard of care for the pregnant opiate addict. However, data on changes in methadone pharmacokinetics (PK) during pregnancy are limited and do not include its disposition by the placenta due to obvious ethical and safety considerations. Accordingly, investigations in our laboratory are focusing on human placental disposition of opiates including methadone. Recently, we reported on methadone metabolism by placental aromatase and provide here data on its bidirectional transfer across the tissue utilizing the technique of dual perfusion of placental lobule. The concentrations of the opiate transfused into the term placental tissue were those reported for its in vivo levels in the maternal serum of women under treatment with the drug. Data obtained indicated that the opiate has no adverse effects on placental viability and functional parameters and that it is retained by the tissue. Also, methadone transfer and its clearance index in the fetal to maternal direction (0.97+/-0.05) was significantly higher (P<0.05) than in the maternal to fetal (0.83+/-0.09). The observed asymmetry in methadone transfer could be explained by the unidirectional activity of the efflux transporter P glycoprotein (P-gp) that is highly expressed in variable amounts in trophoblast tissue. Therefore, placental disposition of methadone might be an important contributor to the regulation of its concentration in the fetal circulation and consequently may affect the incidence and intensity of neonatal abstinence syndrome for women treated with the drug during pregnancy.

  9. Placenta Growth Factor in Diabetic Wound Healing

    PubMed Central

    Cianfarani, Francesca; Zambruno, Giovanna; Brogelli, Laura; Sera, Francesco; Lacal, Pedro Miguel; Pesce, Maurizio; Capogrossi, Maurizio C.; Failla, Cristina Maria; Napolitano, Monica; Odorisio, Teresa

    2006-01-01

    Reduced microcirculation and diminished expression of growth factors contribute to wound healing impairment in diabetes. Placenta growth factor (PlGF), an angiogenic mediator promoting pathophysiological neovascularization, is expressed during cutaneous wound healing and improves wound closure by enhancing angiogenesis. By using streptozotocin-induced diabetic mice, we here demonstrate that PlGF induction is strongly reduced in diabetic wounds. Diabetic transgenic mice overexpressing PlGF in the skin displayed accelerated wound closure compared with diabetic wild-type littermates. Moreover, diabetic wound treatment with an adenovirus vector expressing the human PlGF gene (AdCMV.PlGF) significantly accelerated the healing process compared with wounds treated with a control vector. The analysis of treated wounds showed that PlGF gene transfer improved granulation tissue formation, maturation, and vascularization, as well as monocytes/macrophages local recruitment. Platelet-derived growth factor, fibroblast growth factor-2, and vascular endothelial growth factor mRNA levels were increased in AdCMV.PlGF-treated wounds, possibly enhancing PlGF-mediated effects. Finally, PlGF treatment stimulated cultured dermal fibroblast migration, pointing to a direct role of PlGF in accelerating granulation tissue maturation. In conclusion, our data indicate that reduced PlGF expression contributes to impaired wound healing in diabetes and that PlGF gene transfer to diabetic wounds exerts therapeutic activity by promoting different aspects of the repair process. PMID:17003476

  10. Economic and reproductive consequences of retained placenta in dairy cattle.

    PubMed

    Joosten, I; Stelwagen, J; Dijkhuizen, A A

    1988-07-09

    The financial losses due to retained placenta in Dutch dairy cattle were estimated by using two different methods of calculation. A data-set containing the birth records of 160,188 Meuse-Rhine-Yssel cows provided data on the reproductive performance of cows with and without retained placenta. The fertility of cows after retention of the placenta appeared to be affected. An economic calculation made by adding the losses due to increased calving interval, increased culling rate, loss of milk production and the costs of veterinary treatment and drugs revealed that the total loss due to retained placenta was 471 pounds per year for a 100-cow farm with an average incidence of the condition (6.6 per cent). For a 'problem' farm with a 30 per cent rate, the loss was 2139 pounds per year. A computer farm simulation model, based on a stochastic determination of events, was used to make calculations for circumstances closely resembling those on farms. A 6.6 per cent rate of retained placenta caused a small but significant decrease in net return on labour and management; however, a 30 per cent rate caused highly significant changes. The economic effects of retained placenta were similar in magnitude in herds of high or low productivity and high or low fertility. Sensitivity analysis showed that the greatest financial losses were caused by loss of milk production, followed by the number of animals suffering from complications. The financial losses in herds with an average rate of retained placenta were thus of limited economic importance and therapeutic measures alone should be adequate.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    PubMed

    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

  12. Drug transfer and metabolism by the human placenta.

    PubMed

    Syme, Michael R; Paxton, James W; Keelan, Jeffrey A

    2004-01-01

    The major function of the placenta is to transfer nutrients and oxygen from the mother to the foetus and to assist in the removal of waste products from the foetus to the mother. In addition, it plays an important role in the synthesis of hormones, peptides and steroids that are vital for a successful pregnancy. The placenta provides a link between the circulations of two distinct individuals but also acts as a barrier to protect the foetus from xenobiotics in the maternal blood. However, the impression that the placenta forms an impenetrable obstacle against most drugs is now widely regarded as false. It has been shown that that nearly all drugs that are administered during pregnancy will enter, to some degree, the circulation of the foetus via passive diffusion. In addition, some drugs are pumped across the placenta by various active transporters located on both the fetal and maternal side of the trophoblast layer. It is only in recent years that the impact of active transporters such as P-glycoprotein on the disposition of drugs has been demonstrated. Facilitated diffusion appears to be a minor transfer mechanism for some drugs, and pinocytosis and phagocytosis are considered too slow to have any significant effect on fetal drug concentrations. The extent to which drugs cross the placenta is also modulated by the actions of placental phase I and II drug-metabolising enzymes, which are present at levels that fluctuate throughout gestation. Cytochrome P450 (CYP) enzymes in particular have been well characterised in the placenta at the level of mRNA, protein, and enzyme activity. CYP1A1, 2E1, 3A4, 3A5, 3A7 and 4B1 have been detected in the term placenta. While much less is known about phase II enzymes in the placenta, some enzymes, in particular uridine diphosphate glucuronosyltransferases, have been detected and shown to have specific activity towards marker substrates, suggesting a significant role of this enzyme in placental drug detoxification. The increasing

  13. Is Grannum grading of the placenta reproducible?

    NASA Astrophysics Data System (ADS)

    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.

  14. A comprehensive analysis of the human placenta transcriptome.

    PubMed

    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. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Three-dimensional ultrasound evaluation of the placenta.

    PubMed

    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. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. A Comprehensive Analysis of the Human Placenta Transcriptome

    PubMed Central

    Saben, Jessica; Zhong, Ying; McKelvey, Samantha; Dajani, Nafisa K.; Andres, Aline; Badger, Thomas M.; Gomez-Acevedo, Horacio; Shankar, Kartik

    2014-01-01

    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. PMID:24333048

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

    PubMed

    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.

  18. Conformity to guidelines for pathologic examination of the placenta.

    PubMed

    Spencer, Michael K; Khong, T Yee

    2003-02-01

    The College of American Pathologists developed a consensual guideline for placental examination that included indications for the submission of placentas for pathologic examination. The adherence to this guideline is not known. To identify the number of placentas that were and that should have been examined by a tertiary-care hospital according to the College of American Pathologists' practice guideline and to compare the indications listed by medical staff on their pathology request forms with the clinical events recorded on the hospital's databases. Data from the hospital computer databases and from pathology request forms were collected for all 987 deliveries occurring at a tertiary-level maternity hospital from April through June 2000. Fewer than 20% of placentas were examined, but about 50% should have been. Maternal fever and suspected neonatal infection were the indications with the lowest examination rates. Neonatal indications were infrequently listed. This hospital examined approximately one third of the placentas that should have been examined. When the placentas were examined, the medical staff often failed to appropriately list the indications on their pathology request forms.

  19. Efficient production of Aschersonia placenta protoplasts for transformation using optimization algorithms.

    PubMed

    Wei, Xiuyan; Song, Xinyue; Dong, Dong; Keyhani, Nemat O; Yao, Lindan; Zang, Xiangyun; Dong, Lili; Gu, Zijian; Fu, Delai; Liu, Xingzhong; Qiu, Junzhi; Guan, Xiong

    2016-07-01

    The insect pathogenic fungus Aschersonia placenta is a highly effective pathogen of whiteflies and scale insects. However, few genetic tools are currently available for studying this organism. Here we report on the conditions for the production of transformable A. placenta protoplasts using an optimized protocol based on the response surface method (RSM). Critical parameters for protoplast production were modelled by using a Box-Behnken design (BBD) involving 3 levels of 3 variables that was subsequently tested to verify its ability to predict protoplast production (R(2) = 0.9465). The optimized conditions resulted in the highest yield of protoplasts ((4.41 ± 0.02) × 10(7) cells/mL of culture, mean ± SE) when fungal cells were treated with 26.1 mg/mL of lywallzyme for 4 h of digestion, and subsequently allowed to recover for 64.6 h in 0.7 mol/L NaCl-Tris buffer. The latter was used as an osmotic stabilizer. The yield of protoplasts was approximately 10-fold higher than that of the nonoptimized conditions. Generated protoplasts were transformed with vector PbarGPE containing the bar gene as the selection marker. Transformation efficiency was 300 colonies/(μg DNA·10(7) protoplasts), and integration of the vector DNA was confirmed by PCR. The results show that rational design strategies (RSM and BBD methods) are useful to increase the production of fungal protoplasts for a variety of downstream applications.

  20. Pregnancy hemoperitoneum and placenta percreta in a patient with previous pelvic irradiation and ovarian failure

    SciTech Connect

    Pridjian, G.; Rich, N.E.; Montag, A.G. )

    1990-05-01

    Placenta percreta in a patient with previous pelvic irradiation has never been described. Reported is a case of placenta percreta with hemoperitoneum associated with a second-trimester incomplete abortion in a patient with previous pelvic irradiation and ovarian failure.

  1. Combined Spinal Epidural Anaesthesia for Caesarean Section and Hysterectomy in a Parturient with Placenta Accreta

    PubMed Central

    Seyhan, Tülay Özkan; Sungur, Mukadder Orhan; Edipoğlu, İpek; Baştu, Ercan

    2014-01-01

    Placenta accreta complicates the anaesthetic and surgical approach in caesarean section. In this report, a parturient with placenta accreta and multiple drug allergies who was managed using combined spinal epidural anaesthesia for caesarean hysterectomy is discussed. PMID:27366410

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

    MedlinePlus

    ... Healthy Pregnancy The Mystery and Miracle of the Placenta Past Issues / Fall 2016 Table of Contents Understanding ... again as if it were yesterday.” Drawn to Placenta Research This experience helped lay the foundation for ...

  3. Bovine retained placenta: aetiology, pathogenesis and economic loss.

    PubMed

    Laven, R A; Peters, A R

    1996-11-09

    The literature on the effects and causes of retained placenta in the cow is reviewed. On a herd basis the condition can adversely affect milk yield and fertility, but on an individual cow basis the effects are unpredictable. The aetiology of retained placenta has been extensively studied and many causal factors have been implicated, but little is known of how many of them cause the condition. As a result its prevention and prediction is uncertain, primarily because of the lack of knowledge of the normal process of placental release. Vascular changes and uterine contractions play a role in placental release, but current opinion suggests that the primary cause of retained placenta is the retention of the feto-maternal union. Release only occurs after a process of maturation, which involves hormonal and structural changes. The factors which are thought to influence these changes, and thus cause the condition, are discussed.

  4. LMWH to prevent placenta-mediated pregnancy complications: an update.

    PubMed

    Duffett, Lisa; Rodger, Marc

    2015-03-01

    Placenta-mediated pregnancy complications, including preeclampsia, placental abruption, intrauterine growth restriction/small for gestational age and recurrent or late pregnancy loss, affect over 5% of pregnancies and can result in significant maternal and perinatal morbidity and mortality. These complications have been suggested to at least partly arise from placental insufficiency, possibly as a result of inappropriate coagulation activation. This association has led to the hypothesis that anticoagulant therapy, such as low molecular weight heparin, might reduce their occurrence. The following review will attempt to summarize the extensive research that has been performed to date exploring this hypothesis and provide guidance on the current and future role of low molecular weight heparin in women at risk for placenta-mediated pregnancy complications. A case will be made to question the widely adopted practice of prescribing low molecular weight heparin to women with prior placenta-mediated pregnancy complications and suggest possible areas for future research.

  5. Human Term Placenta as a Source of Hematopoietic Cells

    PubMed Central

    Serikov, Vladimir; Hounshell, Catherine; Larkin, Sandra; Green, William; Ikeda, Hirokazu; Walters, Mark C.

    2012-01-01

    The main barrier to a broader clinical application of umbilical cord blood (UCB) transplantation is its limiting cellular content. Thus, the discovery of hematopoietic progenitor cells in murine placental tissue led us investigate whether the human placenta contains hematopoietic cells, sites of hematopoiesis, and to develop a procedure of processing and storing placental hematopoietic cells for transplantation. Here we show that the human placenta contains large numbers of CD34-expressing hematopoietic cells, with the potential to provide a cellular yield several-fold greater than that of a typical UCB harvest. Cells from fresh or cryopreserved placental tissue generated erythroid and myeloid colonies in culture, and also produced lymphoid cells after transplantation in immunodeficient mice. These results suggest that human placenta could become an important new source of hematopoietic cells for allogeneic transplantation. PMID:19429852

  6. Advanced MR Imaging of the Placenta: Exploring the in utero placenta-brain connection

    PubMed Central

    Andescavage, Nickie Niforatos; DuPlessis, Adre; Limperopoulos, Catherine

    2015-01-01

    The placenta is a vital organ necessary for the healthy neurodevelopment of the fetus. Despite the known associations between placental dysfunction and neurologic impairment, there is a paucity of tools available to reliably assess in vivo placental health and function. Existing clinical tools for placental assessment remain insensitive in predicting and assessing placental well-being. Advanced MRI techniques hold significant promise for the dynamic, non-invasive, real-time assessment of placental health and identification of early placental-based disorders. In this review, we summarize the available clinical tools for placental assessment including ultrasound, Doppler, and conventional MRI. We then explore the emerging role of advanced placental MR imaging techniques for supporting the developing fetus, appraise the strengths and limitations of quantitative MRI in identifying early markers of placental dysfunction for improved pregnancy monitoring and fetal outcomes. PMID:25765905

  7. Differential methylation of imprinted genes in growth-restricted placentas.

    PubMed

    Lambertini, Luca; Lee, Tin-Lap; Chan, Wai-Yee; Lee, Men-Jean; Diplas, Andreas; Wetmur, James; Chen, Jia

    2011-11-01

    A complex network of epigenetic factors participates in regulating the monoallelic expression of a small subset of genes (~1%) in the human genome. This phenomenon goes under the definition of genomic imprinting, a parent-of-origin effect that, when altered during early embryogenesis, may influence fetal development into adulthood. Pertubations in genomic imprinting have been associated with placental and fetal growth restrictions. We analyzed the differential DNA methylation of all known imprinted genes on 10 appropriate-for-gestational-age, clinically normal, placentas and 7 severe intrauterine growth-restricted placentas. Samples were pooled according to the diagnosis and analyzed by methylated DNA immunoprecipitation (MeDIP) on a tiling microarray platform. The distribution of the differentially methylated regions (DMRs) identified in growth-restricted placentas showed a slight tendency toward hypermethylation. Imprinted genes not expressed in placenta showed a unique DMR profile with the fewest hyper- and hypomethylated DMRs. Promoter and CpG island DMRs were sporadic and randomly distributed. The vast majority of DMR identified (~99%) were mapped in introns, showing no common sequence features. Also, by using the more advanced array data mining softwares, no significant patterns emerged. In contrast, differential methylation showed a highly significant correlation with gene length. Overall these data suggest that differential methylation changes in growth-restricted placentas occur throughout the genomic regions, encompassing genes actively expressed in the placenta. These findings warrant caution in interpreting the significance of genes carrying clustered DMRs because the distribution of DMRs in a gene may be attributed as a function of its length rather than as a specific biological role.

  8. Identification of suitable reference genes in the mouse placenta.

    PubMed

    Solano, María Emilia; Thiele, Kristin; Kowal, Mirka Katharina; Arck, Petra Clara

    2016-03-01

    Quantitative real-time reverse transcription polymerase chain reaction (RT-qPCR) is a reliable tool to analyse gene expression profiles. The expression of housekeeping genes generally serves as a reference for mRNA amount, assuming that it remains stable under pathophysiological and experimental conditions. To date, an empirical validation of reference genes suitable for RT-qPCR-based studies in the mouse placenta is missing. We used NormFinder and BestKeeper statistical software to analyse the expression stability of candidate housekeeping genes quantified by RT-qPCR in mouse placentas. Fifteen of 32 potential candidate housekeeping genes analysed on gestation day (gd) 16.5 in mouse placentas exhibited an optimal cycle threshold (Ct). Among them B2m, Polr2a, Ubc, and Ywhaz genes showed the highest expression stability in placentas from control, but also experimentally-challenged mice. These genes as well as the currently widely used housekeeping genes Hprt1, Actb, and Gapdh were selected for further quality assessments. We quantified the Ct values of these selected genes in placental samples obtained from wild-type or genetically engineered dams at different gds, or upon selected experimental interventions known to affect placental phenotype. Among all housekeeping genes analysed, Polr2a was the most stably expressed and its expression stability excelled in combination with Ubc. Polr2a, especially in combination with Ubc, can be proposed as highly suitable endogenous reference for gene expression analysis in mouse-derived placental tissue. Moreover, the validation of both genes as a stable reference gene in human placenta-derived tissue strengthens the translational relevance of RT-qPCR findings using mouse placenta. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Isolation and analysis of hematopoietic stem cells from the placenta.

    PubMed

    Gekas, Christos; E Rhodes, Katrin; K A Mikkola, Hanna

    2008-06-24

    Hematopoietic stem cells (HSCs) have the ability to self-renew and generate all cell types of the blood lineages throughout the lifetime of an individual. All HSCs emerge during embryonic development, after which their pool size is maintained by self-renewing cell divisions. Identifying the anatomical origin of HSCs and the critical developmental events regulating the process of HSC development has been complicated as many anatomical sites participate during fetal hematopoiesis. Recently, we identified the placenta as a major hematopoietic organ where HSCs are generated and expanded in unique microenvironmental niches (Gekas, et al 2005, Rhodes, et al 2008). Consequently, the placenta is an important source of HSCs during their emergence and initial expansion. In this article, we show dissection techniques for the isolation of murine placenta from E10.5 and E12.5 embryos, corresponding to the developmental stages of initiation of HSCs and the peak in the size of the HSC pool in the placenta, respectively. In addition, we present an optimized protocol for enzymatic and mechanical dissociation of placental tissue into single-cell suspension for use in flow cytometry or functional assays. We have found that use of collagenase for single-cell suspension of placenta gives sufficient yields of HSCs. An important factor affecting HSC yield from the placenta is the degree of mechanical dissociation prior to, and duration of, enzymatic treatment. We also provide a protocol for the preparation of fixed-frozen placental tissue sections for the visualization of developing HSCs by immunohistochemistry in their precise cellular niches. As hematopoietic specific antigens are not preserved during preparation of paraffin embedded sections, we routinely use fixed frozen sections for localizing placental HSCs and progenitors.

  10. Colonization of mouse placentas by Brucella abortus inoculated during pregnancy.

    PubMed Central

    Bosseray, N.

    1980-01-01

    Pregnant mice were challenged at Day 3, 7, 11 or 15 of pregnancy with Brucella abortus Strain 544 and killed at Day 18 of pregnancy for the enumeration of brucella in the spleens and individual placentas. Whatever the route of challenge--i.p., i.v. or s.c. into the foot-pad (F-s.c.) no abortions or foetal deaths were observed. Placental colonization involved either all, none or only some of the placentas in the same uterus (partial placental colonization: 25% of the mice). In the latter case, the probability of colonization was the same for all sites of implantation. Placentas were independent units as regards colonization and bacterial proliferation. Placental colonization was expressed either by (1) the class of placental infection within the uterus, which might be total, partial or nil; (2) the ratio of infected to total placentas analysed per group; or (3) the mean degree of infection per group. Whatever means of expression was chosen, placental colonization increased with the dose of challenge in parallel with splenic infection in the mouse. The challenge doses required at Day 7 to infect 50% of the placentas differed according to the route (i.p. = 54; i.v. = 5.6 x 10(2) and F-s.c. = 3.6 x 10(4) brucella). Placentas were more frequently and more intensively colonized when the challenge was performed at Days 7 and 11 than at Days 3 and 15 at pregnancy. Mice immunized with H.38 B. melitensis killed vaccine 36 days before pregnancy were found to be protected against an i.p. challenge with 2 x 10(5) brucella at Day 7 of pregnancy. PMID:6775668

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

    PubMed

    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 < 0.001]. In complete 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

  12. Type and Location of Placenta Previa Affect Preterm Delivery Risk Related to Antepartum Hemorrhage

    PubMed Central

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

    2013-01-01

    Purpose: To evaluate whether type and location of placenta previa affect risk of antepartum hemorrhage-related preterm delivery. Methods: 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. Results: 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 < 0.001]. In complete 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. Conclusion: Obstetricians should be aware of the increased risk of preterm delivery related to antepartum hemorrhage in women with complete placenta

  13. An update on thrombophilia and placenta mediated pregnancy complications: what should we tell our patients?

    PubMed

    Rodger, Marc A

    2013-01-01

    The placenta mediated pregnancy complications, including pre-eclampsia, birth of a small for gestational age child, placental abruption or late pregnancy loss, are common and often devastating pregnancy complications leading to important maternal/fetal/neonatal morbidity and mortality. In this narrative review I examine two common questions related to women with prior placenta mediated pregnancy complications. Do thrombophilias cause placenta mediated pregnancy complications? Does low molecular weight heparin prevent recurrent placenta mediated pregnancy complications?

  14. Implantation and the placenta: Key pieces of the development puzzle

    SciTech Connect

    Cross, J.C.; Werb, Z.; Fisher, S.J.

    1994-12-02

    The mammalian embryo cannot develop without the placenta. Its specialized cells (trophoblast, endoderm, and extraembryonic mesoderm) form early in development. They attach the embryo to the uterus (implantation) and form vascular connections necessary for nutrient transport. In addition, the placenta redirects maternal endocrine, immune, and metabolic functions to the embryo`s advantage. These complex activities are sensitive to disruption, as shown by the high incidence of early embryonic mortality and pregnancy diseases in humans, as well as the numerous peri-implantation lethal mutations in mice. Integration of molecular and developmental approaches has recently produced insights into the molecules that control these processes.

  15. Second trimester placenta percreta presenting as acute abdomen

    PubMed Central

    Dew, Lauren; Yost, Nicole; Magee, Kevin; dePrisco, Gregory

    2015-01-01

    Diagnosing placenta percreta can be difficult. We describe a 41-year-old woman presenting at 21 weeks' gestation with intraabdominal bleeding and no signs of placental abnormality on ultrasound. The disagreement between results of the ultrasound and magnetic resonance imaging made definitive diagnosis difficult. The bleeding resolved spontaneously after a blood transfusion, and the patient was hospitalized for the remainder of the pregnancy. Delivery was by scheduled repeat cesarean at 34 weeks' gestation. Spontaneous rupture of the entire fundus occurred at the time of delivery. Placenta percreta was confirmed by histologic examination of the operatively excised uterus. PMID:25552794

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

    NASA Astrophysics Data System (ADS)

    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.

  17. 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

    PubMed Central

    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.

    2015-01-01

    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. PMID:23253784

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

    PubMed

    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 < 0.05). None of the women with previous one scar had placenta previa, while with previous 2 scars one had placenta previa (p < 0.05). One woman with 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.

  19. Adherent basal plate myometrial fibers in the delivered placenta as a risk factor for development of subsequent placenta accreta.

    PubMed

    Linn, Rebecca L; Miller, Emily S; Lim, Grace; Ernst, Linda M

    2015-12-01

    Placenta accreta is implantation of chorionic tissue directly upon the myometrium without normal intervening decidua. The clinical significance of myometrial fibers attached to the basal plate (BPMYO) has yet to be fully elucidated. To determine the importance of depth and quantity of BPMYO in predicting subsequent accreta in the next pregnancy. Women with placentas from two successive pregnancies submitted for pathologic evaluation were included. 50 cases had clinical and/or pathologic diagnosis of accreta in an index pregnancy. 100 controls had no evidence of accreta in an index pregnancy. H&E slides were re-reviewed and stage of accreta/BPMYO was determined. The stages were defined as: Stage 0-no BPMYO; Stage 1-BPMYO with intervening decidua; Stage 2 < 2 decidual cells separating myometrium from chorionic tissue; Stage 3-accreta; Stage 4-increta; Stage 5-percreta. The amount of BPMYO for each placenta was quantified. Prior placentas of cases were twice as likely to have BPMYO compared to controls (84%vs42%, P < 0.001). The frequency of stage 1 BPMYO was not significantly different between the two groups (46%v40%, P = 0.489), but cases were more likely to have higher stages of BPMYO (stage 2-3) in a prior placenta (38%vs2%, P < 0.001). A significantly higher number of BPMYO foci and a larger proportion of BPMYO on the basal plate (6.2%vs0.7%, P < 0.001) in cases compared to controls. Small amounts and low stage BPMYO (stage 1) may be common; however, higher stages of BPMYO (stage 2-3) and greater quantities of BPMYO in a delivered placenta are significantly associated with the subsequent development of accreta. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed

    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

  1. 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.

    PubMed

    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.

  2. Blood transfusion for caesarean delivery complicated by placenta praevia.

    PubMed

    Boyle, R K; Waters, B A; O'Rourke, P K

    2009-12-01

    This study was undertaken to determine if the need for red cell blood transfusion in placenta praevia could be predicted. Data from a retrospective observational study of 246 obstetric patients, with placenta praevia, from 1999 to 2005 were analysed to generate a model to predict requirement for transfusion. Seventy-one patients were transfused. Independent risk factors for transfusion were gestational age at delivery of 32-35 weeks [odds ratio (OR): 2.6; 95% confidence interval (CI): 1.1-6.4] and caesarean combined with hysterectomy (OR: 29.4; 95% CI: 5.9-145.9; P < 0.001). No independent risk of transfusion was associated with maternal age, race, parity, smoking status, type of anaesthesia, caesarean combined with arterial balloon occlusion, grade of placenta, accreta and previous uterine surgery. Gestational age at delivery and type of surgery required are predictors of transfusion during caesarean for placenta praevia. Arterial balloon occlusion does not appear to increase transfusion risk and may be considered as one of the techniques in management.

  3. Can we make the pig placenta work better?

    USDA-ARS?s Scientific Manuscript database

    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...

  4. In situ measurements of magnetic nanoparticles after placenta perfusion

    NASA Astrophysics Data System (ADS)

    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.

  5. Chorangiocarcinoma of the placenta: a case report and clinical review.

    PubMed

    Faes, T; Pecceu, A; Van Calenbergh, S; Moerman, P

    2012-08-01

    We describe a case of chorangiocarcinoma, a complex lesion consisting of a trophoblastic proliferation within a chorangioma, presenting in a term placenta. The lesion was diagnosed by ultrasound at a second trimester check-up after amniocentesis, performed because of increased combined risk at first trimester screening for trisomy 21. After uncomplicated vaginal delivery, a healthy child was born and the placenta was expelled spontaneously. Gross examination of the placenta showed a well-demarcated mass, bulging paracentrally from the fetal surface. Histology revealed a trophoblastic proliferation inside a chorangioma, consisting of multiple nodules with characters of focal multinucleation and pleomorphic cell nuclei, extensive central necrosis and high mitotic activity. Immunohistochemical staining showed strong intensity for hCG; Ki-67 (MIB-1) demonstrated a high proliferation index. Histopathological and immunohistochemical profile was compatible with a malignant trophoblastic proliferation. This is only the fifth reported case of so-called "chorangiocarcinoma" of the placenta (Table 1). However, histopathologically only one reported case was identical to ours. A proliferation of atypical trophoblast was observed inside a chorangioma, which formed as it were a shield around the trophoblast. No extravascular stromal invasion was present. Follow-up revealed no metastases, either in the mother or the child, up to 3 months after birth. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Phenotypic characterization of macrophages in human term placenta.

    PubMed Central

    Mues, B; Langer, D; Zwadlo, G; Sorg, C

    1989-01-01

    Immunohistological techniques have been used to study heterogeneity, frequency and distribution of macrophages and T lymphocytes in chorionic villous mesenchyme, stroma of the amniochorion and decidua of 36 human term placentas obtained at spontaneous normal delivery and by caesarean section, using a panel of monoclonal antibodies (mAb) specific for macrophage phenotypes appearing in acute early (mAb 27E10), late (mAb 25F9) and down-regulatory (mAb RM3/1) stages of inflammation. Significant numbers of macrophages were identified. It could be shown that RM3/1+ macrophage phenotypes which in vitro are strongly dexamethasone-inducible and in vivo appear in down-regulatory stages of inflammatory processes are the major cell population in human term placenta. Macrophages characterized by monoclonal antibodies 27E10 and 25F9, as well as CD4+ and CD8+ cells, were distributed sparsely or were completely absent. The finding of anti-inflammatory macrophage phenotypes to be the predominant mononuclear cell population in human term placenta provides support for a mechanism whereby placenta functions as an active immunosuppressive biological barrier between mother and fetus. Images Figure 1 Figure 2 Figure 3 PMID:2788125

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

    PubMed

    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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. [Placenta chorioangioma. Case report at Hospital Español].

    PubMed

    Vázquez Camacho, Eric Emilio; Sánchez Herrera, Rafael; García García, Gerardo; Estrada Natoli, Laura; Sánchez Lazcano, Javier; Saules Bezanilla, Cynthia

    2007-07-01

    Placenta chorioangioma is the most frequent non-trophoblastic tumor of the placenta. Its real incidence is unknown. This incidence is reported as 1% in microscopically examined placentas and counts with clinical evidence in approximately 1: 3,500 to 9,000 births. This tumor is not generally associated to maternal fetal complications, unless the tumor size surpasses a diameter of 5 cm or is near the place of umbilical cord insertion. When the tumor is big, it can complicate the pregnancy with hydramnios, postpartum bleeding, delay in the intrauterine growth, or congestive heart failure in the newborn. The clinic case belongs to a Korean female patient, aged 32, without important antecedents. A placental tumouration, 50.2 x 44.1 mm, was detected by ultrasound to this patient in her 37 1/7 week of pregnancy. She has a normoevolutive pregnancy whose was a term, she had an a eutocic delivery, getting a male whose weight was 2,850 g. The baby is still alive. The placenta histopathological study reported placental chorioangioma, which infracted partially, with multifocal calcification areas.

  9. Stress state and strain rate dependence of the human placenta

    USDA-ARS?s Scientific Manuscript database

    Maternal trauma (MT) in automotive collisions is a source of injury, morbidity, and mortality for both mothers and fetuses. The primary associated pathology is placental abruption in which the placenta detaches from the uterus leading to hemorrhaging and termination of pregnancy. In this study, we f...

  10. Kinetics of silica nanoparticles in the human placenta

    PubMed Central

    Poulsen, Marie Sønnegaard; Mose, Tina; Maroun, Lisa Leth; Mathiesen, Line; Knudsen, Lisbeth Ehlert; Rytting, Erik

    2015-01-01

    The potential medical applications of nanoparticles warrant their investigation in terms of biodistribution and safety during pregnancy. The transport of silica nanoparticles (NPs) across the placenta was investigated using two models of maternal-fetal transfer in human placenta, namely, the BeWo b30 choriocarcinoma cell line and the ex vivo perfused human placenta. Nanotoxicity in BeWo cells was examined by the MTT assay and demonstrated decreased cell viability at concentrations greater than 100 μg/mL. In the placental perfusion experiments, antipyrine crossed the placenta rapidly, with a fetal/maternal ratio of 0.97 ± 0.10 after 2 hours. In contrast, the percentage of silica NPs reaching the fetal perfusate after 6 hours was limited to 4.2 ± 4.9% and 4.6 ± 2.4% for 25-nm and 50-nm NPs, respectively. The transport of silica NPs across the BeWo cells was also limited, with an apparent permeability of only 1.54 × 10−6 ± 1.56 × 10−6 cm/sec. Using confocal microscopy, there was visual confirmation of particle accumulation in both BeWo cells and in perfused placental tissue. Despite the low transfer of silica NPs to the fetal compartment, questions regarding biocompatibility could limit the application of unmodified silica NPs in biomedical imaging or therapy. PMID:23742169

  11. The placenta as a cell source in fetal tissue engineering.

    PubMed

    Kaviani, Amir; Perry, Tjörvi E; Barnes, Carmen M; Oh, Jung-Tak; Ziegler, Moritz M; Fishman, Steven J; Fauza, Dario O

    2002-07-01

    This study was aimed at determining whether fetal tissue constructs can be engineered from cells derived from the placenta. A subpopulation of morphologically distinct cells was isolated mechanically from specimens of human placenta (n = 6) and selectively expanded. The lineage of these cells was determined by immunofluorescent staining against multiple intermediate filaments and surface antigens. Cell proliferation rates were determined by oxidation assays and compared with those of immunocytochemically identical cells derived from human amniotic fluid samples (n = 6). Statistical analysis was by analysis of variance (ANOVA). After expansion, the cells were seeded onto a polyglycolic acid polymer/poly-4-hydroxybutyrate scaffold. The resulting construct was analyzed by both optical and scanning electron microscopy. The immunocytochemical profile of expanded placental cells was consistent with a nontrophoblastic, mesenchymal origin. Their proliferation rate in culture was not significantly different when compared with mesenchymal fetal cells isolated from human amniotic fluid; however, it was greater than previously reported rates for similar cells obtained from postnatal or adult tissues. Construct analysis showed dense layers of cells firmly attached to the scaffold without evidence of cell death. Subpopulations of nontrophoblastic, mesenchymal cells can be isolated consistently from the human placenta. These cells proliferate as rapidly as fetal mesenchymal amniocytes in vitro and attach firmly to polyglycolic acid scaffolds. The placenta can be a valuable and practical source of cells for the engineering of select fetal tissue constructs. Copyright 2002, Elsevier Science (USA). All rights reserved.

  12. Active and passive transport of drugs in the human placenta.

    PubMed

    Włoch, Stanisław; Pałasz, Artur; Kamiński, Marcin

    2009-10-01

    The human placenta, characterized by the processes of passive transport and facilitated diffusion, contains numerous active transport proteins, usually located in the microvilli of the syncytiotrophoblast or in the endothelium of the capillaries of the villi. These proteins use either the energy from ATP hydrolysis or other mechanisms resulting, among others, from the formation of the maternofetal ion gradient, which facilitates the transfer of various endogenous substances or xenobiotics across the body membranes. The proteins either trigger the efflux of these substances from the fetal tissues via the placenta into the maternal bloodstream, or conversely they accumulate them in the fetal tissues. Both the placenta and the fetus are equipped with independent systems of enzymes of 1st and 2nd phase of substrate metabolism, such as CYP450, glucuronyltransferase or sulphatase. An active therapy with a wide range of drugs, often at high toxicity levels, either shortly before or during pregnancy, has naturally posed a question concerning the degree of impermeability of the placental barrier and how effectively it can be crossed, including any possible negative embryotoxic or teratogenic consequences. Such hazards seem to be quite real, as many drugs are substrates for ABC transporters. Also the placenta itself, including its structure, is subject to vast transformations during pregnancy which may be observed as the thinning of the barrier separating the maternal blood from the fetal one, from 20-30 microm in the first trimester of gestation down to 2-4 microm in the third trimester of gestation.

  13. The Importance of Imprinting in the Human Placenta

    PubMed Central

    Frost, Jennifer M.; Moore, Gudrun E.

    2010-01-01

    As a field of study, genomic imprinting has grown rapidly in the last 20 years, with a growing figure of around 100 imprinted genes known in the mouse and approximately 50 in the human. The imprinted expression of genes may be transient and highly tissue-specific, and there are potentially hundreds of other, as yet undiscovered, imprinted transcripts. The placenta is notable amongst mammalian organs for its high and prolific expression of imprinted genes. This review discusses the development of the human placenta and focuses on the function of imprinting in this organ. Imprinting is potentially a mechanism to balance parental resource allocation and it plays an important role in growth. The placenta, as the interface between mother and fetus, is central to prenatal growth control. The expression of genes subject to parental allelic expression bias has, over the years, been shown to be essential for the normal development and physiology of the placenta. In this review we also discuss the significance of genes that lack conservation of imprinting between mice and humans, genes whose imprinted expression is often placental-specific. Finally, we illustrate the importance of imprinting in the postnatal human in terms of several human imprinting disorders, with consideration of the brain as a key organ for imprinted gene expression after birth. PMID:20617174

  14. Creatine biosynthesis and transport by the term human placenta.

    PubMed

    Ellery, Stacey J; Della Gatta, Paul A; Bruce, Clinton R; Kowalski, Greg M; Davies-Tuck, Miranda; Mockler, Joanne C; Murthi, Padma; Walker, David W; Snow, Rod J; Dickinson, Hayley

    2017-04-01

    Creatine is an amino acid derivative that is involved in preserving ATP homeostasis. Previous studies suggest an important role for the creatine kinase circuit for placental ATP turnover. Creatine is obtained from both the diet and endogenous synthesis, usually along the renal-hepatic axis. However, some tissues with a high-energy demand have an inherent capacity to synthesise creatine. In this study, we determined if the term human placenta has the enzymatic machinary to synthesise creatine. Eleven placentae were collected following elective term caesarean section. Samples from the 4 quadrants of each placenta were either fixed in formalin or frozen. qPCR was used to determine the mRNA expression of the creatine synthesising enzymes arginine:glycine amidinotransferase (AGAT) and guanidinoacetate methyltransferase (GAMT), and the creatine transporter (SLC6A8). Protein expression of AGAT and GAMT was quantified by Western blot, and observations of cell localisation of AGAT, GAMT and SLC6A8 made with immunohistochemistry. Synthesis of guanidinoacetate (GAA; creatine precursor) and creatine in placental homogenates was determined via GC-MS and HPLC, respectively. AGAT, GAMT and SLC6A8 mRNA and protein were detected in the human placenta. AGAT staining was identified in stromal and endothelial cells of the fetal capillaries. GAMT and SLC6A8 staining was localised to the syncytiotrophoblast of the fetal villi. Ex vivo, tissue homogenates produce both GAA (4.6 nmol mg protein(-1)h(-1)) and creatine (52.8 nmol mg protein(-1)h(-1)). The term human placenta has the capacity to synthesise creatine. These data present a new understanding of placental energy metabolism. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Persistent Cytomegalovirus Infection in Amniotic Membranes of the Human Placenta.

    PubMed

    Tabata, Takako; Petitt, Matthew; Fang-Hoover, June; Zydek, Martin; Pereira, Lenore

    2016-11-01

    Human cytomegalovirus (HCMV) is the leading viral cause of birth defects, including microcephaly, neurological deficits, hearing impairment, and vision loss. We previously reported that epithelial cells in amniotic membranes of placentas from newborns with intrauterine growth restriction and underlying congenital HCMV infection contain viral proteins in cytoplasmic vesicles. Herein, we immunostained amniotic membranes from 51 placentas from symptomatic and asymptomatic congenital infection with HCMV DNA in amniotic fluid and/or newborn saliva, intrauterine growth restriction, preterm deliveries, and controls. We consistently observed HCMV proteins in amniotic epithelial cells (AmEpCs) from infected placentas, sometimes with aberrant morphology. Primary AmEpCs isolated from mid-gestation placentas infected with pathogenic VR1814 proliferated and released infectious progeny for weeks, producing higher virus titers than late-gestation cells that varied by donor. In contrast to intact virion assembly compartments in differentiated retinal pigment epithelial cells, infected AmEpCs made dispersed multivesicular bodies. Primary AmEpCs and explants of amniochorionic membranes from mid-gestation placentas formed foci of infection, and interferon-β production was prolonged. Infected AmEpCs up-regulated anti-apoptotic proteins survivin and Bcl-xL by mechanisms dependent and independent of the activated STAT3. Amniotic membranes naturally expressed both survivin and Bcl-xL, indicating that fetal membranes could foster persistent viral infection. Our results suggest strengthening innate immune responses and reducing viral functions could suppress HCMV infection in the fetal compartment. Copyright © 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  16. Nanoparticles can cross mouse placenta and induce trophoblast apoptosis.

    PubMed

    Huang, Jian-Pei; Hsieh, Patrick C H; Chen, Chen-Yu; Wang, Tao-Yeuan; Chen, Pei-Chun; Liu, Chang-Ching; Chen, Chen-Chun; Chen, Chie-Pein

    2015-12-01

    The effects of nanoparticles on pregnancy remain unclear. In this study, we investigate whether nanoparticles of a specific size can cross the placenta and affect trophoblast function. Fluorescently labelled carboxylate-modified polystyrene beads with diameters of 20, 40, 100, 200, and 500 nm were chosen as model particles. In vitro, trophoblast cell line (3A-Sub-E) or primary culture of term trophoblasts was used for nanoparticle uptake analysis using flow cytometry, confocal microscopy, BrdU proliferation assay and analysis of cell apoptosis using Western blot. Intravenous injection of nanoparticles into pregnant mice at embryonic day 17 was used to study whether nanoparticles can cross the placenta. The mouse placentas were collected and quantitatively analyzed using high-performance liquid chromatography for nanoparticle uptake. Fluorescent polystyrene particles with diameters of up to 500 nm were taken up by the placenta and were able to cross the placental barrier. The fluorescent polystyrene particles were observed in various organs of fetuses after 4 h of administration to pregnant mice. The nanoparticle uptake by placental tissue was significantly increased in nanoparticles with a diameter of 40 nm. No linear association was evident between nanoparticle size and uptake. Nanoparticles with diameters of 20 nm (200 μg/ml) and 40 nm (500 μg/ml) could induce trophoblast cell apoptosis with increased cleaved caspase 3 and reduced cell proliferation. Our findings suggest that nanoparticles can cross the placenta and be taken up by fetal organs. Certain concentrations of carboxylate-modified polystyrene nanoparticles may be cytotoxic to trophoblasts, which could alter placental function. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed

    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<.01) and likely contributed to the higher incidence of retained placenta associated with twin births (27.9 vs. 1.9%; P<.01). Incidence of retained placenta was also higher in the spring (March-April) than in the fall (August-September) calving season (18.3 vs. 11.4%; P<.01). The higher incidence of dystocia with twins than with singles (46.9 vs. 20.6%, P<.01) was primarily due to abnormal presentation (37.0 vs. 4.5%, respectively) of one or both twin calves at parturition. First- (40.5%) and second- (22.7%) parity dams with a single birth had more (P<.01) dystocia than older dams (13.4%), whereas dystocia was not affected (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.

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

    PubMed

    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%] (P<0.05). The gestational age of pernicious group was (35.6 ± 2.7) weeks, less than that of non-pernicious group [(36.7 ± 2.7) weeks, P<0.001]. Rate of postpartum massive hemorrhage, rate of blood transfusion, rate of placental implantation and hysterectomy in pernicious and non-pernicious group were 29.7%, 35.6%, 27.7%, 11.9% and 8.1%, 10.8%, 5.7%, 0.8%, respectively (P<0.05). Multiple regression analysis showed that placenta accrete was significantly associated with postpartum massive hemorrhage in pernicious group (P<0.05). The awareness of the danger of pregnant women with PPP before operation and paying more attention to antenatal care are key measures to decrease the adverse maternal outcomes of pregnant women with placenta previa.

  19. In vivo and in vitro analysis of lysosomes and acid phosphatase activity in human chagasic placentas.

    PubMed

    Fretes, R E; De Fabro, S P

    1995-12-01

    A structural, cytochemical, stereological, and biochemical study of lysosomes and a lysosome marker, the enzyme acid phosphatase, was performed, both in placentas at term from chagasic pregnant women without fetal infection and in normal placentas at term cocultured in vitro with Trypanosoma cruzi. It was found that in placentas from chagasic women lysosomes were normally distributed in the trophoblast. Stereological analysis showed that lysosomes and cytochemical acid phosphatase (AcP) activity were increased in the trophoblast of chagasic placentas. AcP activity increased in subcellular fractions of the isolated trophoblast from chagasic placentas, and the lysosomal fraction of those placentas exhibited the highest value of enzymatic activity in comparison to controls (P < 0.05). No differences in AcP activity were observed between homogenates of normal placentas cocultured with T. cruzi and controls. These data suggest that the placental lysosome population might be involved in the process of placental infection by T. cruzi.

  20. Comparison of placenta samples with contamination controls does not provide evidence for a distinct placenta microbiota.

    PubMed

    Lauder, Abigail P; Roche, Aoife M; Sherrill-Mix, Scott; Bailey, Aubrey; Laughlin, Alice L; Bittinger, Kyle; Leite, Rita; Elovitz, Michal A; Parry, Samuel; Bushman, Frederic D

    2016-06-23

    Recent studies have suggested that bacteria associated with the placenta-a "placental microbiome"-may be important in reproductive health and disease. However, a challenge in working with specimens with low bacterial biomass, such as placental samples, is that some or all of the bacterial DNA may derive from contamination in dust or commercial reagents. To investigate this, we compared placental samples from healthy deliveries to a matched set of contamination controls, as well as to oral and vaginal samples from the same women. We quantified total 16S rRNA gene copies using quantitative PCR and found that placental samples and negative controls contained low and indistinguishable copy numbers. Oral and vaginal swab samples, in contrast, showed higher copy numbers. We carried out 16S rRNA gene sequencing and community analysis and found no separation between communities from placental samples and contamination controls, though oral and vaginal samples showed characteristic, distinctive composition. Two different DNA purification methods were compared with similar conclusions, though the composition of the contamination background differed. Authentically present microbiota should yield mostly similar results regardless of the purification method used-this was seen for oral samples, but no placental bacterial lineages were (1) shared between extraction methods, (2) present at >1 % of the total, and (3) present at greater abundance in placental samples than contamination controls. We conclude that for this sample set, using the methods described, we could not distinguish between placental samples and contamination introduced during DNA purification.

  1. Pathology of twin placentas with special attention to monochorionic twin placentas.

    PubMed

    Nikkels, P G J; Hack, K E A; van Gemert, M J C

    2008-12-01

    The risk of perinatal morbidity and mortality in twins is 3-7 times higher than in singletons. In comparison to dichorionic twins, monochorionic twins are at increased risk for perinatal mortality and serious morbidity. In both type of twins growth discordance can occur. Discordant growth of dichorionic twins could be due to differences in placental mass or differences in placental parenchymal lesions, whereas birth weight discordancy in monochorionic twins is caused by placental vascular anastomoses. In this review the different types of complications (acardiac twins, acute and chronic twin-twin transfusion syndrome) due to different combinations of vascular anastomoses are discussed in relation to a computer model developed to gain more insight into the development of the twin-twin transfusion syndrome. The angioarchitecture of 395 monochorionic twin placentas was studied. Mortality was highest in the absence of an arterio-arterial anastomosis (42%) and lowest in the presence of an arterio-arterial anastomosis (15%). If mortality occurred, pregnancies with double mortality usually had an arterio-arterial anastomosis. If pregnancies were complicated by one death, a veno-venous anastomosis is more likely to be present. In conclusion, monochorionic twin pregnancies are a high risk pregnancy with a high chance of both mortality and morbidity; placental characteristics are a major contributor to adverse outcome in these pregnancies.

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

    PubMed

    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(P<0.01). Variables with P<0.1 in one-factor analysis were introduced to multi-factor logistic regression analysis, which suggested that one prior cesarean section(OR=12.9,95% CI:6.3-26.3), two or more prior cesarean sections(OR=14.4, 95%CI:3.9-53.2), anterior placenta(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 hemoglobin<100 g/L(OR=1.7, 95%CI: 1.0-2.8)and delivery before 34 gestational weeks(OR=3.2, 95%CI: 1.6-6.3)were independent risk factors of peripartum hysterectomy in patients with placenta previa(P<0.05). Prior cesarean section, anterior placenta, complete placenta previa, placenta accreta, antenatal anemia and delivery before 34 gestational weeks are high risk factors of peripartum hysterectomy in placenta previa

  3. Mitochondrial content, oxidative, and nitrosative stress in human full-term placentas with gestational diabetes mellitus.

    PubMed

    Ramírez-Emiliano, Joel; Fajardo-Araujo, Martha E; Zúñiga-Trujillo, Ismael; Pérez-Vázquez, Victoriano; Sandoval-Salazar, Cuauhtémoc; Órnelas-Vázquez, Jessica K

    2017-04-04

    The purpose of this study was to determine the mitochondrial content, and the oxidative and nitrosative stress of the placenta in women with gestational diabetes mellitus (GDM). Full-term placentas from GDM and healthy pregnancies were collected following informed consent. The lipid peroxidation (TBARS) and oxidized protein (carbonyls) levels were determined by spectrophotometry, and 3-nitrotyrosine (3-NT), subunit IV of cytochrome oxidase (COX4), adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) and actin were determined by western blot, whereas ATPase activity was performed by determining the adenosine triphosphate (ATP) consumption using a High-performance liquid chromatography (HPLC) system. TBARS and carbonyls levels were lower in the placentas of women with GDM compared with the normal placentas (p < 0.001 and p < 0.05, respectively). Also, 3-NT/actin and AMPK/actin ratios were higher in GDM placentas than in the normal placentas (p = 0.03 and p = 0.012, respectively). Whereas COX4/actin ratio and ATPase activity were similar between GDM placentas and those controls. These data suggest that placentas with GDM are more protected against oxidative damage, but are more susceptible to nitrosative damage as compared to normal placentas. Moreover, the increased expression levels of AMPK in GDM placentas suggest that AMPK might have a role in maintaining the mitochondrial biogenesis at normal levels. HGRL28072011 . Registered 28 July 2011.

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

    PubMed

    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. Copyright © 2012. Published by Elsevier Ltd.

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

    PubMed

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

    2017-06-01

    The human placenta is essential for the supply of the fetus. To monitor the fetal development, imaging data is acquired using (US). Although it is currently the gold-standard in fetal imaging, it might not capture certain abnormalities of the placenta. (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.

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

    PubMed Central

    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. PMID:27746590

  7. Crossiella equi sp. nov., isolated from equine placentas.

    PubMed

    Donahue, J M; Williams, N M; Sells, S F; Labeda, D P

    2002-11-01

    Over the course of the past decade, actinomycetes have been isolated from the placentas of horses diagnosed with nocardioform placentitis. The incidence of this infection has generally been low, with typically no more than 30 animals affected in most years, but the incidence increased through 1999, with placentas from 144 mares found to be infected. Approximately half of the cases result in loss of the foal. A typical actinomycete with branching mycelium was isolated from placental lesions, and a comparison of the sequence of the 16S rDNA gene against the public databases indicated a relationship to members of the suborder Pseudonocardineae. Phylogenetic analysis of representative isolates revealed a close relationship to Crossiella cryophila, and subsequent polyphasic comparisons determined that these isolates represent a novel species of Crossiella, for which the name Crossiella equi sp. nov. is proposed, with strain LDDC 22291-98(T) (= NRRL B-24104(T) = DSM 44580(T)) as the type strain.

  8. Global hormone profiling of murine placenta reveals Secretin expression

    PubMed Central

    Knox, K.; Leuenberger, D.; Penn, A.A.; Baker, J.C.

    2013-01-01

    Objective To elucidate and categorize the murine placental hormones expressed across gestation, including the expression of hormones with previously undescribed roles. Study design Expression levels of all genes with known or predicted hormone activity expressed in two separate tissues, the placenta and maternal decidua, were assessed across a timecourse spanning the full lifetime of the placenta. Novel expression patterns were confirmed by in situ hybridization and protein level measurements. Results A combination of temporal and spatial information defines five groups that can accurately predict the patterns of uncharacterized hormones. Our analysis identified Secretin, a novel placental hormone that is expressed specifically by the trophoblast at levels many times greater than in any other tissue. Conclusions The characteristics of Secretin fit the paradigm of known placental hormones and suggest that it may play an important role during pregnancy. PMID:21944867

  9. The omniscient placenta: Metabolic and epigenetic regulation of fetal programming.

    PubMed

    Nugent, Bridget M; Bale, Tracy L

    2015-10-01

    Fetal development could be considered a sensitive period wherein exogenous insults and changes to the maternal milieu can have long-term impacts on developmental programming. The placenta provides the fetus with protection and necessary nutrients for growth, and responds to maternal cues and changes in nutrient signaling through multiple epigenetic mechanisms. The X-linked enzyme O-linked-N-acetylglucosamine transferase (OGT) acts as a nutrient sensor that modifies numerous proteins to alter various cellular signals, including major epigenetic processes. This review describes epigenetic alterations in the placenta in response to insults during pregnancy, the potential links of OGT as a nutrient sensor to placental epigenetics, and the implications of placental epigenetics in long-term neurodevelopmental programming. We describe the role of placental OGT in the sex-specific programming of hypothalamic-pituitary-adrenal (HPA) axis programming deficits by early prenatal stress as an example of how placental signaling can have long-term effects on neurodevelopment.

  10. The omniscient placenta: Metabolic and epigenetic regulation of fetal programming

    PubMed Central

    Nugent, Bridget M.; Bale, Tracy L.

    2015-01-01

    Fetal development could be considered a sensitive period wherein exogenous insults and changes to the maternal milieu can have long-term impacts on developmental programming. The placenta provides the fetus with protection and necessary nutrients for growth, and responds to maternal cues and changes in nutrient signaling through multiple epigenetic mechanisms. The X-linked enzyme O-linked-N-acetylglucosamine transferase (OGT) acts as a nutrient sensor that modifies numerous proteins to alter various cellular signals, including major epigenetic processes. This review describes epigenetic alterations in the placenta in response to insults during pregnancy, the potential links of OGT as a nutrient sensor to placental epigenetics, and the implications of placental epigenetics in long-term neurodevelopmental programming. We describe the role of placental OGT in the sex-specific programming of hypothalamic-pituitary-adrenal (HPA) axis programming deficits by early prenatal stress as an example of how placental signaling can have long-term effects on neurodevelopment. PMID:26368654

  11. The placenta and neurodevelopment: sex differences in prenatal vulnerability

    PubMed Central

    Bale, Tracy L.

    2016-01-01

    Prenatal insults, such as maternal stress, are associated with an increased neurodevelopmental disease risk and impact males significantly more than females, including increased rates of autism, mental retardation, stuttering, dyslexia, and attention deficit/hyperactivity disorder (ADHD). Sex differences in the placenta, which begin with sex chromosomes, are likely to produce sex-specific transplacental signals to the developing brain. Our studies and others have identified X-linked genes that are expressed at higher levels in the female placenta. Through a genome-wide screen after maternal stress in mice, we identified the X-linked gene O-linked N-acetylglucosamine transferase (OGT) and demonstrated its causality in neurodevelopmental programming producing a male-specific stress phenotype. Elucidating the sex-specific molecular mechanisms involved in transplacental signals that impact brain development is key to understanding the sex bias in neurodevelopmental disorders and is expected to yield novel insight into disease risk and resilience. PMID:28179817

  12. Extensive load of somatic CNVs in the human placenta

    PubMed Central

    Kasak, Laura; Rull, Kristiina; Vaas, Pille; Teesalu, Pille; Laan, Maris

    2015-01-01

    Placenta is a temporary, but indispensable organ in mammalian pregnancy. From its basic nature, it exhibits highly invasive tumour-like properties facilitating effective implantation through trophoblast cell proliferation and migration, and a critical role in pregnancy success. We hypothesized that similarly to cancer, somatic genomic rearrangements are promoted in the support of placental function. Here we present the first profiling of copy number variations (CNVs) in human placental genomes, showing an extensive load of somatic CNVs, especially duplications and suggesting that this phenomenon may be critical for normal gestation. Placental somatic CNVs were significantly enriched in genes involved in cell adhesion, immunity, embryonic development and cell cycle. Overrepresentation of imprinted genes in somatic duplications suggests that amplified gene copies may represent an alternative mechanism to support parent-of-origin specific gene expression. Placentas from pregnancy complications exhibited significantly altered CNV profile compared to normal gestations, indicative to the clinical implications of the study. PMID:25666259

  13. Placenta previa percreta with urinary bladder and ureter invasion.

    PubMed

    Caliskan, E; Tan, O; Kurtaran, V; Dilbaz, B; Haberal, A

    2003-10-01

    A 26-year-old woman, with one previous cesarean delivery and two uterine curettage due to incomplete abortion, was admitted to the labor ward with the diagnosis of partial placenta previa at 35 weeks of gestation. Repeat cesarean section was performed due to profuse vaginal bleeding. Placenta previa percreta invading the bladder trigone was confirmed with cystotomy. As bilateral hypogastric artery ligation and supracervical hysterectomy performed were not successful in stopping the profuse bleeding, the abdomen was packed with laparotomy pads. Dilatation of the left ureter was noticed on the second postoperative day. Relaparotomy was performed to remove the pads, and placental invasion of the distal left ureter was noticed. Ureteroneocystostomy was performed. The postoperative course was uneventful, and the double-J-catheter was removed two months later.

  14. The placenta and neurodevelopment: sex differences in prenatal vulnerability.

    PubMed

    Bale, Tracy L

    2016-12-01

    Prenatal insults, such as maternal stress, are associated with an increased neurodevelopmental disease risk and impact males significantly more than females, including increased rates of autism, mental retardation, stuttering, dyslexia, and attention deficit/hyperactivity disorder (ADHD). Sex differences in the placenta, which begin with sex chromosomes, are likely to produce sex-specific transplacental signals to the developing brain. Our studies and others have identified X-linked genes that are expressed at higher levels in the female placenta. Through a genome-wide screen after maternal stress in mice, we identified the X-linked gene O-linked N-acetylglucosamine transferase (OGT) and demonstrated its causality in neurodevelopmental programming producing a male-specific stress phenotype. Elucidating the sex-specific molecular mechanisms involved in transplacental signals that impact brain development is key to understanding the sex bias in neurodevelopmental disorders and is expected to yield novel insight into disease risk and resilience.

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

    PubMed

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

    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.

  16. Immunological studies of the placenta in systemic lupus erythematosus.

    PubMed Central

    Grennan, D M; McCormick, J N; Wojtacha, D; Carty, M; Behan, W

    1978-01-01

    An immunological study was made of the placentae from 5 mothers with lupus erythematosus. 3 of the 5 mothers had anti-DNA antibodies in their sera at the time of delivery and in one of these anti-DNA antibodies were detected in the cord blood. This patient had active renal disease and serological evidence suggestive of circulating immune complexes in her blood at the time of delivery. Immunofluorescence studies showed granular deposition of immunoglobulin and C3 on the trophoblast basement membrane similar to that previously described on the glomerular basement membrane in systemic lupus erythematosus. Anti-DNA antibodies were eluted from the placenta in this case. We suggest that immune complex deposition on the trophoblast basement membrane in patients with active systemic lupus erythematosus may play a part in the increased fetal mortality in this disease. Images PMID:348129

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

    PubMed

    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.

  18. Differentially expressed miRNAs in trisomy 21 placentas.

    PubMed

    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.

  19. [Modification of placenta blood serum proteins under low temperature effect].

    PubMed

    Fal'ko, O V; Zemlianskikh, N G; Lipina, O V; Prokopiuk, O S

    2013-01-01

    Changes in environmental physical and chemical factors upon freeze-thawing and low temperature storage of biological samples can result in impairments of protein structures. This work specifies spontaneous and diamide-induced protein aggregations of placenta blood serum stored at -20 degrees and -196 degrees C during 2 years with SDS-PAGE. It was shown that storage of placenta blood serum at low temperatures did not cause any quantitative and qualitative changes in fraction distribution of proteins denatured with SDS in comparison to the native samples which were not frozen. Application of beta-mercaptoethanol revealed that placenta blood serum proteins upon freeze-thawing did not form spontaneous aggregates linked by disulphide bridges. Oxidation of amino acid sulfhydryl groups induced by diamide and accompanied by high molecular aggregate formation proved to be a quite effective way for indirect estimation of structural changes in protein upon low temperature effects. In samples thawed after low temperature storage the protein aggregation with 4 microM diamide was significantly higher than in native serum. These discrepancies between native and frozen-thawed samples are stipulated by impairments of protein structure under low temperature and increased in accessibility of reactive SH-groups of proteins for oxidation with diamide. Structural changes in placenta blood serum proteins, which caused by low temperatures and revealed by elevated sensibility to diamide-induced aggregate formation, did not depend on temperature (-20 degrees and -196 degrees C) and storage terms (2 years and 3 weeks). They reflect protein reaction to freeze-thawing processes and could be sequence of ice crystal formation which takes place in unprotected media.

  20. Functional MRI of the placenta – From rodents to humans

    PubMed Central

    Avni, R.; Neeman, M.; Garbow, J.R.

    2015-01-01

    The placenta performs a wide range of physiological functions; insufficiencies in these functions may result in a variety of severe prenatal and postnatal syndromes with long-term negative impacts on human adult health. Recent advances in magnetic resonance imaging (MRI) studies of placental function, in both animal models and humans, have contributed significantly to our understanding of placental structure, blood flow, oxygenation status, and metabolic profile, and have provided important insights into pregnancy complications. PMID:25916594

  1. [Ultrastructural study of placentas from HIV seropositive women].

    PubMed

    Villegas Castrejon, H; Carrillo Farga, J; Paredes, Y; Barrón, A; Karchmer, S

    1994-05-01

    Eleven placentas from seropositive women for HIV, were analyzed. In three cases the material came from first trimester abortions and the other eight from term pregnancies. In five cases retroviruses were identified, similar to HIV in the placental tissue. It was demonstrated for the first time the internalization of a retrovirus and its presence in the syncytiotrophoblast. It is communicated for the first time the presence of one cell in the placental stroma different to Hofbauer's by its granules type.

  2. Examination of the placenta: medico-legal implications.

    PubMed

    Chang, Kenneth Tou-En

    2014-10-01

    Formal examination of the placenta may provide valuable information to the clinicians, family, and court of law in cases of adverse pregnancy outcome when litigation is initiated. Placental examination contributes towards the identification of specific intrinsic or secondary placental lesions, and understanding the nature of the intrauterine environment. This article provides an update of important placental pathologies that may contribute towards neurologic injury of the newborn child, and describes the role of placental findings in the adjudication of cases of adverse neonatal outcome.

  3. Structure of the definitive placenta of the tenrec, Echinops telfairi.

    PubMed

    Carter, A M; Blankenship, T N; Künzle, H; Enders, A C

    2004-01-01

    Until recently, tenrecs were classified with insectivores in the order Lipotyphla, but nucleotide sequence data suggest they have closer affinities with a group of African mammals called Afrotheria. The placenta of Echinops has not been described and no studies involving electron microscopy of the placenta of any species of tenrec have been published. We used light and transmission electron microscopy to examine fixed placentae of embryos ranging from 25-66 mm in length. The placental disk is situated in the antimesometrial portion of the bicornuate uterus. The greater part of the disk consists of a labyrinth underlain by a spongy zone. The interhaemal barrier is unusual in that the trophoblastic component is a single layer of cytotrophoblast. These trophoblast cells have thick areas especially near the nuclei and extensive thin flanges but only occasionally have membrane-closed pore regions. The luminal surface has isolated patches of microvilli, and pinocytotic vesicles are numerous both apically and basally. In the centre of the placental disk is an elaborately folded haemophagous region. The primary folds have allantoic endoderm at one surface and columnar cytotrophoblast at the other. These trophoblast cells have numerous lipid droplets and vesicles, and often contain large yellow pigment crystalloids. The labyrinthine zone ends abruptly at the margins of the placental disk. However, the endoderm and connective tissue of the allantois and a layer of cytotrophoblast extend beyond the placental disk as a paraplacental region. Some of these distinctive features of Echinops placenta are shared with individual afrotherians, but no significant characteristic of definitive placentation is shared by all the Afrotheria.

  4. Involvement of leptin in the molecular physiology of the placenta.

    PubMed

    Schanton, Malena; Maymó, Julieta Lorena; Pérez-Pérez, Antonio; Sanchez-Margalet, Victor; Varone, Cecilia

    2017-10-09

    Leptin is a homeostatic regulator in the placenta where it promotes proliferation, protein synthesis and the expression of tolerogenic maternal response molecules such as HLA-G. Leptin also exerts an anti-apoptotic action in placenta controlling the expression of p53 master cell cycle regulator under different stress conditions. On the other hand, leptin is an integrative target of different placental stimuli. The expression of leptin in placenta is regulated by hCG, insulin, steroids, hypoxia, and many other growth hormones, suggesting that it might have an important endocrine function in the trophoblastic cells. Leptin expression is induced involving the cAMP/PKA or cAMP/Epac pathways which have profound actions upon human trophoblast function. The activation of PI3K and MAPK pathways is also participating in leptin expression. Estrogens play a central role during pregnancy, particularly 17β-estradiol upregulates leptin expression in placental cells through genomic and non-genomic actions. Leptin promoter analysis reveals specific elements that are active in placental cells. The transcription factors CREB, AP1, Sp1, NFkB and the coactivator CBP are involved in placental leptin expression. Moreover placental leptin promoter is a target of epigenetic marks such as DNA methylation and histone acetylation that regulates not only leptin expression in placenta during pregnancy but also determine the predisposition of acquiring adult metabolism diseases. Taken together all these results allow a better understanding of leptin function and regulatory mechanisms of leptin expression in human placental trophoblasts, and support the importance of leptin during pregnancy and in programming adult health.

  5. Consumption of the Placenta in the Postpartum Period.

    PubMed

    Hayes, Emily Hart

    2016-01-01

    Postpartum women are consuming their placentas to achieve claimed health benefits, including improved mood, energy, and lactation. Strong scientific evidence to substantiate these claims is lacking. Self-reported benefits from some women include improved mood and lactation; animal models suggest there may be an analgesic effect. Possible risks include infection, thromboembolism from estrogens in placental tissue, and accumulation of environmental toxins. Women's health care providers should be aware of this practice to help women make informed decisions.

  6. Transplacental transfer of nitrosodimethylamine in perfused human placenta.

    PubMed

    Annola, K; Heikkinen, A T; Partanen, H; Woodhouse, H; Segerbäck, D; Vähäkangas, K

    2009-03-01

    Nitrosodimethylamine (NDMA) is a carcinogenic compound present in tobacco smoke and food such as cured meat, smoked fish and beer. The O(6)-methylguanine formed in human cord blood in mothers highly exposed to such products implicates NDMA exposure of the fetus. Dual recirculating human placental perfusion was used to get direct evidence of the transplacental transfer of NDMA and DNA adduct formation in perfused human placenta. Eleven placentas from normal full-term pregnancies were collected immediately after delivery and an isolated lobule was perfused with 1 or 5 microM of (14)C-NDMA with a reference substance, antipyrine (0.1mg/ml) added to the maternal circulation. Perfusate samples were collected from both maternal and fetal circulations every half an hour for the first two hours and once per hour from thereon. NDMA was analyzed by scintillation counting and antipyrine by high performance liquid chromatography. The transfer of NDMA was comparable to that of antipyrine and probably occurred through passive diffusion, with the concentrations in maternal and fetal sides equilibrating in 2-3h. No indication of any effect by efflux transporters on NDMA kinetics was noticed in the experiments utilizing Caco-2 or MDCK- MDCKII-MDR1 cell culture monolayer in a transwell system, either. Furthermore, no NDMA-DNA-adducts were found after the perfusions and no DNA-binding of NDMA was seen in in vitro incubations with human placental microsomes from 8 additional placentas. Thus, our study demonstrates that the human fetus can be exposed to NDMA from the maternal circulation. According to this study and the literature, NDMA is not metabolized in full-term human placenta from healthy non-smoking, non-drinking mothers. It remains to be studied whether NDMA concentrations high enough to evoke fetal toxicity can be obtained from dietary sources.

  7. Bacterial communities in neonatal feces are similar to mothers' placentae.

    PubMed

    Dong, Xu-Dong; Li, Xiao-Ran; Luan, Jian-Jun; Liu, Xiao-Feng; Peng, Juan; Luo, Yi-Yong; Liu, Chen-Jian

    2015-01-01

    The gut microbiota plays an important role in human health. It is essential to understand how the composition of the gut microbiota in neonates is established. To investigate the nature of the microbial community in the first feces of newborn infants compared with the mothers' placentae and vaginas. One infant who was delivered via Cesarean section was compared with an infant who was delivered vaginally. Bar-coded pyro-sequencing of 16S ribosomal RNA genes was used to investigate the bacterial community composition and structure of each site. Neonatal feces of both infants had similar bacterial communities, and they were similar to the mother's placenta regardless of the method of delivery. The vaginal bacterial community differed between the two mothers, but not different sites within the vagina. The bacteria in the neonatal feces and the mothers' placentae demonstrated considerably higher diversity compared with the vaginas. The family Lactobacillaceae dominated in the vaginal samples, while the most abundant family in the fecal and placental samples was Micrococcineae. These results may provide new directions for the study of infant gut microbial formation.

  8. Sclerotherapy with 6% polidocanol solution in patients with placenta accreta.

    PubMed

    Malagón Reyes, Ricardo Mauricio; Castorena de Ávila, Rubén; Ángeles Vázquez, María de Jesús; Núñez Monteagudo, César Augusto; Mendieta Zerón, Hugo

    2016-10-01

    Placenta accreta is one of the main obstetrical complications worldwide. The aim of this study was to report the experience of managing placenta accreta with a 6% polidocanol solution sclerotherapy. We selected patients between 37 weeks of gestation and 38 weeks of gestation, diagnosed with placenta accreta, treated at the Maternal Perinatal Hospital "Monica Pretelini Sáenz", Toluca, Mexico, during the period from November 2013 to August 2014. The surgical technique has two steps: (1) fundic-arciform caesarean section followed by a 6% polidocanol sclerosing solution through a 6Fr neonatal feeding tube upon its reaching the placental bed; (2) total abdominal hysterectomy with internal hypogastric artery ligation. Data were collected from 11 patients with a mean age of 33.9 years (range, 26-42 years) and 2.8±0.6 days of hospitalization in the obstetrical intensive care unit. The majority of patients were classified as having pregnancies at an advanced age. All women were multigravidas. Bleeding volume exhibited a range between 2.5 L and 3 L without any case of neonatal death but one mother died because of coagulopathy. We conclude that the technique that we are reporting is feasible for implementation in obstetric hospitals, with technical and economic feasibility. Copyright © 2016. Published by Elsevier B.V.

  9. Kisspeptins and the placenta: regulation of trophoblast invasion.

    PubMed

    Hiden, Ursula; Bilban, Martin; Knöfler, Martin; Desoye, Gernot

    2007-03-01

    The invasion of extravillous trophoblasts into the uterine wall is of crucial importance for placental and fetal development, and its dysregulation has been implicated in a wide spectrum of abnormal pregnancies. Mechanistically, trophoblast invasion strongly resembles the invasion of tumour cells, but differs from it by tight regulation in time and space. This regulation is accomplished by different factors including cytokines and hormones, which are produced by both fetal as well as maternal tissues i.e., placenta and uterus, respectively. Recently, products of the KiSS-1 gene (kisspeptins) have been identified to not only inhibit metastasis in various tumours, but also to repress trophoblast invasion via binding to the G protein-coupled receptor KiSS-1R. In the placenta, expression levels of kisspeptins and their receptor are highest in the first trimester in humans and at day 12.5 in rats, respectively. This coincides with the time when invasiveness peaks and invasion regulation is of central importance. Human kisspeptins are predominantly produced by the syncytiotrophoblast, whereas KiSS-1R is additionally expressed on the invading extravillous trophoblasts indicating a paracrine regulation of extravillous trophoblast invasion by the syncytiotrophoblast. In the structurally different rat placenta both KiSS-1 and its receptor are predominantly expressed by the invasive trophoblast giant cells, thus establishing an autocrine system in the invasion regulation of this trophoblast subpopulation. Amongst all kisspeptins the highly conserved kisspeptin Kp-10 has strongest invasion inhibiting effects suggesting its major role in regulation of trophoblast invasion.

  10. [Anaesthesia and recovery in a case of placenta percreta].

    PubMed

    Bermejo Álvarez, M A; Soto Mesa, D; González Castaño, R; Blanco Rodríguez, I; del Valle Ruiz, V

    2013-01-01

    Placenta percreta is a sub-type of placenta accreta in which this organ invades the whole uterine wall and affects the adjacent organs. It is a condition with a high surgical risk which generally requires an obstetric hysterectomy. We present the case of a 36 year-old pregnant woman diagnosed with placenta percreta with bladder and intestinal invasion. She suffered a hypovolaemic shock during surgery which required a massive transfusion of blood products and inotropic support. Three further successive surgeries were required due to the bleeding, with selective embolisation of the hypogastric arteries being performed in one of them. She required 13 days in intensive care. The total volume of blood products transfused was, 43 units of red cells, 28 units of plasma, and 8 platelet pools. The importance of early prenatal diagnosis is emphasised in order to adequately plan the operation, and should include a multidisciplinary team (general surgeons, urologists, vascular surgeons), as well as experienced anaesthesiologists and obstetricians. Copyright © 2011 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  11. Trypanosoma cruzi infection induces microfilament depletion in human placenta syncytiotrophoblast.

    PubMed

    Sartori, M J; Pons, P; Mezzano, L; Lin, S; de Fabro, S P

    2003-08-01

    Congenital Chagas disease, endemic in Latin America, is associated with premature labour, miscarriage, and placentitis. Metacyclic trypomastigotes adhere to specific receptors on the outer membrane of host cells as a prelude to intracellular invasion, causing calcium ion mobilization, rearrangement of host cell microfilaments, recruitment of lysosomes and parasite internalization. The actin cytoskeleton plays an important role in many cellular processes including the parasite invasion into mammalian cells. In order to observe if placental cytoskeleton is altered in the process of parasite invasion into placental villi, actin microfilaments were studied. Using immunohistochemical techniques, it was observed that the presence of actin in the syncytiotrophoblast was intense throughout the brush border in control placentae belonging to non-chagasic women. But after culture with the trypomastigote, this labelling disappeared, indicating that the parasite induced disassembly of the cortical actin cytoskeleton when the placenta was infected. As a control, placentae from chagasic women were studied, and no actin was found. The same results were obtained by the electron microscope. We confirmed that cortical actin rearrangements may be an early step in the Trypanosoma cruzi invasion mechanism into placental cells, in order to allow lysosomes access to the plasma membrane, and formation of the parasitophorous vacuole. The recruitment of lysosomes occurs directly beneath the invasion site, and this process is required for parasite internalization.

  12. Purification and characterization of the human interferon-. gamma. receptor from placenta

    SciTech Connect

    Calderon, J.; Sheehan, K.C.F.; Chance, C.; Thomas, M.L.; Schreiber, R.D. )

    1988-07-01

    Purification of the human interferon-{gamma} (IFN-{gamma}) receptor was facilitated by identification of human placenta as a large-scale receptor source. When analyzed in radioligand binding experiments, intact placental membranes and detergent-solubilized membrane proteins expressed 1.3 and 5.9 {times} 10{sup 12} receptors per mg of protein, respectively, values that were 13-163 times greater than that observed for U937 membranes. Two protocols were followed to purify the IFN-{gamma} receptor from octyl glucoside-solubilized membranes: (i) sequential affinity chromatography over wheat germ agglutinin- and INF-{gamma}-Sepharose and (ii) affinity chromatography over columns containing receptor-specific monoclonal antibody and wheat germ agglutinin. Both procedures resulted in fully active preparations that were 70-90% pure. Purified receptor migrated as a single molecular species of 90 kDa either when analyzed on silver-stained NaDodSO{sub 4}/polyacrylamide gels or when subjected to electrophoretic transfer blot analysis using a labeled IFN-{gamma} receptor-specific monoclonal antibody. The identity of the 90-kDa component as the receptor was confirmed by demonstrating its ability to specifically bind {sup 125}I-labeled IFN-{gamma} following NaDodSO{sub 4}/PAGE and transfer to nitrocellulose. The ligand binding site, the epitope for the receptor-specific monoclonal antibody, and all of the N-linked carbohydrate could be localized to the 55-kDa domain of the molecule.

  13. Quantitative morphology of the placenta. III. The growth of the placenta and its relationship to birth weight.

    PubMed

    Bouw, G M; Stolte, L A; Baak, J P; Oort, J

    1978-04-01

    The relationship of placental components to birth weight was investigated by stereology. 37 placentas from nonpathological pregnancies delivered after a period of 224-303 days of amenorrhea were examined. The umbilical cord was clamped immediately after birth. The ratios of the volume, the surface, the length of the villous vessels and the surface of the villi with birth weight showed a decrease after 277 days of amenorrhea. In contrast to this decrease, the ratio of the volume of the trophoblast with birth weight seems to increase. No difference could be found for the ratios of the placental volume (placental index), the volume of the villous tissue, the volume of the intervillous space and the volume of the nonfunctional tissue with birth weight. These ratios reveal a quantitative morphological base for the clinical experience that postmature fetuses are at a higher risk through deterioration of the placenta.

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

    PubMed

    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.

  15. 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.

    PubMed

    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. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Prevalence of abnormally invasive placenta among deliveries in mainland China

    PubMed Central

    Fan, Dazhi; Li, Song; Wu, Shuzhen; Wang, Wen; Ye, Shaoxin; Xia, Qing; Liu, Li; Feng, Jinping; Wu, Song; Guo, Xiaoling; Liu, Zhengping

    2017-01-01

    Abstract Background: Abnormally invasive placenta (AIP) or placenta accreta (PA) is considered numerous adverse maternal and fetal-neonatal complications. There has been no detailed study to characterize the prevalence of AIP among deliveries in mainland China. Objectives: We aimed to fill this gap and obtained overall and regional estimates of AIP prevalence via a systematic review and meta-analysis. Methods: This systematic review and meta-analysis was totally performed following the Meta-analysis of Observational Studies in Epidemiology guidelines for systematic reviews of observational studies, and the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement for reporting systematic reviews and meta-analysis. Results: A total of 23 articles (including 350,939) were included. Most studies (22) focused on the placenta increta (PI), only 2 articles in PA, and none in placenta percreta (PP). In this meta-analysis, the overall prevalence of AIP was 0.22% (95% confidence interval 0.18%–0.27%) in a heterogeneous set of studies (I2 = 93.5%). In a subgroup, the prevalence of PA and PI was 0.48% and 0.23%, respectively. Stratified analyses of PI found that the prevalence was similar in North (0.23% [0.14%–0.32%]) and South (0.23% [0.15%–0.32%]), and lower in Central (0.20% [0.09–0.31%]); the inlanders (0.17% (0.12%–0.23%]) had a lower prevalence of PI than those living in coastal areas (0.24% [0.35%–0.63%]). As time goes on, the prevalence, from 0.03% (0.02%–0.04%) in 1970 to 1979 to 0.48% (0.30%–0.66%) in 2010 to present, was higher and higher. The different prevalence was also found in different in maternal age groups. Conclusions: This first systematic review and meta-analysis found that the prevalence differed among different geographic areas and maternal age groups. The results would be useful for the design of abnormally invasive placenta planning and implementation adequate health care systems and treatment programs in

  17. Telomere homeostasis in placentas from pregnancies with uncontrolled diabetes.

    PubMed

    Biron-Shental, Tal; Liberman, Meital; Elbaz, Michal; Laish, Ido; Sharony, Reuven; Amiel, Aliza

    2016-08-01

    Diabetes during pregnancy causes an intrauterine environment that influences lifetime sickness of the mother and the fetus. There is a correlation between diabetes and telomere shortening; however, very little is known about telomere homeostasis in the placenta. We aimed to study the telomerase complex in placentas and in cord blood leukocytes from patients with poorly controlled diabetes. Biopsies from 16 third-trimester placentas and cord blood samples from pregnancies complicated with uncontrolled diabetes and from 16 gestational age-matched controls from uncomplicated pregnancies were examined. The expression of hTERT (human telomerase reverse transcriptase) was evaluated by immunohistochemistry and by RT-RCR. TERC gene copy number and telomere capture were evaluated by FISH. Telomerase expression was significantly lower in the diabetic placentas, both the protein (17.8 ± 2.8% cellular staining vs. 37 ± 5.32%, P = 0.012) and the mRNA levels (0.42 ± 0.03 folds, P = 0.022). Lower expression of TERC gene copy number were shown in the diabetic placentas compared to the healthy controls (1.7 ± 0.8% vs. 3.7 ± 1.6%, P = 0.035). We also detected higher percentage of cells with telomere capture among the diabetic trophoblasts compared to the healthy controls (19.8 ± 5.12% vs. 9.6 ± 3.65%, P = 0.038). Those differences were not observed in cord blood leukocytes from the same samples. Uncontrolled diabetes during pregnancy disrupts telomere-telomerase homeostasis in the trophoblasts. These changes may increase the risk for metabolic diseases in adulthood among offspring of pregnancies complicated by gestational diabetes mellitus as part of intrauterine programming. These variations were not observed in cord blood leukocytes, which imply different telomere homeostasis mechanisms in fetal cord blood. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Leaving the placenta in situ versus conservative and radical surgery in the treatment of placenta accreta spectrum disorders.

    PubMed

    Kutuk, Mehmet S; Ak, Mehmet; Ozgun, Mahmut T

    2017-08-21

    To compare different treatment methods in the management of placenta accreta spectrum (PAS) disorders. In a retrospective cohort study, medical records were retrieved for patients who underwent elective surgery at 24 weeks of pregnancy or more after a diagnosis of PAS disorder (creta, increta, or percreta) at a center in Turkey between May 2, 2010, and August 10, 2016. The final analysis included patients whose diagnosis was confirmed intraoperatively and for whom complete data were available. Patients were divided into three groups: group 1 included those who underwent hysterectomy without placental removal, group 2 included patients whose placenta was left in situ, and group 3 included those who underwent placental removal and conservative surgery. Among 79 included patients (33 creta, 18 increta, 28 percreta), 27 (34%) were in group 1, 15 (19%) in group 2, and 37 (47%) in group 3. Total blood loss and the amounts of blood products transfused were lowest in group 2; significant differences between groups were noted (all P ≤ 0.001). Surgical complication rates were similar between groups (4/27 [15%], 1/15 [7%], and 11/37 [30%], respectively; P=0.119). Overall uterine preservation rates were not significantly different between groups 2 and 3 (14/15 [93%] vs 33/37 [89%]; P>0.99). Leaving the placenta in situ could become the treatment of choice for PAS disorders. © 2017 International Federation of Gynecology and Obstetrics.

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

    PubMed

    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. Equine retained placenta: technique for and tolerance to umbilical artery injections of collagenase.

    PubMed

    Haffner, J C; Fecteau, K A; Held, J P; Eiler, H

    1998-03-01

    Under laboratory conditions and in clinical experiments, bacterial collagenase has proven to be effective in hydrolyzing placenta and detaching cotyledon from caruncle in the bovine species. Laboratory studies in which placental samples were incubated with collagenase have also demonstrated that collagenase is 3.7 times more effective in hydrolyzing equine placenta than bovine placenta. This led to the hypothesis that collagenase may be a potential treatment for mares with retained placenta. However, that collagenase may hydrolyze the uterine wall and perforate the uterus was a concern. It was the purpose of this study thus to determine any adverse effects of collagenase on the equine uterus and to develop a method for intraplacental injection of collagenase. Three normally expelled intact placentas from Arabian mares, 10 cyclic mixed-breed mares, and 4 mares of various breeds with retained placenta were used. Fluoroscein dye and latex were used to study the placental vasculature and to determine a suitable dose of collagenase; placentas were hydrolyzed by collagenase solution in vitro. Bacterial collagenase solution (40,000 units, 200 ml) was infused into the uterine lumen of each cyclic mare. Uterine biopsies were obtained from the mares before collagenase infusion and again at 16 h and 26 d after infusion. In the mares with retained placenta, each placenta was infused via its umbilical cord vessels with 200,000 units of bacterial collagenase in 1 L of saline. Results showed that none of the uteri from cyclic mares were damaged by collagenase treatment. During a 4-wk period of monitoring (including endoscopy) mares with retained placenta did not show any abnormalities. Retained placentas were expelled in less than 6 h after collagenase treatment. It was concluded that intraplacental injections of collagenase are a safe and potentially effective treatment for retained placenta in mares.

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

    PubMed Central

    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

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

    PubMed

    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.

  3. Prophylactic hypogastric artery ballooning in a patient with complete placenta previa and increta.

    PubMed

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

    2010-04-01

    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.

  4. Color Difference in Placentas with Twin Anemia-Polycythemia Sequence: An Additional Diagnostic Criterion?

    PubMed

    Tollenaar, Lisanne S A; Zhao, Danny P; Middeldorp, Johanna M; Slaghekke, Femke; Oepkes, Dick; Lopriore, Enrico

    2016-01-01

    To determine the color intensity difference between the 2 placental shares in monochorionic placentas with twin anemia-polycythemia sequence (TAPS). We evaluated all digital pictures of TAPS placentas examined at our center and compared them to a control group of uncomplicated monochorionic placentas. We determined the color intensity of individual placental share on the maternal side of each monochorionic placenta using an image processing program and calculated the color difference ratio (CDR). Digital pictures of 19 TAPS and 19 uncomplicated monochorionic placentas were included in this study. The TAPS group consisted of 12 spontaneous TAPS placentas (63%) and 7 post-laser TAPS placentas (37%). The median CDR in the group with TAPS was significantly higher than in the control group, 2.73 (range 1.73-6.36) versus 1.09 (range 1.00-1.35), respectively (p < 0.01). We found a positive correlation between CDR and inter-twin hemoglobin (Hb) difference in the TAPS group (R = 0.66, p < 0.01) but not in the control group (R = 0.04, p = 0.87). TAPS placentas have a significantly higher CDR compared to uncomplicated monochorionic twin placentas. Large inter-twin Hb differences in TAPS are associated with higher CDR. © 2016 The Author(s) Published by S. Karger AG, Basel.

  5. Kappa-opioid receptor from human placenta: hydrodynamic characteristics and evidence for its association with a G protein

    SciTech Connect

    Porthe, G.; Frances, B.; Verrier, B.; Cros, J.; Meunier J.C.

    1988-01-01

    The kappa nature of opioid binding sites in a brush border membrane (BBM) fraction from human placenta has been confirmed: these sites display considerably higher apparent affinity for the kappa selective ligand U-50488 than they do for the ..mu.. and delta selective ligands enkephalin and enkephalyl-Thr, respectively. Two lines of evidence indicated that the placental kappa opioid receptor is capable of interacting with a guanine nucleotide regulatory (G) protein: (i) equilibrium binding of the angonist /sup 3/H-etorphine in the BBM fraction was clearly inhibited by 5'-guanylylimidodiphosphate (Gpp(NH)p), especially in the presence of Na/sup +/ ions while binding of the antagonist /sup 3/H-diprenorphine was significantly less so and (ii) the sedimentation velocity of the kappa opioid receptor was decreased down to about 10 S when the BBM fraction was prelabeled with radioligand in the presence of Gpp(NH)p prior to its solubilization with digitonin. The G protein that mediates the effect of Gpp(NH)p might be neither G/sub s/ nor G/sub i/ since no adenylate cyclase activity could be demonstrated in the BBM fraction from human placenta.

  6. Apical uptake of choline and cationic drugs in epithelial cell lines derived from human placenta.

    PubMed

    Müller, J; Born, I; Neubert, R H; Brandsch, M

    2005-01-01

    Many cationic drugs are administered during pregnancy and might enter the fetal circulation by transplacental passage. This study was performed to characterize the apical uptake of choline and several cationic drugs at cultured epithelial cells of the human placenta. Total uptake of [3H]choline in BeWo cells was H(+)-independent and to 65% Na(+)-independent. Uptake rates into both cell lines were saturable with Michaelis-Menten constants (Kt) of 108 microM (BeWo) and 206 microM (JEG-3), respectively. Cationic drugs such as etilefrine, clonidine, ranitidine, diphenhydramine, imipramine and butylscopolamine strongly inhibited the [3H]choline uptake in BeWo cells and in JEG-3 cells, with Ki values ranging from 0.18 to 3.3 mM. In contrast, tetraethylammonium had only little inhibitory effect on [3H]choline uptake. Using high-performance capillary electrophoresis for quantitative analyses, uptake of etilefrine and diphenhydramine into JEG-3 or BeWo cells was measured. Diphenhydramine was transported into JEG-3 cells in a saturable manner with a Kt value of 0.75 mM. In the presence of sodium, diphenhydramine uptake at BeWo cells was inhibited to 69% by the addition of 50 mM choline chloride. Like choline uptake, total diphenhydramine uptake was to 68% Na(+)-independent in BeWo cells. We conclude that in addition to choline, several cationic drugs, in particular diphenhydramine, are taken up by placental epithelial cells from the maternal blood by carrier-mediated processes. Etilefrine, clonidine, ranitidine, diphenhydramine and butylscopolamine interact with the Na(+)-independent placental choline transport system.

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

    PubMed

    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

  8. Landscape of Transcriptional Deregulations in the Preeclamptic Placenta

    PubMed Central

    Vaiman, Daniel; Calicchio, Rosamaria; Miralles, Francisco

    2013-01-01

    Preeclampsia is a pregnancy disease affecting 5 to 8% of pregnant women and a leading cause of both maternal and fetal mortality and morbidity. Because of a default in the process of implantation, the placenta of preeclamptic women undergoes insufficient vascularization. This results in placental ischemia, inflammation and subsequent release of placental debris and vasoactive factors in the maternal circulation causing a systemic endothelial activation. Several microarray studies have analyzed the transcriptome of the preeclamptic placentas to identify genes which could be involved in placental dysfunction. In this study, we compared the data from publicly available microarray analyses to obtain a consensus list of modified genes. This allowed to identify consistently modified genes in the preeclamptic placenta. Of these, 67 were up-regulated and 31 down-regulated. Assuming that changes in the transcription level of co-expressed genes may result from the coordinated action of a limited number of transcription factors, we looked for over-represented putative transcription factor binding sites in the promoters of these genes. Indeed, we found that the promoters of up-regulated genes are enriched in putative binding sites for NFkB, CREB, ANRT, REEB1, SP1, and AP-2. In the promoters of down-regulated genes, the most prevalent putative binding sites are those of MZF-1, NFYA, E2F1 and MEF2A. These transcriptions factors are known to regulate specific biological pathways such as cell responses to inflammation, hypoxia, DNA damage and proliferation. We discuss here the molecular mechanisms of action of these transcription factors and how they can be related to the placental dysfunction in the context of preeclampsia. PMID:23785430

  9. Characterization of Choline Transporters in the Human Placenta over Gestation

    PubMed Central

    Baumgartner, Heidi K.; Trinder, Kinsey M.; Galimanis, Carly E.; Post, Annalisa; Phang, Tzu; Ross, Randal G.; Winn, Virginia D.

    2015-01-01

    INTRODUCTION The developing fetus relies on the maternal blood supply to provide the choline it requires for making membrane lipids, synthesizing acetylcholine, and performing important methylation reactions. It is vital, therefore, that the placenta is efficient at transporting choline from maternal to fetal circulation. Although choline transporters have been found in term placenta samples, little is known about what cell types express specific choline transporters and how expression of the transporters may change over gestation. The objective of this study was to characterize choline transporter expression levels and localization in the human placenta throughout placental development. METHODS We analyzed CTL1 and −2 expression over gestation in human placental biopsies from 6 to 40 weeks gestation (n=6–10 per gestational window) by immunoblot analysis. To determine the cellular expression pattern of the choline transporters throughout gestation, immunofluorescence analysis was then performed. RESULTS Both CTL1 and CTL2 were expressed in the chorionic villi from 6 weeks gestation to term. Labor did not alter expression levels of either transporter. CTL1 localized to the syncytial trophoblasts and the endothelium of the fetal vasculature within the chorionic villous structure. CTL2 localized mainly to the stroma early in gestation and by the second trimester co-localized with CTL1 at the fetal vasculature. DISCUSSION The differential expression pattern of CTL1 and CTL2 suggests that CTL1 is the key transporter involved in choline transport from maternal circulation and both transporters are likely involved in stromal and endothelial cell choline transport. PMID:26601765

  10. Characterization of choline transporters in the human placenta over gestation.

    PubMed

    Baumgartner, Heidi K; Trinder, Kinsey M; Galimanis, Carly E; Post, Annalisa; Phang, Tzu; Ross, Randal G; Winn, Virginia D

    2015-12-01

    The developing fetus relies on the maternal blood supply to provide the choline it requires for making membrane lipids, synthesizing acetylcholine, and performing important methylation reactions. It is vital, therefore, that the placenta is efficient at transporting choline from the maternal to the fetal circulation. Although choline transporters have been found in term placenta samples, little is known about what cell types express specific choline transporters and how expression of the transporters may change over gestation. The objective of this study was to characterize choline transporter expression levels and localization in the human placenta throughout placental development. We analyzed CTL1 and -2 expression over gestation in human placental biopsies from 6 to 40 weeks gestation (n = 6-10 per gestational window) by immunoblot analysis. To determine the cellular expression pattern of the choline transporters throughout gestation, immunofluorescence analysis was then performed. Both CTL1 and CTL2 were expressed in the chorionic villi from 6 weeks gestation to term. Labor did not alter expression levels of either transporter. CTL1 localized to the syncytial trophoblasts and the endothelium of the fetal vasculature within the chorionic villous structure. CTL2 localized mainly to the stroma early in gestation and by the second trimester co-localized with CTL1 at the fetal vasculature. The differential expression pattern of CTL1 and CTL2 suggests that CTL1 is the key transporter involved in choline transport from maternal circulation and both transporters are likely involved in stromal and endothelial cell choline transport. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Exocyst Complex Protein Expression in the Human Placenta

    PubMed Central

    Gonzalez, I.M.; Ackerman, W.E.; Vandre, D.D.; Robinson, J.M.

    2014-01-01

    Introduction Protein production and secretion are essential to syncytiotrophoblast function and are associated with cytotrophoblast cell fusion and differentiation. Syncytiotrophoblast hormone secretion is a crucial determinant of maternal-fetal health, and can be misregulated in pathological pregnancies. Although, polarized secretion is a key component of placental function, the mechanisms underlying this process are poorly understood. Objective While the octameric exocyst complex is classically regarded as a master regulator of secretion in various mammalian systems, its expression in the placenta remained unexplored. We hypothesized that the syncytiotrophoblast would express all exocyst complex components and effector proteins requisite for vesicle-mediated secretion more abundantly than cytotrophoblasts in tissue specimens. Methods A two-tiered immunobiological approach was utilized to characterize exocyst and ancillary proteins in normal, term human placentas. Exocyst protein expression and localization was documented in tissue homogenates via immunoblotting and immunofluorescence labeling of placental sections. Results The eight exocyst proteins, EXOC1, 2, 3, 4, 5, 6, 7, and 8, were found in the human placenta. In addition, RAB11, an important exocyst complex modulator, was also expressed. Exocyst and Rab protein expression appeared to be regulated during trophoblast differentiation, as the syncytiotrophoblast expressed these proteins with little, if any, expression in cytotrophoblast cells. Additionally, exocyst proteins were localized at or near the syncytiotrophoblast apical membrane, the major site of placental secretion Discussion/Conclusion Our findings highlight exocyst protein expression as novel indicators of trophoblast differentiation. The exocyst’s regulated localization within the syncytiotrophoblast in conjunction with its well known functions suggests a possible role in placental polarized secretion PMID:24856041

  12. Exocyst complex protein expression in the human placenta.

    PubMed

    Gonzalez, I M; Ackerman, W E; Vandre, D D; Robinson, J M

    2014-07-01

    Protein production and secretion are essential to syncytiotrophoblast function and are associated with cytotrophoblast cell fusion and differentiation. Syncytiotrophoblast hormone secretion is a crucial determinant of maternal-fetal health, and can be misregulated in pathological pregnancies. Although, polarized secretion is a key component of placental function, the mechanisms underlying this process are poorly understood. While the octameric exocyst complex is classically regarded as a master regulator of secretion in various mammalian systems, its expression in the placenta remained unexplored. We hypothesized that the syncytiotrophoblast would express all exocyst complex components and effector proteins requisite for vesicle-mediated secretion more abundantly than cytotrophoblasts in tissue specimens. A two-tiered immunobiological approach was utilized to characterize exocyst and ancillary proteins in normal, term human placentas. Exocyst protein expression and localization was documented in tissue homogenates via immunoblotting and immunofluorescence labeling of placental sections. The eight exocyst proteins, EXOC1, 2, 3, 4, 5, 6, 7, and 8, were found in the human placenta. In addition, RAB11, an important exocyst complex modulator, was also expressed. Exocyst and Rab protein expression appeared to be regulated during trophoblast differentiation, as the syncytiotrophoblast expressed these proteins with little, if any, expression in cytotrophoblast cells. Additionally, exocyst proteins were localized at or near the syncytiotrophoblast apical membrane, the major site of placental secretion. Our findings highlight exocyst protein expression as novel indicators of trophoblast differentiation. The exocyst's regulated localization within the syncytiotrophoblast in conjunction with its well known functions suggests a possible role in placental polarized secretion. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Effects of cadmium of the human placenta in vitro

    SciTech Connect

    Wier, P.J.

    1985-01-01

    Human placental lobules (25 g) were maintained in vitro for 12 hours by dual perfusion of the fetal vessels and intervillous space (maternal circulation). A synthetic tissue culture medium was used for the perfusates. Maternal perfusate was gassed with 95% O/sub 2//5% CO/sub 2/; fetal perfusate was gassed with 95% N/sub 2//5% CO/sub 2/. Both perfusates were recirculated (maternal 15-25 ml/min, fetal 3 ml/min) and exchanged for fresh perfusates every 4 hours. The integrity of the fetal vasculature was demonstrated by the stabilities of fetal arterial pressure (30-36 mm Hg) and circulatory volume (volume loss <2 ml/h). The metabolic viability of the placenta was documented by measurements of oxygen consumption (100-137 umole/min.kg), glucose consumption (133-163 umole/min.kg), and lactate production (163-229 umole/min.kg). Exposure of placenta to 10 nmole Cd/ml maternal perfusate led to accumulation of cadmium (45 nmole Cd/g), yet there was limited movement of cadmium from maternal to fetal circulations. This exposure did not result in significant changes in fetal capillary permeability of resistance, oxygen or glucose consumptions, lactate production, nCg release, transport of AlB by placental slices, or ultrastructure. Transfer of zinc from maternal to fetal circulations did not appear to be reduced. Exposure of perfused placenta to 100 nmole Cd/ml maternal perfusate resulted in a cadmium burden of 150 nmole Cd/g. This exposure induced syncytiotrophoblast necrosis, increased fetal capillary permeability, and reduced hCG release.

  14. Transplacental transfer of 2-naphthol in human placenta.

    PubMed

    Mirghani, Hisham; Osman, Nawal; Dhanasekaran, Subramanian; Elbiss, Hassan M; Bekdache, Gharid

    2015-01-01

    To determine the transfer of 2-naphthol (2-NPH) in fullterm human placental tissues. Six placentas were studied. The ex-vivo dual closed-loop human placental cotyledon perfusion model was used. 2-NPH was added to the perfusate in the maternal compartment. Samples were obtained from the maternal and fetal up to 360 min measuring. The mean fetal weight was 2880 ± 304.2 g. Mean perfused cotyledon weight was 26.3 (±5.5) g. All unperfused placental tissue samples contained NPH with a mean level of 7.98 (±1.73) μg\\g compared to a mean of 15.58 (±4.53) μg\\g after 360 min perfusion. A rapid drop in maternal 2-NPH concentration was observed; from 5.54 μg\\g in the first 15 min and 13.8 μg\\g in 360 min. The fetal side increased from 0.65 μg\\g in the initial 15 min to 1.5 μg\\g in 360 min. The transfer rate of NPH was much lower than that of antipyrine. 2-NPH has the ability to rapidly across the placenta from the maternal to the fetal compartment within 15 min. The placenta seems to play a role in limiting the passage of 2-NPH in the fetal compartment.

  15. Influence of Tropolone on Poria placenta Wood Degradation

    PubMed Central

    Diouf, P. N.; Delbarre, N.; Perrin, D.; Gérardin, P.; Rapin, C.; Jacquot, J. P.; Gelhaye, E.

    2002-01-01

    Fenton reactions are believed to play important roles in wood degradation by brown rot fungi. In this context, the effect of tropolone (2-hydroxycyclohepta-2,4,6-trienone), a metal chelator, on wood degradation by Poria placenta was investigated. Tropolone (50 μM) strongly inhibits fungal growth on malt agar, but this inhibition could be relieved by adding iron salts. With an experimental system containing two separate parts, one supplemented with tropolone (100 μM) and the other not, it was shown that the fungus is able to reallocate essential minerals from the area where they are available and also to grow in these conditions on malt-agar in the presence of tropolone. Nevertheless, even in the presence of an external source of metals, P. placenta is not able to attack pine blocks impregnated with tropolone (5 mM). This wood degradation inhibition is related to the presence of the tropolone hydroxyl group, as shown by the use of analogs (cyclohepta-2,4,6-trienone and 2-methoxycyclohepta-2,4,6-trienone). Furthermore, tropolone possesses both weak antioxidative and weak radical-scavenging properties and a strong affinity for ferric ion and is able to inhibit ferric iron reduction by catecholates, lowering the redox potential of the iron couple. These data are consistent with the hypothesis that tropolone inhibits wood degradation by P. placenta by chelating iron present in wood, thus avoiding initiation of the Fenton reaction. This study demonstrates that iron chelators such as tropolone could be also involved in novel and more environmentally benign preservative systems. PMID:12200290

  16. Neither normal nor diseased placentas contain lymphatic vessels.

    PubMed

    Castro, E; Tony Parks, W; Galambos, C

    2011-04-01

    Scant data on placental lymphatic vessels have pointed to the absence of lymphatic circulation. A recent study on mesenchymal dysplasia (MD), however, has identified pathologic lymphangiogenesis using the D2-40 lymphatic marker. These conflicting data have prompted us to investigate whether lymphatic vessels are present in normal developing placentas and in placental disorders characterized by cistern formation. Seventeen human placentas without significant pathological abnormality ranging from 12 to 39 weeks of gestational age were studied. Cisternal placental disorders were represented by mesenchymal dysplasia (n = 1), partial hydatitiform mole (n = 2), spontaneous abortion (n = 3) and complete hydatiform mole (n = 2). To identify lymphatic vessels, we used lymphatic endothelial markers Prox-1 and D2-40. The pan-endothelial marker CD31 was used to highlight overall placental vasculature and to determine if the lining cells of cisterns were of endothelial origin. Lymphatic marker positivity was assessed in maternal (decidual) as well as in fetal (chorionic villous) vasculature. No staining with Prox-1 or D2-40 was identified in fetal vessels in developing or term placentas, or in selected cisternal placental disorders, although both markers highlighted a number of thin-walled decidual vessels. Cistern lining cells were negative for Prox-1, D2-40 and CD31. D2-40 consistently marked stromal cells in chorionic villi and highlighted perivascular/pericellular extracellular matrix. We established that no lymphatic vasculature is present in the chorionic villi during development, at term or in selected edematous placental disorders. The cisternal lining cells are not endothelial cells; most likely they are of stromal cell origin. Lymphangiogenesis is a part of decidual vascular remodeling during gestation. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    PubMed

    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.

  18. Antenatal diagnosis of chorioangioma of the placenta: MR features

    SciTech Connect

    Mochizuki, Takao; Imai, Michiko; Isoda, Haruo

    1996-05-01

    We report a case of chorioangioma of the placenta, in which MR findings were useful in establishing the antenatal diagnosis. Polyhydramnios and a placental tumor that was 5 cm in size were visualized. The tumor had relatively high signal intensities on proton density imaging and T2-weighted imaging and showed partially high intensity signal rims on T1-weighted imaging, especially when using a breath-holding technique. Magnetic resonance imaging has an important role in detection and diagnosis of these lesions, particularly the larger tumors, so that appropriate steps can be taken to deal with the complications that may accompany this tumor. 27 refs., 4 figs.

  19. Effect of oxygen on multidrug resistance in term human placenta.

    PubMed

    Javam, M; Audette, M C; Iqbal, M; Bloise, E; Gibb, W; Matthews, S G

    2014-05-01

    The placenta contains efflux transporters, including P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP), that limit the passage of xenobiotics, certain hormones and nutrients from the maternal to the fetal circulation. The expression of these transporters changes with gestational age, yet the mechanisms involved remain unknown. However, the changes in P-gp and BCRP transporter expression coincide with those of oxygen tension in the placenta, and oxygen tension has been shown to modulate P-gp and BCRP expression in other tissues. The objective of this study was to investigate the effects of oxygen tension on P-gp and BCRP expression in the term human placenta. Following equilibration in culture (96 h), term placental explants (n = 7) were cultured in 3% or 20% oxygen for 24 and 48 h. Culture medium was collected every 24 h to measure lactate dehydrogenase (LDH; explant viability) and human chorionic gonadotropin (hCG; syncytiotrophoblast function). P-gp (encoded by ABCB1) and BCRP (encoded by ABCG2) protein and mRNA, as well as VEGFA mRNA were measured using western blot and qRT-PCR. P-gp localization was determined using immunofluorescence. Oxygen tension had a significant effect on P-gp expression, with ABCB1/P-gp mRNA and protein levels increased in the hypoxic condition (3% O2) after 48 h (p < 0.05). VEGFA mRNA was elevated by hypoxia at both 24 and 48 h (p < 0.05). In contrast, placental ABCG2/BCRP mRNA and protein expression were stable with changes in oxygen tension. We identified profound differences in the glycosylation of P-gp between cultured and non-cultured placental tissue, with cultured explants expressing deglycosylated P-gp. These findings demonstrate that, at term, the expression of placental P-gp, is regulated by oxygen tension. This suggests that changes in oxygenation of the placenta in the third trimester may alter levels of placental P-gp, and in doing so alter fetal exposure to P-gp substrates, including xenobiotics and certain

  20. Functional MRI of the placenta--From rodents to humans.

    PubMed

    Avni, R; Neeman, M; Garbow, J R

    2015-06-01

    The placenta performs a wide range of physiological functions; insufficiencies in these functions may result in a variety of severe prenatal and postnatal syndromes with long-term negative impacts on human adult health. Recent advances in magnetic resonance imaging (MRI) studies of placental function, in both animal models and humans, have contributed significantly to our understanding of placental structure, blood flow, oxygenation status, and metabolic profile, and have provided important insights into pregnancy complications. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

    PubMed

    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.

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

    PubMed

    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.

  3. Expression of G-Protein Subunit α-14 Is Increased in Human Placentas from Preeclamptic Pregnancies

    PubMed Central

    Zhao, Ying-Jie; Zou, Qing-Yun; Li, Yan; Li, Hui-Hui; Wu, Yan-Ming; Li, Xing-Fu; Wang, Kai

    2014-01-01

    G-proteins mediate cellular function upon interaction with G-protein coupled receptors. Of the 16 mammalian G-protein α subunits identified, G-protein subunit α-11 (GNA11) and -14 (GNA14) have been implicated in modulating hypertension and endothelial function. However, little is known about their expression and roles in human placentas. Here, we examined GNA11 and GNA14 protein expression in first trimester (FT), normal term (NT), and severe preeclamptic (sPE) human placentas as well as in NT human umbilical cords. We found that GNA11 and GNA14 were immunolocalized primarily in trophoblasts, villous stromal cells, and endothelial cells in placentas as well as in endothelial and/or smooth muscle cells of the umbilical cord artery and vein. Western blotting revealed that the GNA14, but not GNA11, protein levels were increased (2.5-2.9 fold; p<0.01) in sPE vs. NT placentas. GNA11 protein was detected only in NT, but not FT, placentas, whereas GNA14 protein levels were increased (7.7-10.6 fold; p<0.01) in NT vs. FT placentas. Thus, GNA11 and GNA14 may mediate the function of several cell types in placentas. Moreover, the high expression of GNA14 in sPE placentas may also imply its importance in sPE pregnancies as in the other hypertension-related disorders. PMID:24423937

  4. Expression of G-protein subunit α-14 is increased in human placentas from preeclamptic pregnancies.

    PubMed

    Zhao, Ying-Jie; Zou, Qing-Yun; Li, Yan; Li, Hui-Hui; Wu, Yan-Ming; Li, Xing-Fu; Wang, Kai; Zheng, Jing

    2014-05-01

    G-proteins mediate cellular function upon interaction with G-protein coupled receptors. Of the 16 mammalian G-protein α subunits identified, G-protein subunit α-11 (GNA11) and -14 (GNA14) have been implicated in modulating hypertension and endothelial function. However, little is known about their expression and roles in human placentas. Here, we examined GNA11 and GNA14 protein expression in first trimester (FT), normal term (NT), and severe preeclamptic (sPE) human placentas as well as in NT human umbilical cords. We found that GNA11 and GNA14 were immunolocalized primarily in trophoblasts, villous stromal cells, and endothelial cells in placentas as well as in endothelial and/or smooth muscle cells of the umbilical cord artery and vein. Western blotting revealed that the GNA14, but not GNA11, protein levels were increased (2.5-2.9 fold; p<0.01) in sPE vs. NT placentas. GNA11 protein was detected only in NT, but not FT, placentas, whereas GNA14 protein levels were increased (7.7-10.6 fold; p<0.01) in NT vs. FT placentas. Thus, GNA11 and GNA14 may mediate the function of several cell types in placentas. Moreover, the high expression of GNA14 in sPE placentas may also imply its importance in sPE pregnancies as in the other hypertension-related disorders.

  5. Differential expression and activity of matrix metalloproteinases 2 and 9 in canine early placenta.

    PubMed

    Diessler, M; Ventureira, M; Hernandez, R; Sobarzo, C; Casas, L; Barbeito, C; Cebral, E

    2017-02-01

    The zonary and endotheliochorial dog placenta is the most invasive placenta of carnivores. The importance of matrix metalloproteinases (MMP) in placenta invasiveness has been determined in several mammals including species with haemochorial, epitheliochorial and endotheliochorial placentation. Regarding the latter, the expression of MMP enzymes has been studied in the cat and the mature canine placenta. The aim of this study was to analyse the expression and activity of MMP-2 and MMP-9 in the early dog placenta. Placentae from 18 to 30 days of pregnancy were collected from four bitches. Two placentae from each bitch were analysed. Placental tissue from one uterine horn was fixed in formaldehyde for immunohistochemistry, while marginal haematoma, labyrinth, non-implantative and implantative endometrium from the contralateral horn were immediately frozen in dry ice for the analysis of MMP expression (Western blot [WB]) and activity (zymography). MMP-2 and MMP-9 were evidenced in the labyrinth, maternal glands and marginal haematoma; this finding was directly correlated with levels of MMP expression by WB, and with the activity of MMP-2, mainly in the haematoma (the area of major remodelling of tissues). Thus, although MMP-9 is well expressed in the early canine placenta, it is not active. Given the important role of MMPs for invasiveness, maternal-foetal angiogenesis and the establishment of a correct foetal nutrition, the results are consistent with the findings in other species in which the MMP-2 activation precedes the MMP-9 one in early placentation.

  6. Hectd1 is required for development of the junctional zone of the placenta.

    PubMed

    Sarkar, Anjali A; Nuwayhid, Samer J; Maynard, Thomas; Ghandchi, Frederick; Hill, Jonathon T; Lamantia, Anthony S; Zohn, Irene E

    2014-08-15

    The placenta plays a critical role in the growth and survival of the fetus. Here we demonstrate that the Homologous to the E6-AP Carboxyl Terminus (HECT) domain E3 ubiquitin ligase, Hectd1, is essential for development of the mouse placenta. Hectd1 is widely expressed during placentation with enrichment in trophoblast giant cells (TGCs) and other trophoblast-derived cell subtypes in the junctional and labyrinth zones of the placenta. Disruption of Hectd1 results in mid-gestation lethality and intrauterine growth restriction (IUGR). Variable defects in the gross structure of the mutant placenta are found including alterations in diameter, thickness and lamination. The number and nuclear size of TGCs is reduced. Examination of subtype specific markers reveals altered TGC development with decreased expression of Placental lactogen-1 and -2 (Pl1 and Pl2) and increased expression of Proliferin (Plf). Reduced numbers of spongiotrophoblasts and glycogen trophoblasts were also found at the junctional zone of the Hectd1 mutant placenta. Finally, there was an increase in immature uterine natural killer (uNK) cells in the maternal decidua of the Hectd1 mutant placenta. Proliferation and apoptosis are differentially altered in the layers of the placenta with an increase in both apoptosis and proliferation in the maternal decidua, a decrease in proliferation and increase in apoptosis in the labyrinth layer and both unchanged in the junctional zone. Together these data demonstrate that Hectd1 is required for development of multiple cell types within the junctional zone of the placenta.

  7. Birth weight correlates with size but not shape of the normal human placenta.

    PubMed

    Haeussner, E; Schmitz, C; von Koch, F; Frank, H-G

    2013-07-01

    Studies on developmental programming rely on various measures of size and form of the human placenta. Size and form are not independent of each other and covariation patterns were not determined systematically. Twenty-two morphologic parameters were determined on 418 placentas from uncomplicated singleton pregnancies. We determined (i) placenta weight and birth weight, (ii) form parameters such as diameters, thickness, roundness, and eccentricity of cord insertion, and (iii) shape variability by geometric morphometry. Geometric morphometry analyzes shape variability independent of size. We define the technical terms form and shape according to the language of geometric morphometry. Placenta weight correlated with birth weight. The form parameters correlated variably with placenta weight and shape. Shape variability did not correlate with birth weight and placenta weight. The correlation of placenta weight with birth weight stays a cornerstone of prenatal programming. Shape analysis shows that form parameters are hybrids of size and shape. Shape variability can be interpreted as an outcome of adaptation of a placenta to maternal factors and the associated uterine habitat. Correlation analysis of the whole data array provides a rigorous statistical frame to interpret published data and plan new studies. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Retrospective analysis of placenta accreta: management strategies--evaluation of 41 cases.

    PubMed

    Evsen, Mehmet Siddik; Sak, Muhammet Erdal; Soydine, Hatice Ender; Nur, Caca Fatma; Mehmet, Obut; Gul, Talip

    2012-07-01

    The aim of the study was to evaluate maternal characteristics, surgical treatment options, and morbidity of patients with placenta accreta. We retrospectively reviewed the medical records of placenta accreta patients who were diagnosed and hospitalized between 2006 and 2010 at the Obstetrics and Gynecology Clinics of the Dicle University Hospital (Center A) and Maternity Hospital (Center B) in Diyarbakir Turkey The data were retrieved from medical charts of both hospitals. Maternal demographic features, clinical outcomes, type of surgical intervention, and complications were evaluated. The incidence of placenta accreta was 1/426 deliveries in Center A and 1/7573 deliveries in Center B over a 5-year period. Thirty-nine (95.1%) patients had placenta previa, and 32 (78.0%) patients had at least one previous cesarean delivery Hysterectomy was performed in 28 (68.3%) of 41 women with placenta accreta and uterine preservation was achieved in 13 (31.7%) of them. One (2.4%) maternal death occurred. Estimated blood loss was >2 liters and all patients required blood products transfusion. Placenta accreta is highly associated with the existence of placenta previa, especially in cases with previous cesarean delivery When placenta accreta is diagnosed or suspected, the patient should be referred to a tertiary center for optimum care, where the obstetrical team should include experienced pelvic surgeons who are capable of performing emergent hysterectomy internal iliac artery ligation, and uterine devascularization procedures.

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

    PubMed

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

    PubMed

    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 < .05 as significant. 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 < .001). The likelihood of 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.

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

    PubMed Central

    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. PMID:24453467

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

    PubMed Central

    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

  13. Relationships of CD163 and CD169 positive cell numbers in the endometrium and fetal placenta with type 2 PRRSV RNA concentration in fetal thymus.

    PubMed

    Novakovic, Predrag; Harding, John C S; Ladinig, Andrea; Al-Dissi, Ahmad N; MacPhee, Daniel J; Detmer, Susan E

    2016-08-05

    Several routes of porcine reproductive and respiratory virus PRRSV transmission across the porcine diffuse epitheliochorial placentation have been proposed, but none have been proven. The objectives of this study were to investigate associations between numbers of CD163 and CD169 positive macrophages, cathepsin positive areolae, and type 2 PRRSV load at the maternal-fetal interface in order to examine important factors related to transplacental infection. On gestation day 85 ± 1, naïve pregnant gilts were inoculated with PRRSV (n = 114) or were sham inoculated (n = 19). At 21 days post-inoculation (dpi), dams and their litters were humanely euthanized and necropsied. Samples of the maternal-fetal interface (uterus with fully attached placenta) and fetal thymus were collected for analysis by RT-qPCR to quantify PRRSV RNA concentration. The corresponding paraffin-embedded uterine tissue sections were subjected to immunohistochemistry for PRRSV nucleocapsid N protein, CD163, CD169, and cathepsin. Our findings confirm significant increases in the numbers of PRRSV, CD163 and CD169 positive cells at the maternal-fetal interface during type 2 PRRSV infection in pregnant gilts. PRRSV load in fetal thymus was positively related to CD163(+) cell count in endometrium and negatively related to CD163(+) cell count in placenta, but unrelated to CD169 counts or cathepsin positive areolae. The endometrium:placenta ratio of CD163 cells, and to a lesser extent CD169 cells, was significantly associated with an increase fetal viral load in thymus. These findings suggest a more important role for CD163(+) cells following trans-placental PRRSV infection, but dichotomous responses in endometrium and placenta for both CD163 and CD169 cells.

  14. Cloning of a new member of the insulin gene superfamily (INSL4) expressed in human placenta

    SciTech Connect

    Chassin, D.; Laurent, A.; Janneau, J.L.

    1995-09-20

    A new member of the insulin gene superfamily was identified by screening a subtracted cDNA library of first-trimester human placenta and, hence, was tentatively named early placenta insulin-like peptide (EPIL). In this paper, we report the cloning and sequencing of the EPIL cDNA and the EPIL gene (INSL4). Comparison of the deduced amino acid sequence of the early placenta insulin-like peptide revealed significant overall and structural homologies with members of the insulin-like hormone superfamily. Moreover, the organization of the early placenta insulin-like gene, which is composed of two exons and one intron, is similiar to that of insulin and relaxin. By in situ hybridization, the INSL4 gene was assigned to band p24 of the short arm of chromosome 9. RT-PCR analysis of EPIL tissue distribution revealed that its transcripts are expressed in the placenta and uterus. 22 refs., 3 figs.

  15. Bovine placenta: a review on morphology, components, and defects from terminology and clinical perspectives.

    PubMed

    Peter, Augustine T

    2013-10-15

    The bovine placenta has been the subject of many studies. Concurrently, several specialized terms have been developed to describe its development, morphology, components, function, and pathology. Many of these terms are simple, some are difficult to understand and use, and others are antiquated and may not be scientifically accurate. Defining and adopting terminology for the bovine placenta that is clear, precise and understandable, and available in a single source is expected to facilitate exchange of clinical and research information. This review presents a brief overview of the current knowledge regarding the bovine placenta and attempts to define terms. In this process, conventional terminology is presented, and contemporary and novel terms are proposed from a biological perspective. For example, use of terms such as syndesmochorial, retained placenta, and large offspring syndrome should be revisited. Furthermore, the clinical relevance of the structure and function of the bovine placenta is reviewed. Finally, terms discussed in this review are summarized (in table format).

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

    PubMed

    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.

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

    PubMed

    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, P<0.01). The incidence rate of complicated placenta 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, P<0.01). (4) The incidence of blood loss was more than 1 000 ml, blood transfusion rate, the rate of hysterectomy and the rate of asphyxia of newborn in the research group were respectively 41.7% (25/60), 38.3% (23/60), 8.3% (5/60), 15.0% (9/60), and the

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

    PubMed

    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.

  19. Random X inactivation in the mule and horse placenta

    PubMed Central

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

    2012-01-01

    In eutherian mammals, dosage compensation of X-linked genes is achieved by X chromosome inactivation. X inactivation is random in embryonic and adult tissues, but imprinted X inactivation (paternal X silencing) has been identified in the extra-embryonic membranes of the mouse, rat, and cow. Few other species have been studied for this trait, and the data from studies of the human placenta have been discordant or inconclusive. Here, we quantify X inactivation using RNA sequencing of placental tissue from reciprocal hybrids of horse and donkey (mule and hinny). In placental tissue from the equid hybrids and the horse parent, the allelic expression pattern was consistent with random X inactivation, and imprinted X inactivation can clearly be excluded. We characterized horse and donkey XIST gene and demonstrated that XIST allelic expression in female hybrid placental and fetal tissues is negatively correlated with the other X-linked genes chromosome-wide, which is consistent with the XIST-mediated mechanism of X inactivation discovered previously in mice. As the most structurally and morphologically diverse organ in mammals, the placenta also appears to show diverse mechanisms for dosage compensation that may result in differences in conceptus development across species. PMID:22645258

  20. Glucose metabolism in cultured trophoblasts from human placenta

    SciTech Connect

    Moe, A.J.; Farmer, D.R.; Nelson, D.M.; Smith, C.H. )

    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. Isolation of multipotent cells from human term placenta.

    PubMed

    Yen, B Linju; Huang, Hsing-I; Chien, Chih-Cheng; Jui, Hsiang-Yiang; Ko, Bor-Sheng; Yao, Ming; Shun, Chia-Tung; Yen, Men-Luh; Lee, Meng-Chou; Chen, Yao-Chang

    2005-01-01

    Current sources of stem cells include embryonic stem cells (ESCs) and adult stem cells (ASCs). However, concerns exist with either source: ESCs, with their significant ethical considerations, tumorigenicity, and paucity of cell lines; and ASCs, which are possibly more limited in potential. Thus, the search continues for an ethically conducive, easily accessible, and high-yielding source of stem cells. We have isolated a population of multipotent cells from the human term placenta, a temporary organ with fetal contributions that is discarded postpartum. These placenta-derived multipotent cells (PDMCs) exhibit many markers common to mesenchymal stem cells--including CD105/endoglin/SH-2, SH-3, and SH-4--and they lack hematopoietic-, endothelial-, and trophoblastic-specific cell markers. In addition, PDMCs exhibit ESC surface markers of SSEA-4, TRA-1-61, and TRA-1-80. Adipogenic, osteogenic, and neurogenic differentiation were achieved after culturing under the appropriate conditions. PDMCs could provide an ethically uncontroversial and easily accessible source of multipotent cells for future experimental and clinical applications.

  2. Review: The placenta is a programming agent for cardiovascular disease.

    PubMed

    Thornburg, K L; O'Tierney, P F; Louey, S

    2010-03-01

    Cardiovascular disease remains the number one killer in western nations in spite of declines in death rates following improvements in clinical care. It has been 20 years since David Barker and colleagues showed that slow rates of prenatal growth predict mortality from ischemic heart disease. Thus, fetal undergrowth and its associated cardiovascular diseases must be due, in part, to placental inadequacies. This conclusion is supported by a number of studies linking placental characteristics with various adult diseases. A "U" shaped relationship between placental-to-fetal weight ratio and heart disease provides powerful evidence that placental growth-regulating processes initiate vulnerabilities for later heart disease in offspring. Recent evidence from Finland indicates that placental morphological characteristics predict risks for coronary artery disease, heart failure, hypertension and several cancers. The level of risk imparted by placental shape is sex dependent. Further, maternal diet and body composition strongly influence placental growth, levels of inflammation, nutrient transport capacity and oxidative stress, with subsequent effects on offspring health. Several animal models have demonstrated the placental roots of vulnerability for heart disease. These include findings that abnormal endothelial development in the placenta is associated with undergrown myocardial walls in the embryo, and that placental insufficiency leads to depressed maturation and proliferation of working cardiomyocytes in the fetal heart. Together these models suggest that the ultimate fitness of the heart is determined by hemodynamic, growth factor, and oxygen/nutrient cues before birth, all of which are influenced, if not regulated by the placenta.

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

    PubMed

    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.

  4. Ultrastructural findings in placentae of HIV-positive women.

    PubMed

    Villegas, H; Carrillo-farga, J; Paredes, Y; Karchmer, S

    1993-01-01

    Transmission of human immunodeficiency virus (HIV) from an infected mother to the fetus has been shown to occur. The route of infection is probably through the placenta, yet the exact mechanism of how this occurs is still unclear. Researchers in Mexico report in this article their findings on placental tissue taken from 9 HIV-seropositive women. The placentas from new deliveries were sectioned and the tissue fixed and embedded in plastic. Thin sections were cut, stained, and examined using transmission electron microscopy (TEM). HIV-like particles were found near or inside the trophoblastic villi in 4 placental specimens examined. In one case these particles were found in the endothelium of the umbilical artery. Mast-like cells were found in the free villous stroma in 2 tissue samples. Vertical transmission of HIV has been a major source of HIV infections in Europe and the US. On the other hand, Mexico doesn't report similar findings. The authors suggest that this is the case because of lower female drug use. It is still unclear why some babies from HIV-seropositive mothers become infected while others do not.

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

    PubMed

    Myren, Maja; Mose, Tina; Mathiesen, Line; Knudsen, Lisbeth Ehlert

    2007-10-01

    Pregnant women are daily exposed to a wide selection of foreign substances. Sources are as different as lifestyle factors (smoking, daily care products, alcohol consumption, etc.), maternal medication or occupational/environmental exposures. The placenta provides the link between mother and foetus, 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 of the foetus (e.g. cigarette smoke) and development of the foetal organs (e.g. methylmercury and thalidomide). The scope of this review is to give insight to the placental anatomy, development and function. Furthermore, the compounds physical properties and the transfer mechanism across the placental barrier are evaluated. In order to determine the actual foetal risk from exposure to a chemical many studies regarding the topic are necessary, including means of transportation, toxicological targets and effects. For this purpose several in vivo and in vitro models including the placental perfusion system are models of choice.

  6. Placenta-an alternative source of stem cells

    SciTech Connect

    Matikainen, Tiina; Laine, Jarmo . E-mail: jarmo.laine@bts.redcoss.fi

    2005-09-01

    The two most promising practical applications of human stem cells are cellular replacement therapies in human disease and toxicological screening of candidate drug molecules. Both require a source of human stem cells that can be isolated, purified, expanded in number and differentiated into the cell type of choice in a controlled manner. Currently, uses of both embryonic and adult stem cells are investigated. While embryonic stem cells are pluripotent and can differentiate into any specialised cell type, their use requires establishment of embryonic stem cell lines using the inner cell mass of an early pre-implantation embryo. As the blastocyst is destroyed during the process, ethical issues need to be carefully considered. The use of embryonic stem cells is also limited by the difficulties in growing large numbers of the cells without inducing spontaneous differentiation, and the problems in controlling directed differentiation of the cells. The use of adult stem cells, typically derived from bone marrow, but also from other tissues, is ethically non-controversial but their differentiation potential is more limited than that of the embryonic stem cells. Since human cord blood, umbilical cord, placenta and amnion are normally discarded at birth, they provide an easily accessible alternative source of stem cells. We review the potential and current status of the use of adult stem cells derived from the placenta or umbilical cord in therapeutic and toxicological applications.

  7. Optoacoustic measurements of human placenta and umbilical blood oxygenation

    NASA Astrophysics Data System (ADS)

    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.

  8. Localisation of Lactate Transporters in Rat and Rabbit Placentae

    PubMed Central

    Picut, Catherine A.; Charlap, Jeffrey H.

    2016-01-01

    The distribution of monocarboxylate transporter (MCT) isoforms 1 and 4, which mediate the plasmalemmal transport of l-lactic and pyruvic acids, has been identified in the placentae of rats and rabbits at different ages of gestation. Groups of three pregnant Sprague-Dawley rats and New Zealand White rabbits were sacrificed on gestation days (GD) 11, 14, 18, or 20 and on GD 13, 18, or 28, respectively. Placentae were removed and processed for immunohistochemical detection of MCT1 and MCT4. In the rat, staining for MCT1 was associated with lakes and blood vessels containing enucleated red blood cells (maternal vessels) while staining for MCT4 was associated with vessels containing nucleated red blood cells (embryofoetal vessels). In the rabbit, staining for MCT1 was associated with blood vessels containing nucleated red blood cells while staining for MCT4 was associated with vessels containing enucleated red blood cells. Strength of staining for MCT1 decreased during gestation in both species, but that for MCT4 was stronger than that for MCT1 and was consistent between gestation days. The results imply an opposite polarity of MCT1 and MCT4 across the trophoblast between rat and rabbit. PMID:27843454

  9. Functional amino acids in the development of the pig placenta.

    PubMed

    Wu, Guoyao; Bazer, Fuller W; Johnson, Gregory A; Herring, Cassandra; Seo, Heewon; Dai, Zhaolai; Wang, Junjun; Wu, Zhenlong; Wang, Xiaolong

    2017-09-01

    The mammalian placenta is essential for supplying nutrients (e.g., amino acids and water) and oxygen from the mother to fetus and for removing fetal metabolites (e.g., ammonia and CO2 ) from fetus to mother. Thus, placental growth and development are determinants of fetal survival, growth, and development. Indeed, low birth weight is closely associated with reduced placental growth. Providing gestating gilts or sows with dietary supplementation of arginine and glutamine, increases placental growth (including vascular growth), improves embryonic/fetal growth and survival, and reduces the large variation in birth weight among litters. These two amino acids serve as building blocks for tissue protein as well as substrates for the production of polyamines and nitric oxide, which stimulate DNA and protein synthesis and angiogenesis and vascular growth in the placenta. These recent findings not only greatly advance the field of mammalian amino acid metabolism and nutrition, but also provide practical, mechanism-based methods to enhance reproductive efficiency in swine. These results may also help improve embryonic/fetal survival and growth in other livestock species (e.g., sheep and cattle) and in humans. © 2017 Wiley Periodicals, Inc.

  10. Gene expression in the placenta: maternal stress and epigenetic responses.

    PubMed

    Gheorghe, Ciprian P; Goyal, Ravi; Mittal, Ashwani; Longo, Lawrence D

    2010-01-01

    Successful placental development is crucial for optimal growth, development, maturation and survival of the embryo/fetus into adulthood. Numerous epidemiologic and experimental studies have demonstrated the profound influence of intrauterine environment on life, and the diseases to which one is subject as an adult. For the most part, these invidious influences, whether maternal hypoxia, protein or caloric deficiency or excess, and others, represent types of maternal stress. In the present review, we examine certain aspects of gene expression in the placenta as a consequence of maternal stressors. To examine these issues in a controlled manner, and in a species in which the genome has been sequenced, most of these reported studies have been performed in the mouse. Although each individual maternal stress is characterized by up- or down-regulation of specific genes in the placenta, functional analysis reveals some patterns of gene expression common to the several forms of stress. Of critical importance, these genes include those involved in DNA methylation and histone modification, cell cycle regulation, and related global pathways of great relevance to epigenesis and the developmental origins of adult health and disease.

  11. Vitamin D Effects on Pregnancy and the Placenta

    PubMed Central

    Shin, Joong Sik; Choi, Mee Yun; Longtine, Mark S.; Nelson, D. Michael

    2010-01-01

    Vitamin D is a pleiotropic secosteroid hormone important for health and disease prevention. The actions of vitamin D are mediated by the vitamin D receptor that binds the active form of vitamin D [1,25(OH)2D] to induce both transcriptional and non-genomic responses. Vitamin D has well known classical functions in calcium uptake and bone metabolism, but more recent work highlights the importance of the nonclassical actions of vitamin D in a variety of cell types. These actions include modulation of the innate and adaptive immune systems and regulation of cell proliferation. Adequate vitamin D intake is essential for maternal and fetal health during pregnancy, and epidemiological data indicate that many pregnant women have sub-optimal vitamin D levels. Notably, vitamin D deficiency correlates with preeclampsia, gestational diabetes mellitus, and bacterial vaginosis, and an increased risk for C-section delivery. Recent work emphasizes the importance of nonclassical roles of vitamin D in pregnancy and the placenta. The placenta produces and responds to vitamin D where vitamin D functions as a modulator of implantation, cytokine production and the immune response to infection. We describe vitamin D metabolism and the cellular responses to vitamin D, and then summarize the role of vitamin D in placental trophoblast, pregnancy and the fetus. PMID:20863562

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

    PubMed Central

    Atabaki pasdar, Fatemeh; Khooei, Alireza; Fazel, Alireza; Rastin, Maryam; Tabasi, Nafise; Peirouvi, Tahmineh; Mahmoudi, Mahmoud

    2015-01-01

    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. PMID:26221125

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

    PubMed

    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.

  14. 45 CFR 46.206 - Research involving, after delivery, the placenta, the dead fetus or fetal material.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Research involving, after delivery, the placenta..., 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...

  15. 45 CFR 46.206 - Research involving, after delivery, the placenta, the dead fetus or fetal material.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Research involving, after delivery, the placenta..., 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...

  16. 45 CFR 46.206 - Research involving, after delivery, the placenta, the dead fetus or fetal material.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Research involving, after delivery, the placenta..., 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...

  17. 45 CFR 46.206 - Research involving, after delivery, the placenta, the dead fetus or fetal material.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Research involving, after delivery, the placenta..., 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...

  18. 45 CFR 46.206 - Research involving, after delivery, the placenta, the dead fetus or fetal material.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Research involving, after delivery, the placenta..., 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...

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

    PubMed

    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 (P<0.05), but there was no difference between IUGR and normal placenta in the late third trimester. Western immunoblotting findings in IUGR and normal placentae were in accord with mRNA data. MCT8 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

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

    PubMed

    Schroeder, Diane I; Jayashankar, Kartika; Douglas, Kory C; Thirkill, Twanda L; York, Daniel; Dickinson, Pete J; Williams, Lawrence E; Samollow, Paul B; Ross, Pablo J; Bannasch, Danika L; Douglas, Gordon C; LaSalle, Janine M

    2015-08-01

    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.

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

    PubMed

    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.

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

    PubMed

    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

  3. Placenta Previa and the Risk of Delivering a Small-for-Gestational-Age Newborn

    PubMed Central

    Kancherla, Vijaya; Kramer, Michael R.; Gissler, Mika; Heinonen, Seppo

    2014-01-01

    Objective 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. Methods A cross sectional study utilizing 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 (< 2 standard deviations below the mean) and placenta previa was modeled by parity-specific unadjusted and adjusted statistical models. Results 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 (IVF); placenta previa was not associated with an increased prevalence of SGA, controlling for maternal age, smoking, IVF, socioeconomic status, and preeclampsia (aOR=0.81; 95% CI=0.57–1.17). Among multiparous women, placenta previa was associated with a two-fold increased risk of SGA, controlling for maternal age, parity, prior preterm birth, prior caesarean delivery, prior SGA newborn, prior preeclampsia, smoking, IVF, socioeconomic status, and preeclampsia (aOR=2.08; 95% CI=1.50–2.89). Further, 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. Conclusions Placenta previa is associated with impaired fetal growth in multiparous but not nulliparous women. PMID:25004348

  4. Purification of a Factor from Human Placenta That Stimulates Capillary Endothelial Cell Protease Production, DNA Synthesis, and Migration

    NASA Astrophysics Data System (ADS)

    Moscatelli, David; Presta, Marco; Rifkin, Daniel B.

    1986-04-01

    A protein that stimulates the production of plasminogen activator and latent collagenase in cultured bovine capillary endothelial cells has been purified 106-fold from term human placenta by using a combination of heparin affinity chromatography, ion-exchange chromatography, and gel chromatography. The purified molecule has a molecular weight of 18,700 as determined by NaDodSO4/PAGE under both reducing and nonreducing conditions. The purified molecule stimulates the production of plasminogen activator and latent collagenase in a dose-dependent manner between 0.1 and 10 ng of protein/ml. The purified protein also stimulates DNA synthesis and chemotaxis in capillary endothelial cells in the same concentration range. Thus, this molecule has all of the properties predicted for an angiogenic factor.

  5. Immunoregulatory effects on T lymphocytes by human mesenchymal stromal cells isolated from bone marrow, amniotic fluid, and placenta.

    PubMed

    Mareschi, Katia; Castiglia, Sara; Sanavio, Fiorella; Rustichelli, Deborah; Muraro, Michela; Defedele, Davide; Bergallo, Massimiliano; Fagioli, Franca

    2016-02-01

    Mesenchymal stromal cells (MSCs) are a promising tool in cell therapies because of their multipotent, bystander, and immunomodulatory properties. Although bone marrow represents the main source of MSCs, there remains a need to identify a stem cell source that is safe and easily accessible and yields large numbers of cells without provoking debates over ethics. In this study, MSCs isolated from amniotic fluid and placenta were compared with bone marrow MSCs. Their immunomodulatory properties were studied in total activated T cells (peripheral blood mononuclear cells) stimulated with phytohemagglutinin (PHA-PBMCs). In particular, an in vitro co-culture system was established to study: (i) the effect on T-lymphocyte proliferation; (ii) the presence of T regulatory lymphocytes (Treg); (iii) the immunophenotype of various T subsets (Th1 and Th2 naïve, memory, effector lymphocytes); (iv) cytokine release and master gene expression to verify Th1, Th2, and Th17 polarization; and (v) IDO production. Under all co-culture conditions with PHA-PBMCs and MSCs (independently of tissue origin), data revealed: (i) T proliferation inhibition; (ii) increase in naïve T and decrease in memory T cells; (iii) increase in T regulatory lymphocytes; (iv) strong Th2 polarization associated with increased interleukin-10 and interleukin-4 levels, Th1 inhibition (significant decreases in interleukin-2, tumor necrosis factor-α, interferon-γ, and interleukin-12) and Th17 induction (production of high concentrations of interleukins-6 and -17); (v) indoleamine-2,3-dioxygenase mRNA induction in MSCs co-cultured with PHA-PBMCs. AF-MSCs had a more potent immunomodulatory effect on T cells than BM-MSCs, only slightly higher than that of placenta MSCs. This study indicates that MSCs isolated from fetal tissues may be considered a good alternative to BM-MSCs for clinical applications.

  6. Placental location, postpartum hemorrhage and retained placenta in women with a previous cesarean section delivery: a prospective cohort study.

    PubMed

    Belachew, Johanna; Eurenius, Karin; Mulic-Lutvica, Ajlana; Axelsson, Ove

    2017-08-22

    Women previously giving birth with cesarean section have an increased risk of postpartum hemorrhage (PPH) and retained placenta. The objective of this study was to determine if anterior placental location increased the risk of PPH and retained placenta in such women. We performed a prospective cohort study on 400 women with cesarean section delivery in a previous pregnancy. Ultrasound examinations were performed at gestational week 28-30, and placental location, myometrial thickness, and three-dimensional vascularization index (VI) were recorded. Data on maternal age, parity, BMI, smoking, gestational week at delivery, induction, delivery mode, oxytocin, preeclampsia, PPH, retained placenta, and birth weight were obtained for all women. Outcome measures were PPH (≥1,000 mL) and retained placenta. The overall incidence of PPH was 11.0% and of retained placenta 3.5%. Twenty-three women (11.8%) with anterior placenta had PPH compared to 12 (6.9%) with posterior or fundal locations. The odds ratio was 1.94, but it did not reach statistical significance. There was no significant risk increase for retained placenta in women with anterior placentae. Seven of eight women with placenta previa had PPH, and four had retained placenta. The overall risk of PPH and retained placenta was high for women with previous cesarean section. Anterior location of the placenta in such women tended to impose an increased risk for PPH but no risk increase of retained placenta. Placenta previa in women with previous cesarean section is associated with a high risk for PPH and retained placenta.

  7. 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.

    PubMed

    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 < .01 and P < .05, respectively. We found a sensitivity of 100% and a specificity of 61.5% for the prediction of invasive 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.

  8. 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

    PubMed Central

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

    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 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 < .01 and P < .05, respectively. We found a sensitivity of 100% and a specificity of 61.5% for the prediction of invasive 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. PMID:23744883

  9. Expression of human placental lactogen and variant growth hormone genes in placentas.

    PubMed

    Martinez-Rodriguez, H G; Guerra-Rodriguez, N E; Iturbe-Cantu, M A; Martinez-Torres, A; Barrera-Saldaña, H A

    1997-01-01

    Previous studies comparing the expression levels of human placental lactogen (hPL) genes have shown varying results, due to, perhaps, the fact that in all of them only one placenta was being analyzed. Here, the expression of hPL and growth hormone variant (hGH-V) genes in fifteen term placentas was comparatively analyzed at the RNA level, using reverse transcription coupled to polymerase chain reaction (RT-PCR). The abundance of the combined RNA transcripts derived from these genes varied from one placenta to another. The authors found that hPL-4 transcripts were more abundant than those of hPL-3 in most samples (ratios from 1:1 to 6:1), transcripts from the putative hPL-1 pseudogene were more abundant at the unprocessed stage while those of the hGH-V gene were mostly processed. Again, the authors of this study observed wide variation from placenta to placenta in the abundance of both of these types of transcripts. The same was observed when a group of six placentas from abortuses and nine from pregnancies complicated by preclampsia, diabetes and hypertension was studied. The authors conclude that the disagreeing results reported in the literature which are not in agreement concerning the expression levels of hPL genes could be explained by normal variations of their expression levels among the different placentas analyzed.

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

    PubMed Central

    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

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

    PubMed

    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. Published by Elsevier Ltd.

  12. Autophagy in the placenta of women with hypertensive disorders in pregnancy.

    PubMed

    Akaishi, R; Yamada, T; Nakabayashi, K; Nishihara, H; Furuta, I; Kojima, T; Morikawa, M; Yamada, T; Fujita, N; Minakami, H

    2014-12-01

    Autophagy has not been studied extensively in the human placenta. This study was performed to determine whether autophagy is increased in the placentas of women with hypertensive disorders in pregnancy compared to normotensive pregnancies. LC3-II and p62 protein expression were examined by quantitative Western blotting analysis in 40 placentas from women not experiencing labor pains. The 40 placentas were from 13, 8, and 19 women with preeclampsia, gestational hypertension, and normal pregnancy, respectively. Hypertensive disorders in pregnancy included preeclampsia and gestational hypertension. LC3-II expression was significantly increased, while that of p62 was significantly reduced in 21 placentas of women with hypertensive disorders compared to those with normal blood pressure irrespective of the presence or absence of fetal growth restriction (FGR). LC3-II expression was also significantly increased in 13 placentas of women with preeclampsia irrespective of the presence or absence of FGR. The results of this study suggested that autophagy is active in the placenta of hypertensive disorders even in the absence of FGR. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Kinetic assessment of manganese using magnetic resonance imaging in the dually perfused human placenta in vitro

    SciTech Connect

    Miller, R.K.; Mattison, D.R.; Panigel, M.; Ceckler, T.; Bryant, R.; Thomford, P.

    1987-10-01

    The transfer and distribution of paramagnetic manganese was investigated in the dually perfused human placenta in vitro (using 10, 20, 100 ..mu..M Mn with and without /sup 54/Mn) using magnetic resonance imaging (MRI) and conventional radiochemical techniques. The human placenta concentrated /sup 54/Mn rapidly during the first 15 min of perfusion and by 4 hr was four times greater than the concentrations of Mn in the maternal perfusate, while the concentration of Mn in the fetal perfusate was 25% of the maternal perfusate levels. Within placentae, 45% of the /sup 54/Mn was free in the 100,000g supernatant, with 45% in the 1000g pellet. The magnetic field dependence of proton nuclear spin-lattice relaxation time (T/sub 1/) in placental tissue supports this Mn binding. Mn primarily affected the MRI partial saturation rather than spin-echo images of the human placenta, which provided for the separation of perfusate contributions from those produced by Mn. The washout of the Mn from the placenta was slow compared with its uptake, as determined by MRI. Thus, Mn was concentrated by the human placenta, but transfer of Mn across the placenta was limited in either direction. These studies also illustrate the opportunity for studies of human placental function using magnetic resonance imaging as a noninvasive biomarker.

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

    PubMed Central

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

    2016-01-01

    Objective To demonstrate the safety of fetal delivery through placental incision in a placenta previa pregnancy. Methods 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. Results 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. Conclusion 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. PMID:27004200

  15. Management of patients with placenta accreta in association with fever following vaginal delivery.

    PubMed

    Zhong, Liuying; Chen, Dunjin; Zhong, Mei; He, Yutian; Su, Chunhong

    2017-03-01

    This study aims to analyze the clinical characteristics and to manage patients with retained placenta left in situ accompanied by fever following vaginal delivery.Twenty-one patients with retained placenta in association with fever following vaginal delivery were enrolled and managed at the maternity department of our university hospital between 2012 and 2014.All patients had risk factors for development of placenta accreta: previous cesarean sections (4/21), previous curettage (15/21), or uterine malformations (7/21). Placenta accreta was diagnosed following vaginal delivery in all patients, and manual removal of the placenta was attempted in 20 of 21 patients. The placenta left in situ was partial in 19 patients and was complete in 2 patients. All patients were managed with a multidisciplinary approach. Mifepristone was administrated to 16 patients. Fourteen patients received uterine artery embolization. Eleven patients were treated with ultrasound-guided curettage within 24 hours following delivery. Seven patients needed delayed-hysterectomy due to development of complications.Intrauterine operations during labor are not recommended if placenta accreta occurs in the fundus and/or in the cornual region of the uterus. Antibiotic treatment, interventional therapy, and ultrasound-guided curettage within 24 hours following vaginal delivery are the recommended conservative management strategies.

  16. Retrospective Analysis of the Incidence of Retained Placenta in 3 Large Colonies of NHP

    PubMed Central

    Bauer, Cassondra; Harrison, Tara

    2016-01-01

    During 1999 through 2014, retained placenta was the most common cause of clinical admission for reproductive complications in breeding colonies of baboons (approximate colony size, 2000 animals), cynomolgus macaques (approximately 1000), and rhesus macaques (approximately 500) at the Southwest National Primate Research Center. Retained placentas occurred in 2.7% of baboons, 3.3% of cynomolgus macaques, and 1.0% of rhesus macaques. Apparent risk factors for retained placenta included stillbirth or abortion and at least one prior cesarean section. There was a significant association between stillbirth and retained placenta in all species. Cesarean sections were performed routinely for baboons to meet research objectives but occurred only as needed for cynomolgus and rhesus macaques. Having had at least one prior cesarean section was an incidence factor for retained placenta in 37.0% of baboons and 4.7% of cynomolgus macaques; none of the rhesus macaques with retained placentas had undergone cesarean section previously. More than 90% of dams with retained placenta returned to a successful reproductive life or assignment to a nonbreeding research protocol. Advances in reproductive management will benefit from prospective studies that capture additional data from all members of a breeding group prior to reproductive complications. PMID:27053569

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

    PubMed

    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.

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

    PubMed

    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 < 0.001) whereas the number of trophoblast cells and the expression of HLA-G by trophoblast are similar in the decidua of PA and CP. We speculate that adequate numbers of uNK cells in the basal decidua are needed for normal expulsion of the placenta.

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

    PubMed

    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.

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

    PubMed Central

    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

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

    PubMed

    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 < 0.05 significance. There were 19,069 patients in the study: 452 in the 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.

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

    PubMed

    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 (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.

  3. Management of patients with placenta accreta in association with fever following vaginal delivery

    PubMed Central

    Zhong, Liuying; Chen, Dunjin; Zhong, Mei; He, Yutian; Su, Chunhong

    2017-01-01

    Abstract This study aims to analyze the clinical characteristics and to manage patients with retained placenta left in situ accompanied by fever following vaginal delivery. Twenty-one patients with retained placenta in association with fever following vaginal delivery were enrolled and managed at the maternity department of our university hospital between 2012 and 2014. All patients had risk factors for development of placenta accreta: previous cesarean sections (4/21), previous curettage (15/21), or uterine malformations (7/21). Placenta accreta was diagnosed following vaginal delivery in all patients, and manual removal of the placenta was attempted in 20 of 21 patients. The placenta left in situ was partial in 19 patients and was complete in 2 patients. All patients were managed with a multidisciplinary approach. Mifepristone was administrated to 16 patients. Fourteen patients received uterine artery embolization. Eleven patients were treated with ultrasound-guided curettage within 24 hours following delivery. Seven patients needed delayed-hysterectomy due to development of complications. Intrauterine operations during labor are not recommended if placenta accreta occurs in the fundus and/or in the cornual region of the uterus. Antibiotic treatment, interventional therapy, and ultrasound-guided curettage within 24 hours following vaginal delivery are the recommended conservative management strategies. PMID:28272244

  4. Retrospective Analysis of the Incidence of Retained Placenta in 3 Large Colonies of NHP.

    PubMed

    Bauer, Cassondra; Harrison, Tara

    2016-04-01

    During 1999 through 2014, retained placenta was the most common cause of clinical admission for reproductive complications in breeding colonies of baboons (approximate colony size, 2000 animals), cynomolgus macaques (approximately 1000), and rhesus macaques (approximately 500) at the Southwest National Primate Research Center. Retained placentas occurred in 2.7% of baboons, 3.3% of cynomolgus macaques, and 1.0% of rhesus macaques. Apparent risk factors for retained placenta included stillbirth or abortion and at least one prior cesarean section. There was a significant association between stillbirth and retained placenta in all species. Cesarean sections were performed routinely for baboons to meet research objectives but occurred only as needed for cynomolgus and rhesus macaques. Having had at least one prior cesarean section was an incidence factor for retained placenta in 37.0% of baboons and 4.7% of cynomolgus macaques; none of the rhesus macaques with retained placentas had undergone cesarean section previously. More than 90% of dams with retained placenta returned to a successful reproductive life or assignment to a nonbreeding research protocol. Advances in reproductive management will benefit from prospective studies that capture additional data from all members of a breeding group prior to reproductive complications.

  5. Morbidly Adherent Placenta: Ultrasound Assessment and Supplemental Role of Magnetic Resonance Imaging.

    PubMed

    Shetty, Mahesh K; Dryden, Damla K

    2015-08-01

    Morbidly adherent placenta or placenta accreta is being increasingly encountered in obstetrical practice mainly owing to the increasing rates of cesarean delivery. This condition is associated with increased maternal morbidity and mortality resulting from postpartum hemorrhage. When unsuspected, outcomes can be catastrophic to the pregnant woman. Timely diagnosis during the antenatal period, on the contrary, allows for optimal planning of a multidisciplinary management approach and delivery at a tertiary care institution. A higher index of suspicion in those at greatest risk such as in women with placenta previa and with history of some prior cesarean deliveries should lead to diligent antenatal evaluation for possible placenta accreta. Management of invasive placenta implantation often involves cesarean delivery hysterectomies; uterus-sparing alternatives to manage this condition can be an option in selected cases. Ultrasound imaging remains the modality of choice for the diagnosis. This review article discusses the ultrasound image findings in placenta accreta, its limitations and pitfalls, and the supplemental role of magnetic resonance imaging in the imaging evaluation of placenta accreta.

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

    PubMed Central

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

    2014-01-01

    Objective 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. Material and Methods 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. Results 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. Conclusion 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. PMID:25584028

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

    PubMed

    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.

  8. Postpartum Women's Perspectives on the Donation of Placentas for Scientific Research in Campinas, Brazil.

    PubMed

    Yoshizawa, Rebecca Scott; Osis, Maria José Duarte; Nascimento, Simony Lira; Bento, Silvana Ferreira; Godoy, Ana Carolina; Coelho, Suelene; Cecatti, José Guilherme

    2015-02-01

    Little is known about public perspectives of scientific and therapeutic uses of placentas. Gaps in knowledge potentiate ethical and clinical problems regarding collection and applications. As such, this study sought to assess the perspectives of placenta donation of a sample of women. Postpartum women's perspectives on placental donation were assessed at the State University of Campinas in the Centro de Atençäo Integral a Saúde da Mulher (CAISM) maternity hospital using a cross-sectional survey (n = 384) and semi-structured interviews (n = 12). Surveys were analyzed quantitatively and interviews were analyzed qualitatively using grounded coding; results were compared. The average age of respondents was 27. Fifty-six percent had more than one child, 45% were Caucasian, 38% were mixed-race, 74% identified with a Christian faith, 52% had high school education or higher, 13% regarded the placenta as spiritually important, 72% felt that knowing what happens to the placenta after birth was somewhat or very important, 78% supported the use of the placenta in research and medicine, 59% reported that consent to collect the placenta was very or somewhat important, 78% preferred their doctor to invite donation, and only 7% preferred the researcher to invite donation. Interviews suggested women appreciate being part of research and that receiving information about studies was important to them. Informed by these results, we argue that women support scientific and therapeutic uses of placentas, want to be included in decision making, and desire information about the placenta. Placentas should not be viewed as "throwaway" organs that are poised for collection without the involvement and permission of women. Women want to be meaningfully included in research processes. © The Author(s) 2014.

  9. Macroscopic and histological characteristics of retained placenta: A prospectively collected case-control study.

    PubMed

    Endler, Margit; Saltvedt, Sissel; Papadogiannakis, Nikos

    2016-05-01

    Retained placenta is a potentially fatal obstetric disorder due to postpartum hemorrhage, its pathophysiology is however unknown. We aimed to assess if retained placenta was associated with increased macroscopic and histological signs of placental maternal underperfusion, a pattern otherwise seen in preeclampsia and other disorders of defective placentation. This was a case-control study of retained (n = 49) and non-retained (n = 47) placentas, collected from full-term singleton and otherwise healthy pregnancies, carried out at a tertiary level obstetric department. Macroscopic and histological analysis was performed. Signs of maternal placental underperfusion and signs of placental inflammation, fetal vascular thrombo-occlusive disease and increased placental attachment were recorded in a primary and secondary analysis respectively. Variables were compared groupwise using unconditional logistic regression or comparison of median or mean values. Compared to non-retained placentas retained placentas had a significantly smaller surface area (p = 0.05), were more oblong in shape (OR 5.24 95% CI:1.34-20.21) and showed overall more signs of maternal underperfusion (OR 2.52 95% CI: 1.07-5.87). There was no significant difference in signs of placental inflammation, fetal vascular thrombo-occlusive disease or placenta accreta but basal plate myometrial fibers were more common among retained placentas. In regard to shape, surface area and histological signs of maternal placental underperfusion, retained placentas showed a histological pattern similar to that seen in preeclamptic placentas. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    PubMed

    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. Placenta-based therapies for the treatment of epidermolysis bullosa

    PubMed Central

    Nevala-Plagemann, Christopher; Lee, Catherine; Tolar, Jakub

    2015-01-01

    Recessive dystrophic epidermolysis bullosa (RDEB) is a severe blistering skin disease caused by mutations in the COL7A1 gene. These mutations lead to decreased or absent levels of collagen VII at the dermal-epidermal junction. Over the past decade, significant progress has been made in the treatment of RDEB, including the use of hematopoietic cell transplantation, but a cure has proven elusive. Patients still experience life-limiting and life-threatening complications as a result of painful and debilitating wounds. The continued suffering of these patients drives the need to improve existing therapies and develop new ones. In this review, we will discuss how recent advances in placenta-, umbilical cord blood- and amniotic membrane-based therapies may play a role in the both the current and future treatment of RDEB. PMID:25795271

  12. Isolation of mesenchymal stem cells from amniotic fluid and placenta.

    PubMed

    Steigman, Shaun A; Fauza, Dario O

    2007-06-01

    Diverse progenitor cell populations, including mesenchymal, hematopoietic, trophoblastic, and possibly more primitive stem cells can be isolated from the amniotic fluid and the placenta. At least some of the amniotic and placental cells share a common origin, namely the inner cell mass of the morula. Indeed, most types of progenitor cells that can be isolated from these two sources share many characteristics. This unit will focus solely on the mesenchymal stem cells, the most abundant progenitor cell population found therein and, unlike some of the other stem cell types, present all through gestation. Protocols for isolation, expansion, freezing, and thawing of these cells are presented. Preference is given to the simplest methods available for any given procedure. Copyright 2007 by John Wiley & Sons, Inc.

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

    PubMed

    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.

  14. MSX2 Induces Trophoblast Invasion in Human Placenta

    PubMed Central

    Lu, Junjie; Yang, Genling; Tian, Na; Wang, Xiaojie; Tan, Yi; Tan, Dongmei

    2016-01-01

    Normal implantation depends on appropriate trophoblast growth and invasion. Inadequate trophoblast invasion results in pregnancy-related disorders, such as early miscarriage and pre-eclampsia, which are dangerous to both the mother and fetus. Msh Homeobox 2 (MSX2), a member of the MSX family of homeobox proteins, plays a significant role in the proliferation and differentiation of various cells and tissues, including ectodermal organs, teeth, and chondrocytes. Recently, MSX2 was found to play important roles in the invasion of cancer cells into adjacent tissues via the epithelial-mesenchymal transition (EMT). However, the role of MSX2 in trophoblastic invasion during placental development has yet to be explored. In the present study, we detected MSX2 expression in cytotrophoblast, syncytiotrophoblast, and extravillous cytotrophoblast cells of first or third trimester human placentas via immunohistochemistry analysis. Furthermore, we found that the in vitro invasive ability of HTR8/SVneo cells was enhanced by exogenous overexpression of MSX2, and that this effect was accompanied by increased protein expression of matrix metalloproteinase-2 (MMP-2), vimentin, and β-catenin. Conversely, treatment of HTR8/SVneo cells with MSX2-specific siRNAs resulted in decreased protein expression of MMP-2, vimentin, and β-catenin, and reduced invasion levels in a Matrigel invasion test. Notably, however, treatment with the MSX2 overexpression plasmid and the MSX2 siRNAs had no effect on the mRNA expression levels of β-catenin. Meanwhile, overexpression of MSX2 and treatment with the MSX2-specific siRNA resulted in decreased and increased E-cadherin expression, respectively, in JEG-3 cells. Lastly, the protein expression levels of MSX2 were significantly lower in human pre-eclamptic placental villi than in the matched control placentas. Collectively, our results suggest that MSX2 may induce human trophoblast cell invasion, and dysregulation of MSX2 expression may be associated

  15. Barrier Capacity of Human Placenta for Nanosized Materials

    PubMed Central

    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

  16. Policies for manual removal of placenta at vaginal delivery: variations in timing within Europe.

    PubMed

    Deneux-Tharaux, C; Macfarlane, A; Winter, C; Zhang, W-H; Alexander, S; Bouvier-Colle, M-H

    2009-01-01

    The length of the third stage of labour is a potential modifiable risk factor for postpartum haemorrhage at vaginal delivery, but there is no definitive evidence that early intervention to remove the placenta manually will prevent postpartum haemorrhage. We report a wide variation between countries in Europe in policies about the timing of manual removal of placenta. Two groups of countries with clearly divergent policies were identified. A randomised controlled trial is needed to provide definitive evidence on the risks and benefits of manual removal of placenta at different timings after vaginal delivery.

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

    PubMed

    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.

  18. Shear wave elastography of the placenta in patients with gestational diabetes mellitus.

    PubMed

    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 < 0.001). No difference was observed in the mean elasticity values of the central and the peripheral part of the placentas in two groups (p > 0.05). SWE imaging technology might provide a quantitative assessment of the morphological pathologies of placentas in pregnant women with GDM.

  19. Buttock Necrosis after Uterine Artery Embolization for Delayed Hysterectomy in Placenta Percreta

    PubMed Central

    Perez-Delboy, Annette; Burke, William M.; Tergas, Ana I.

    2016-01-01

    Background. Morbidly adherent placenta (MAP) is increasing in incidence and is commonly associated with maternal hemorrhage and cesarean hysterectomy. Uterine artery embolization (UAE) may be utilized in the conservative management of placenta percreta to potentially reduce blood loss. The incidence of complications from UAE in the conservative management of placenta percreta is poorly described. To our knowledge, we present the first reported case of buttock necrosis in this setting. Case. A 39-year-old gravida nine para two with placenta percreta who underwent conservative management with UAE complicated by right buttock necrosis. Conclusion. While UAE may potentially decrease blood loss, it is not without risk. More studies must be performed in order to quantify those risks and determine the clinical utility of UAE. PMID:28050294

  20. Radioactivity in breast milk and placentas during the year after Chernobyl

    SciTech Connect

    Gori, G.; Cama, G.; Guerresi, E.; Cocchi, G.; Dalla Casa, P.; Gattavecchia, E.; Ghini, S.; Tonelli, D.

    1988-11-01

    After the April 1986 nuclear reactor accident at Chernobyl in the Union of Soviet Socialist Republics, samples of human placenta and breast milk were tested for 1 year to determine the levels of radioactivity. The radionuclide iodine 131 was never beyond the detection limit of our gamma detector for both matrices. As to cesium isotopes 134 and 137, the highest levels detected in breast milk (6 Bq.L-1) and placenta (15.8 Bq.kg-1) were recorded in March 1987. Study data for breast milk and placenta are in agreement with the values calculated by means of double-compartment food-milk and food-placenta models. With regard to placental content, the cesium contribution to the average dose during the year after the Chernobyl accident was calculated to be 40 to 60 microSv.

  1. A Lipidomic Analysis of Placenta in Preeclampsia: Evidence for Lipid Storage

    PubMed Central

    Brown, Simon H. J.; Eather, Samuel R.; Freeman, Dilys J.; Meyer, Barbara J.; Mitchell, Todd W.

    2016-01-01

    In preeclampsia, maternal insulin resistance leads to defective expansion of adipocytes, enhanced adipocyte lipolysis, up-regulation of very low density lipoprotein synthesis, maternal hypertriglyceridaemia and the potential for ectopic fat storage. Our aim was to quantitate and compare the total amount and type of lipid in placenta from pregnancies complicated with preeclampsia and healthy pregnancies. Quantitative lipid analysis of lipid extracts from full thickness placental biopsies was carried out by shotgun lipidomics. Placental lipid profiles from pregnancies complicated by preeclampsia (n = 23) were compared to healthy pregnancies (n = 68), and placenta from intrauterine growth restriction pregnancies (n = 10) were used to control for gross differences in placental pathology. Placentae from pregnancies complicated with preeclampsia had higher neutral lipid content than healthy placentae (40% higher triacyglycerol (P = 0.001) and 33% higher cholesteryl ester (P = 0.004)) that was specific to preeclampsia and independent of maternal gestation. PMID:27685997

  2. Independent origins and rapid evolution of the placenta in the fish genus Poeciliopsis.

    PubMed

    Reznick, David N; Mateos, Mariana; Springer, Mark S

    2002-11-01

    The evolution of complex organs is a source of controversy because they require the contributions of many adaptations to function properly. We argue that placentas are complex, that they have evolved multiple times in Poeciliopsis, and that there are closely related sister taxa that have either no placentas or intermediate stages in the evolution of a placenta. Furthermore, placentas can evolve in 750,000 years or less, on the same time scale as suggested by theoretical calculations for the evolution of complex eyes. Independent origins of such complexity, accompanied by sister taxa that either lack or have intermediate stages in the evolution of the trait, present an opportunity to study the evolution of novelty and complexity from a comparative, evolutionary perspective.

  3. The hepatobiliary-like excretory function of the placenta. A review.

    PubMed

    Marin, J J G; Macias, R I R; Serrano, M A

    2003-05-01

    In the adult, several endogenous compounds, such as bile acids and biliary pigments, as well as many xenobiotics are mainly biotransformed and eliminated by the hepatobiliary system. However, because this function is immature in the foetus, this role is carried out by the placenta during the intrauterine life. This review describes current knowledge of the trophoblastic machinery responsible for this function, which includes transport and metabolic processes, similar in part to those existing in the mature liver. Because many of the studies reviewed here were conducted on human or rat near-term placentae, two aspects should be borne in mind: (i) although both types of placenta are haemochorial, profound species-specific differences at the structural, molecular and functional levels do exist, and (ii) the placenta is an organ undergoing continuous developmental changes, including its hepatobiliary-like excretory function.

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

    PubMed

    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.

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

    PubMed

    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.

  6. Maternal buprenorphine dose, placenta buprenorphine, and metabolite concentrations and neonatal outcomes.

    PubMed

    Concheiro, Marta; Jones, Hendreé E; Johnson, Rolley E; Choo, Robin; Shakleya, Diaa M; Huestis, Marilyn A

    2010-04-01

    Buprenorphine is approved as pharmacotherapy for opioid dependence in nonpregnant patients in multiple countries and is currently under investigation for pregnant women in the United States and Europe. This research evaluates the disposition of buprenorphine, opiates, cocaine, and metabolites in five term placentas from a US cohort. Placenta and matched meconium concentrations were compared, and relationships among maternal buprenorphine dose, placenta concentrations, and neonatal outcomes after controlled administration during gestation were investigated. Buprenorphine and/or metabolites were detected in all placenta specimens and were uniformly distributed across this tissue (coefficient of variation less than 27.5%, four locations), except for buprenorphine in three placentas. In two of these, buprenorphine was not detected in some locations and in the third placenta was totally absent. Median (range) concentrations were 1.6 ng/g buprenorphine (not detected to 3.2), 14.9 ng/g norbuprenorphine (6.2-24.2), 3 ng/g buprenorphine-glucuronide (1.3-5.0), and 14.7 ng/g norbuprenorphine-glucuronide (11.4-25.8). Placenta is a potential alternative matrix for detecting in utero buprenorphine exposure, but at lower concentrations (15- to 70-fold) than in meconium. Statistically significant correlations were observed for mean maternal daily dose from enrollment to delivery and placenta buprenorphine-glucuronide concentration and for norbuprenorphine-glucuronide concentrations and time to neonatal abstinence syndrome onset and duration, for norbuprenorphine/norbuprenorphine-glucuronide ratio and maximum neonatal abstinence syndrome score, and newborn length. Analysis of buprenorphine and metabolites in this alternative matrix, an abundant waste product available at the time of delivery, may be valuable for prediction of neonatal outcomes for clinicians treating newborns of buprenorphine-exposed women.

  7. Clearance of. cap alpha. -aminoisobutyric acid during in-situ perfusion of the guinea pig placenta

    SciTech Connect

    Kelman, B.J.; Sikov, M.R.

    1983-05-01

    Extensive investigation of the transport of ..cap alpha..-aminoisobutyric acid (AIB; a nonmetabolized amino acid) has shown that AIB is actively transported from mother to fetus across the hemochorial placenta of the guinea pig. As a step towards clarifying the relative rolls of active and passive movements of amino acids across the placenta, it would be useful to obtain concurrent measurements of transplacental movements of a substance which crosses the placenta rapidly by simple diffusion (water) and of a substance which is actively transported across the placenta (AIB). In our study, placentas from guinea pigs between 59 and 61 days of gestation were perfused in situ through cannulated umbilical vessels with the maternal circulation left intact. Tritiated water and /sup 14/C-AIB were injected into a maternal jugular vein and maternal blood samples were obtained at 1 to 10 minute intervals; perfusate samples were collected sequentially after one pass through the placenta. Clearance of /sup 14/C-AIB from mother to fetus (AIB/sub MF/) and AIB concentrations in placental tissue, maternal plasma, and perfusate were consistent in magnitude with data obtained by other invetigators who have clearly shown an active transport of AIB in the placenta. On the other hand, in this study AIB/sub MF/ ranged from approximately 50% to 96% of the clearance of /sup 3/H-labeled water from mother to fetus (T/sub MF/) and that changes in AIB/sub MF/ correlated closely with changes in T/sub MF/ in all perfusions. Thus, it appears that AIB/sub MF/ closely paralleled T/sub MF/ and these data suggest that a relatively large component of AIB/sub MF/ is of passive origin in the in situ placenta.

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

    PubMed

    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.

  9. Maternal Buprenorphine Dose, Placenta Buprenorphine and Metabolite Concentrations and Neonatal Outcomes

    PubMed Central

    Concheiro, Marta; Jones, Hendreé E.; Johnson, Rolley E.; Choo, Robin; Shakleya, Diaa M.; Huestis, Marilyn A.

    2010-01-01

    Buprenorphine is approved as pharmacotherapy for opioid dependence in non-pregnant patients in multiple countries, and is currently under investigation for pregnant women in the US and Europe. This research evaluates the disposition of buprenorphine, opiates, cocaine, and metabolites in 5 term placentas from a US cohort. Placenta and matched meconium concentrations were compared, and relationships between maternal buprenorphine dose, placenta concentrations, and neonatal outcomes following controlled administration during gestation were investigated. Buprenorphine and/or metabolites were detected in all placenta specimens and were uniformly distributed across this tissue (CV<27.5%, 4 locations), except for buprenorphine in 3 placentas. In 2 of these, buprenorphine was not detected in some locations and, in the 3rd placenta, was totally absent. Median (range) concentrations were buprenorphine 1.6ng/g (not detected to 3.2), norbuprenorphine 14.9ng/g (6.2 to 24.2), buprenorphine-glucuronide 3ng/g (1.3 to 5.0) and norbuprenorphine-glucuronide 14.7ng/g (11.4 to 25.8). Placenta is a potential alternative matrix for detecting in utero buprenorphine exposure, but at lower concentrations (15–70 fold) than in meconium. Statistically significant correlations were observed for mean maternal daily dose from enrollment to delivery and placenta buprenorphine-glucuronide concentration, and for norbuprenorphine-glucuronide concentrations and time to neonatal abstinence syndrome (NAS) onset and duration, and for norbuprenorphine/norbuprenorphine-glucuronide ratio and maximum NAS score, and newborn length. Analysis of buprenorphine and metabolites in this alternative matrix, an abundant waste product available at the time of delivery, may be valuable for prediction of neonatal outcomes for clinicians treating newborns of buprenorphine-exposed women. PMID:20216119

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

    PubMed

    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.

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

    PubMed

    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. © 2015 Wiley Periodicals, Inc.

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

    PubMed

    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.

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

    PubMed

    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.

  14. [Immunofluorescent-histologic localization of a placenta-antigen with antibodies from pregnancy blood (author's transl)].

    PubMed

    Skrabei, H; Meyer-Falk, E; Mettler, L

    1977-08-01

    Placenta-specific antibodies were isolated by the incubation of washed placental tissue with pregancy serum and then desorption with citric acid pH3. The antigen responsible for the formation of the antibody could be localized via the immunofluorescence technique together with application of the placenta antibody in the syncytiotrophoblast layer. The antibodies are not complement-fixing and belong to the IgG class.

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

    PubMed

    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.

  16. Receptor-mediated uptake and transport of macromolecules in the human placenta.

    PubMed

    Schneider, Henning; Miller, Richard K

    2010-01-01

    The human placenta is required to be the anchor, the conduit and the controller during pregnancy. The survival of the baby and its associated placenta is dependent upon the placenta shielding the embryo/fetus from harm, e.g., autoimmune disease - thrombophilia, antiphospholipid syndrome or infections, while simultaneously providing for the passage of critical nutrients (e.g., amino acids, vitamins) and beneficial immunoglobulins. In a number of instances, the movements of macromolecules into and through the placenta can result in the passage of the intact molecules into the fetal circulation or in the case of proteins - catabolism to amino acids which are utilized by the placenta and the fetus for continued growth and development. The transfer of two such macromolecules, immunoglobulin G (IgG) and vitamin B12 (cyanocobalamin or B12), are examined as to the unique receptor-mediated transfer capability of the human placenta, its transfer specificity as related to specific receptors and the role of endogeneous placental proteins (trancobalamins) in facilitating the recognition and transport of specifically B12. Brief comparisons will be made to other animal species and the differences in specific organ transfer capabilities.

  17. The incidence and risk factors for retained placenta after vaginal delivery - a single center experience.

    PubMed

    Ashwal, Eran; Melamed, Nir; Hiersch, Liran; Wiznitzer, Arnon; Yogev, Yariv; Peled, Yoav

    2014-12-01

    We aimed to determine the incidence and risk factors for retained placenta immediately after vaginal delivery in a single, university-affiliated tertiary center. A case-control study. Women who delivered vaginally and diagnosed with suspected retained placenta were compared to control group of women with spontaneous vaginal delivery with spontaneous non-complicated placental separation between the years 2007 and 2012. Eligibility was limited to singleton fetuses in vertex presentation with no history of more than one cesarean section, stillbirth or major fetal anomaly. Overall, 33,925 women delivered vaginally, of them, 491 (1.4%) underwent revision of uterine cavity due to suspected retained placenta. Women with retained placenta were characterized by a higher rate of previous cesarean section (OR 1.71, 95% CI 1.23-2.36), previous abortions, lower parity (OR 0.79, 95% CI 0.68-0.91), lower gestational age at delivery. Hypertensive disorders, oligohydramnios and labor and delivery interventions as induction of labor (OR 1.84, 95% CI 1.30-2.59), neuro-axial analgesia (OR 1.60, 95% CI 1.27-2.00) and vacuum delivery (OR 1.89, 95% CI 1.48-2.41) were independently associated with uterine revision for retained placenta. Risk factors for manual revision due to retained placenta can be recognized. This data should be taken into consideration in the assessment of women immediately after delivery.

  18. Time course analysis of RNA quality in placenta preserved by RNAlater or flash freezing.

    PubMed

    Martin, Nicole M; Cooke, Katherine M; Radford, Caitlin C; Perley, Lauren E; Silasi, Michelle; Flannery, Clare A

    2017-04-01

    Preservation of biospecimen quality is critical to accurately and reliably assessing genes and proteins. We evaluated the effect of preparation method and storage duration on RNA quality in placenta and decidua. Aliquots of nine placentas and decidua were placed in RNAlater(®) (RL) or flash frozen (FF) within 30 minutes of delivery. RNA was extracted immediately (baseline) and from matched samples stored at -80°C for 1 and 8-10 months. RNA Integrity Number (RIN) and housekeeping gene expression were quantified. At both time points, RL placenta had RIN and housekeeping gene Ct values similar to baseline. However, FF placenta had significantly lower RIN and higher Ct values at 1 and 8-10 months. In RL and FF decidua, RIN was unchanged from baseline. We found RNAlater more effectively and consistently preserved placenta, compared to flash freezing. However, for decidua, which is less dense than placenta, both modes yielded comparable RNA integrity over time. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    Unverdorben, Laura; Haufe, Thomas; Santoso, Laura; Hofmann, Simone; Jeschke, Udo; Hutter, Stefan

    2016-04-28

    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.

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

    PubMed Central

    Unverdorben, Laura; Haufe, Thomas; Santoso, Laura; Hofmann, Simone; Jeschke, Udo; Hutter, Stefan

    2016-01-01

    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. PMID:27136536

  3. Syncytiotrophoblast Extracellular Vesicles from Pre-Eclampsia Placentas Differentially Affect Platelet Function

    PubMed Central

    Tannetta, Dionne S.; Hunt, Kathryn; Jones, Chris I.; Davidson, Naomi; Coxon, Carmen H.; Ferguson, David; Redman, Christopher W.; Gibbins, Jonathan M.; Sargent, Ian L.; Tucker, Katherine L.

    2015-01-01

    Pre-eclampsia (PE) complicates around 3% of all pregnancies and is one of the most common causes of maternal mortality worldwide. The pathophysiology of PE remains unclear however its underlying cause originates from the placenta and manifests as raised blood pressure, proteinuria, vascular or systemic inflammation and hypercoagulation in the mother. Women who develop PE are also at significantly higher risk of subsequently developing cardiovascular (CV) disease. In PE, the failing endoplasmic reticulum, oxidative and inflammatory stressed syncytiotrophoblast layer of the placenta sheds increased numbers of syncytiotrophoblast extracellular vesicles (STBEV) into the maternal circulation. Platelet reactivity, size and concentration are also known to be altered in some women who develop PE, although the underlying reasons for this have not been determined. In this study we show that STBEV from disease free placenta isolated ex vivo by dual placental perfusion associate rapidly with platelets. We provide evidence that STBEV isolated from normal placentas cause platelet activation and that this is increased with STBEV from PE pregnancies. Furthermore, treatment of platelets with aspirin, currently prescribed for women at high risk of PE to reduce platelet aggregation, also inhibits STBEV-induced reversible aggregation of washed platelets. Increased platelet reactivity as a result of exposure to PE placenta derived STBEVs correlates with increased thrombotic risk associated with PE. These observations establish a possible direct link between the clotting disturbances of PE and dysfunction of the placenta, as well as the known increased risk of thromboembolism associated with this condition. PMID:26551971

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

    PubMed

    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.

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

    PubMed

    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

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

    PubMed Central

    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

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

    PubMed

    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

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

    PubMed

    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 < 0.05). Placental TRAIL-R2 levels and previous cesarean section were found to be significantly associated with 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 < 0.001, respectively). Placental and serum TRAIL-R2 levels were positively correlated. Decreased levels of placental TRAIL-R2 and previous history of cesarean section were found to be significantly associated with placenta accreta, suggesting a possible role of apoptosis in abnormal trophoblast invasion. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Diagnosis, treatment and application of color Doppler in conservative management of abnormally adherent placenta.

    PubMed

    Merz, W; Van de Vondel, P; Strunk, H; Geipel, A; Gembruch, U

    2009-12-01

    Placenta ac-, in-, percreta is rare, but associated with high maternal morbidity. We report the results of diagnosis and management of patients with this condition at our institution. Serial color Doppler examinations were performed to investigate the pattern and duration of perfusion to abnormally adherent placenta after conservative treatment. The influence of these results on management decisions was evaluated. Women with placenta ac-, in-, percreta delivering within a three-year interval were included. Diagnosis was established by ultrasound, color Doppler, MRI, and histology specimen. B-mode ultrasound and color Doppler were applied post-operatively. Fifteen cases of placenta ac-, in-, percreta occurred (0.29% of deliveries). 73.3% were associated with placenta previa, 66.6% had > or = 1 previous uterine surgery. Abnormal placentation was diagnosed antenatally in 5/15 cases; in these women complication rate (0/5 vs. 8/10, p = 0.12) and blood loss was significantly lower (mean 1.140 vs. 3.080 ml, p < 0.01). 8/15 women underwent Cesarean hysterectomy, 2 after embolization of uterine arteries. 7/15 women had conservative management. In 3 of these cases complete removal of the placenta was achieved; in the remaining 4 the entire (n = 2) or parts (n = 2) of the placenta were left in place, methotrexate was administered postoperatively, and close clinical and laboratory controls were performed. Serial color Doppler examinations revealed cessation of blood flow to the adherent tissue 9 - 13 weeks postoperatively, followed by complete resorption (n = 1)/expulsion (n = 1) of placental fragments. In two cases (placenta previa percreta) curettage was performed without major complications after negative blood flow. The high maternal morbidity of placenta ac-, in-, percreta can be reduced with antenatal diagnosis and elective delivery. Conservative management of placenta percreta may be considered in selected cases, with embolization and/or methotrexate as an adjuvant

  10. ATP-Binding Cassette Efflux Transporters in Human Placenta

    PubMed Central

    Ni, Zhanglin; Mao, Qingcheng

    2010-01-01

    Pregnant women are often complicated with diseases including viral or bacterial infections, epilepsy, hypertension, or pregnancy-induced conditions such as depression and gestational diabetes that require treatment with medication. In addition, substance abuse during pregnancy remains a major public health problem. Many drugs used by pregnant women are off label without the necessary dose, efficacy, and safety data required for rational dosing regimens of these drugs. Thus, a major concern arising from the widespread use of drugs by pregnant women is the transfer of drugs across the placental barrier, leading to potential toxicity to the developing fetus. Knowledge regarding the ATP-binding cassette (ABC) efflux transporters, which play an important role in drug transfer across the placental barrier, is absolutely critical for optimizing the therapeutic strategy to treat the mother while protecting the fetus during pregnancy. Such transporters include P-glycoprotein (P-gp, gene symbol ABCB1), the breast cancer resistance protein (BCRP, gene symbol ABCG2), and the multidrug resistance proteins (MRPs, gene symbol ABCCs). In this review, we summarize the current knowledge with respect to developmental expression and regulation, membrane localization, functional significance, and genetic polymorphisms of these ABC transporters in the placenta and their relevance to fetal drug exposure and toxicity. PMID:21118087

  11. Effect of fermented porcine placenta on physical fatigue in mice

    PubMed Central

    Kim, Hee-Yun; Han, Na-Ra; Kim, Na-Rae; Lee, Mikyung; Kim, Jongbae; Kim, Chang-Ju

    2016-01-01

    The fatigue spreads among the people who live under stressful life and brings about a negative impact on physical function. Here we evaluated the anti-fatigue effects of fermented porcine placenta (FPP) and main constituents, lysine (Lys) and leucine (Leu) with treadmill stress test and forced swimming test (FST) in animal models. The mice were administrated with FPP, Lys, and Leu for 21 days. After treadmill exercise, FPP, Lys, and Leu significantly reduced fatigue-related biochemical parameters, including lactate, lactate dehydrogenase, glucose, creatine kinase, urea nitrogen, cortisol, and pro-inflammatory cytokines, whereas superoxide dismutase activity and glycogen levels were significantly increased by FPP, Lys, and Leu. In the FST, FPP, Lys, and Leu significantly decreased immobility times and up-regulated brain-derived neurotrophic factor expression in brain. Furthermore, FPP, Lys, and Leu significantly decreased production of tumor necrosis factor-α, interleukin (IL)-6, IL-1β, and IL-4 through blockade of caspase-1/nuclear factor-κB pathway in stimulated splenocytes. In addition, FPP, Lys, and Leu significantly promoted proliferation of splenocytes. In conclusion, these findings suggest the potential of FPP as a novel functional food for the regulation of fatigue. PMID:27439540

  12. Effect of fermented porcine placenta on physical fatigue in mice.

    PubMed

    Kim, Hee-Yun; Han, Na-Ra; Kim, Na-Rae; Lee, Mikyung; Kim, Jongbae; Kim, Chang-Ju; Jeong, Hyun-Ja; Kim, Hyung-Min

    2016-11-01

    The fatigue spreads among the people who live under stressful life and brings about a negative impact on physical function. Here we evaluated the anti-fatigue effects of fermented porcine placenta (FPP) and main constituents, lysine (Lys) and leucine (Leu) with treadmill stress test and forced swimming test (FST) in animal models. The mice were administrated with FPP, Lys, and Leu for 21 days. After treadmill exercise, FPP, Lys, and Leu significantly reduced fatigue-related biochemical parameters, including lactate, lactate dehydrogenase, glucose, creatine kinase, urea nitrogen, cortisol, and pro-inflammatory cytokines, whereas superoxide dismutase activity and glycogen levels were significantly increased by FPP, Lys, and Leu. In the FST, FPP, Lys, and Leu significantly decreased immobility times and up-regulated brain-derived neurotrophic factor expression in brain. Furthermore, FPP, Lys, and Leu significantly decreased production of tumor necrosis factor-α, interleukin (IL)-6, IL-1β, and IL-4 through blockade of caspase-1/nuclear factor-κB pathway in stimulated splenocytes. In addition, FPP, Lys, and Leu significantly promoted proliferation of splenocytes. In conclusion, these findings suggest the potential of FPP as a novel functional food for the regulation of fatigue. © 2016 by the Society for Experimental Biology and Medicine.

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

    PubMed

    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.

  14. Proteomics of the Human Placenta: Promises and Realities

    PubMed Central

    Robinson, J.M.; Ackerman, W.E.; Kniss, D.A.; Takizawa, T.; Vandré, D.D.

    2015-01-01

    Proteomics is an area of study that sets as its ultimate goal the global analysis of all of the proteins expressed in a biological system of interest. However, technical limitations currently hamper proteome-wide analyses of complex systems. In a more practical sense, a desired outcome of proteomics research is the translation of large protein data sets into formats that provide meaningful information regarding clinical conditions (e.g., biomarkers to serve as diagnostic and/or prognostic indicators of disease). Herein, we discuss placental proteomics by describing existing studies, pointing out their strengths and weaknesses. In so doing, we strive to inform investigators interested in this area of research about the current gap between hyperbolic promises and realities. Additionally, we discuss the utility of proteomics in discovery-based research, particularly as regards the capacity to unearth novel insights into placental biology. Importantly, when considering under studied systems such as the human placenta and diseases associated with abnormalities in placental function, proteomics can serve as a robust ‘shortcut’ to obtaining information unlikely to be garnered using traditional approaches. PMID:18222537

  15. Subcellular localization and properties of adenosine diphosphatase in human placenta.

    PubMed

    Martínez, F; Moncada, R; Barcenas, F J; Espinosa-García, T

    1992-01-01

    It was found that mitochondria from human placenta exhibited an ADPase activity with the following characteristics. The enzyme responsible for this activity was associated with the inner mitochondrial membrane. It was not released by treatment of the submitochondrial particles with solutions of high ionic strength. Maximal ADP hydrolysis was reached at pH 8. Specific inhibitors for alkaline phosphatase (L-phenylalanine), myokinase (P1,P5-di(adenosine-5')pentaphosphate), or 5'-nucleotidase (concanavalin A) did not decrease ADP hydrolysis. ATP synthesis from ADP by myokinase was about 13 nmol/mg/min, whereas ADP hydrolysis reached values around 500 to 550 nmol/mg/min, indicating that a myokinase-H+ATPase combination could not account for the observed rates of ADP hydrolysis. The activity was stimulated by Mg2+, but high concentrations of this cation produced inhibition. High ADP concentrations did not inhibit ADPase activity. Kinetic measurements of the activity in the submitochondrial particles showed that the true substrate was ADP-Mg. The kinetic studies showed V(app) values of 476 and 270 nmol/mg/min, and Kmapp values of 416 and 8.7 microM.

  16. The endocrine function of human placenta: an overview.

    PubMed

    Costa, Mariana A

    2016-01-01

    During pregnancy, several tightly coordinated and regulated processes take place to enable proper fetal development and gestational success. The formation and development of the placenta is one of these critical pregnancy events. This organ plays essential roles during gestation, including fetal nourishment, support and protection, gas exchange and production of several hormones and other mediators. Placental hormones are mainly secreted by the syncytiotrophoblast, in a highly and tightly regulated way. These hormones are important for pregnancy establishment and maintenance, exerting autocrine and paracrine effects that regulate decidualization, placental development, angiogenesis, endometrial receptivity, embryo implantation, immunotolerance and fetal development. In addition, because they are released into maternal circulation, the profile of their blood levels throughout pregnancy has been the target of intense research towards finding potential robust and reliable biomarkers to predict and diagnose pregnancy-associated complications. In fact, altered levels of these hormones have been associated with some pathologies, such as chromosomal anomalies or pre-eclampsia. This review proposes to revise and update the main pregnancy-related hormones, addressing their major characteristics, molecular targets, function throughout pregnancy, regulators of their expression and their potential clinical interest.

  17. Evaluation of gestational deficiencies in cloned sheep fetuses and placentae.

    PubMed

    De Sousa, P A; King, T; Harkness, L; Young, L E; Walker, S K; Wilmut, I

    2001-07-01

    Sheep fetal development at 35 days of gestation was examined following natural mating, in vitro production (IVP) of fertilized embryos, or somatic cell nuclear transfer (NT). Five crossbred (Blackface x Black Welsh) and four purebred (Black Welsh) fetuses and their associated placentae produced by natural mating were morphologically normal and consistent with each other. From 10 ewes receiving 21 IVP embryos, 17 fetuses (81%) were recovered, and 15 of these (88%) were normal. The NT fetuses were derived from two Black Welsh fetal fibroblast cell lines (BLW1 and 6). Transfer of 21 BLW1 and 22 BLW6 NT embryos into 12 and 11 ewes, respectively, yielded 7 (33%) and 8 (36%) fetuses, respectively. Only three (43%) BLW1 and two (25%) BLW6 NT fetuses were normal, with the rest being developmentally retarded. The NT fetal and placental deficiencies included liver enlargement, dermal hemorrhaging, and lack of placental vascular development reflected by reduced or absent cotyledonary structures. Fibroblasts isolated from normal and abnormal cloned fetuses did not differ in their karyotype from sexually conceived fetuses or nuclear donor cell lines. Our results demonstrate that within the first quarter of gestation, cloned fetuses are characterized by a high incidence of developmental retardation and placental insufficiency. These deficiencies are not linked to gross defects in chromosome number.

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

    PubMed

    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.

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

    PubMed

    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

  20. Chemotactic activity of cotyledons for mononuclear leukocytes related to occurrence of retained placenta in dexamethasone induced parturition in cattle.

    PubMed

    Benedictus, L; Jorritsma, R; Knijn, H M; Vos, P L A M; Koets, A P

    2011-09-15

    Induction of parturition with glucocorticosteroids in cattle is used for research purposes, in diseased or injured pregnant cows, and as a management tool to time parturition. A negative side effect of induction of parturition with glucocorticosteroids is the high incidence of retained placenta that occurs after these calvings. Reaction of the maternal immune system against the 'foreign' foetal membranes contributes to the breakdown of the foetal-maternal attachment. Several studies indicate that failure of this immune assisted detachment increases the occurrence of retained placenta. We hypothesized that retained placenta occurring after induction of parturition with glucocorticosteroids is caused by failure of immune assisted detachment of the foetal membranes. The chemotactic activity of cotyledons for mononuclear leukocytes was used as a parameter to see whether immune assisted detachment of the foetal membranes had occurred. Cotyledons were collected from spontaneously calving non-retained placenta cows and from dexamethasone induced non-retained placenta and retained placenta cows. The study showed that the chemotactic activity of cotyledons for mononuclear leukocytes was lower (P < 0.001) in cotyledons obtained from retained placenta cows in which parturition was induced with dexamethasone compared to the chemotactic activity of cotyledons obtained from spontaneously calving non-retained placenta cows, whereas the chemotactic activity of cotyledons obtained from induced non-retained placenta cows was not lower (P = 0.10) than the chemotactic activity of cotyledons obtained from spontaneously calving non-retained placenta cows. We concluded that induction of parturition with dexamethasone causes a failure of immune assisted detachment of the foetal membranes and the accompanying release of chemotactic factors. As a result, the chemotactic activity of cotyledons for mononuclear leukocytes is lower in induced retained placenta cows than in cotyledons from non

  1. Obstetric risk factors associated with placenta previa development: case-control study.

    PubMed

    Tuzović, Lea; Djelmis, Josip; Ilijić, Marcela

    2003-12-01

    To evaluate potential risk factors and perinatal outcome of pregnancies complicated with placenta previa in Croatian population of pregnant women recruited from the largest tertiary care perinatal center in Croatia. This retrospective case-control study included a total of 202 singleton pregnancies with placenta previa during a 10-year study period and 1,004 randomly selected simple singleton controls. Data on potential risk factors for placenta previa development were carefully extracted from medical records, reviewed, and compared with a control group of women. Data were statistically analyzed with chi-square test and Mann-Whitney U test, and crude odds ratio (OR) with 95% confidence interval (95% CI) were provided. The incidence of placenta previa was 0.4%. Factors significantly associated with a placenta previa development were advanced maternal age (especially >34 years, even after adjustment for high parity), gravidity of 3 and more (OR, 4; 95% CI, 2.5-6.6), more than one previous delivery (OR, 2.76; 95% CI, 1.7-4.3), history of previous cesarean sections (OR, 2.0; 95% CI, 1.17-3.44), abortions (OR, 2.8; 95% CI, 2.04-3.83), and presence of various uterine abnormalities (OR, 8.5; 95% CI, 1.75-44.5). The risk was significantly increased after two previous cesarean sections (OR, 7.32; 95% CI, 2.1-25) and after one previous abortion (OR, 4.8; 95% CI, 2.7-8.3). No difference between the groups was found regarding the history of previous placenta previa, drug abuse, and male sex at birth. Smoking history was significantly less frequent in women with placenta previa than controls (16.3% vs 25.6%, chi-square=7.9, p=0.007). The main perinatal complication was preterm birth, with 14-fold higher risk in women with placenta previa. Preterm infants of mothers with placenta previa were more likely to have lower first- (6 vs 10, p<0.001) and fifth-minute median Apgar scores (8 vs 10, p<0.045). Term infants of mothers with placenta previa had significantly lower birth weight

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

    PubMed

    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. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    PubMed

    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.

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

    PubMed

    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.

  5. Cotinine in Human Placenta Predicts Induction of Gene Expression in Fetal Tissues

    PubMed Central

    Riffel, Amanda K.; Haley, Kathleen J.; Sharma, Sunita; Dai, Hongying; Tantisira, Kelan G.; Weiss, Scott T.; Leeder, J. Steven

    2013-01-01

    Maternal cigarette smoking during pregnancy is associated with increased risk of perinatal morbidity and mortality. However, the mechanisms underlying adverse birth outcomes following prenatal exposure to cigarette smoke remain unknown due, in part, to the absence or unreliability of information regarding maternal cigarette smoke exposure during pregnancy. Our goal was to determine if placental cotinine could be a reliable biomarker of fetal cigarette smoke exposure during pregnancy. Cotinine levels were determined in placentas from 47 women who reported smoking during pregnancy and from 10 women who denied cigarette smoke exposure. Cotinine levels were significantly higher in placentas from women reporting cigarette smoking (median = 27.2 ng/g) versus women who reported no smoke exposure (2.3 ng/g, P < 0.001). Receiver operating characteristic curve analysis identified an optimal cut point of 7.5 ng/g (sensitivity = 78.7%, specificity = 100%) to classify placenta samples from mothers who smoked versus those from mothers who did not. Among 415 placentas for which maternal cigarette smoking status was unavailable, 167 had cotinine levels > 7.5 ng/g and would be considered positive for cigarette smoke exposure. Data from quantitative reverse-transcription polymerase chain reaction analyses demonstrated that in utero cigarette smoke exposure predicted by cotinine in placenta is associated with changes in the expression of xenobiotic-metabolizing enzymes in fetal tissues. CYP1A1 mRNA in fetal lung and liver tissue and CYP1B1 mRNA in fetal lung tissue were significantly induced when cotinine was detected in placenta. These findings indicate that cotinine in placenta is a reliable biomarker for fetal exposure and response to maternal cigarette smoking during pregnancy. PMID:23209192

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

    PubMed

    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.

  7. MT-MMPs in pre-eclamptic placenta: relationship to soluble endoglin production.

    PubMed

    Kaitu'u-Lino, T J; Tuohey, L; Ye, L; Palmer, K; Skubisz, M; Tong, S

    2013-02-01

    Pre-eclampsia is a serious complication of pregnancy, characterized by severe endothelial dysfunction resulting in hypertension, proteinuria and maternal end-organ damage. Soluble endoglin is an anti-angiogenic factor released from placenta that has been linked to severe pre-eclampsia. We recently reported MMP-14 is capable of cleaving endoglin to release soluble endoglin from placenta, however inhibition studies only partially repressed production. To this end we have sought to identify other proteases that mediate endoglin shedding from placenta. MMP-14 is one of six-membrane-type (MT-) MMPs, a sub-family of the MMP superfamily, so named because they are membrane bound. MMP-15 is phylogenetically the closest MMP relative to MMP-14, however its inhibition has no effect on soluble endoglin production from placenta. Here we aimed to characterize the remaining four MT-MMPs (MMP-16, -17, -24 and -25) in severe early-onset pre-eclamptic placenta and assess their relative contribution to soluble endoglin production. Immunolocalisation studies revealed MMP-16, -24 and -25 were localized to the syncytiotrophoblast, the same site as endoglin, whilst MMP-17 was predominantly localized to fetal vessels and underlying stroma. MMP-17 protein was significantly (p < 0.05) up-regulated in pre-eclamptic placentas compared to gestationally matched pre-term controls, whilst MMP-25 mRNA was significantly (p < 0.05) down regulated. siRNA knockdown of MMP-16, -17, -24 and -25 in syncytialised BeWo cells did not alter soluble endoglin production in vitro. This is the first study to characterize MT-MMP protein localization in human placenta and indicates that MMP-14 is the only MT-MMP that contributes to soluble endoglin production in pre-eclampsia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Reactive Oxygen and Nitrogen Species and Functional Adaptation of the Placenta

    PubMed Central

    Myatt, Leslie

    2009-01-01

    The placenta regulates fetal growth and development via transport of nutrients and gases, and synthesis and secretion of steroid and peptide hormones. These functions are determined by vascular development and blood flow and by growth and differentiation of the trophoblast, which contains receptors, transporters and enzymes. The placenta generates reactive oxygen species which may contribute to the oxidative stress seen even in normal pregnancy but this is increased in pregnancies complicated by preeclampsia, IUGR and pregestational diabetes where oxidative and nitrative stress have been clearly documented. Nitrative stress is the covalent modification of proteins and DNA by peroxynitrite formed by the interaction of superoxide and nitric oxide. We have demonstrated nitrative stress by localizing nitrotyrosine residues in these placentas and found increased expression of NADPH oxidase (NOX) enzyme isoforms 1 and 5 as a potential source of superoxide generation. The presence of nitrative stress was associated with diminished vascular reactivity of the fetal placental circulation, a situation that could be reproduced by treatment with peroxynitrite in vitro. We find many nitrated proteins in the placenta, including p38 MAP kinase which has a role in development of the villous vasculature. Nitration of p38 MAPK was increased in the preeclamptic placenta and associated with loss of catalytic activity. We hypothesize that nitration of proteins in the placenta including receptors, transporters, enzymes and structural proteins can alter protein and placental function and this influences fetal growth and development. Increasing nitrative stress but a decrease in oxidative stress, measured as protein carbonylation, is found in the placenta with increasing BMI. Formation of peroxynitrite may then consume superoxide, decreasing nitrative stress. As protein carbonylation is a covalent modification at Lys, Arg, Pro and Thr residues the switch from carbonylation to nitration at

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

    PubMed

    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.

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

    PubMed

    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.

  11. Toxic compounds from tobacco in placenta samples analyzed by UPLC-QTOF-MS.

    PubMed

    Mohammadi, Somayeh; Domeno, Celia; Nerin, Isabel; Aznar, Margarita; Samper, Pilar; Khayatian, Gholamreza; Nerin, Cristina

    2017-10-25

    Polycyclic aromatic hydrocarbons (PAHs), tobacco-specific nitrosamines (TSNAs) and aromatic amines are carcinogens present in cigarette smoke. These compounds are distributed in the human body and they could be transferred to the foetus during the pregnancy. Placenta is the main barrier to these toxic compounds and its study is the objective of this work. A method based on solid-phase extraction (SPE) with ultra-performance liquid chromatography-tandem quadrupole-time-of-flight mass spectrometry (UPLC-QTOF-MS) has been examined and optimized for the analysis of 9 target analytes (4 tobacco-specific nitrosamines and some of their metabolites, 3 aromatic amines, nicotine and cotinine) in 26 placenta samples from smoking and non-smoking women. Limits of detection (LODs) were in the range of 3-27ng/g of placenta. Nicotine, cotinine, N-nitrosoanatabine (NAT) and 4-(methylnitrosamino)-1- (3-pyridyl)-1-butanone (NNK) metabolite, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) were detected in the placenta samples of smoking woman. Nicotine was detected in 3 out of 8 placentas from smoking women, always below the limit of quantification (88ng/g). This could be expected, as the half-life of nicotine in the body is limited to about 0.5-3h. Cotinine, the main metabolite from nicotine, was detected in all placentas from smoking women at concentrations between 17.2 and 61.8ng/g, reaching the highest values for those women that smoked the highest number of cigarettes. NAT and NNAL were detected in all placentas from smoking women, always below the limit of quantification (40ng/g and 33ng/g respectively). Copyright © 2017 Elsevier B.V. All rights reserved.

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

    PubMed Central

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

    2017-01-01

    Background: Placenta previa, a major cause of obstetric hemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. Methodology: 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. Results: 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 < 0.05). Similarly, there was a significant association between gestational age at delivery, mode of delivery, intraoperative blood loss, and birth weight at delivery and types of placenta previa (P < 0.05). Perinatal mortality was 12.2%, 15.6% of babies had severe birth asphyxia, and there was no maternal mortality. Conclusion: From this study, the risk factors for 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. PMID:28539861

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

    PubMed

    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 < 0.05). Similarly, there was a significant association between gestational age at delivery, mode of delivery, intraoperative blood loss, and birth weight at delivery and types of placenta previa (P < 0.05). Perinatal mortality was 12.2%, 15.6% of babies had severe birth asphyxia, and there was no maternal mortality. From this study, the risk factors for 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.

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

    PubMed Central

    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

  15. Magnetic resonance imaging of hypoxic injury to the murine placenta.

    PubMed

    Tomlinson, Tracy M; Garbow, Joel R; Anderson, Jeff R; Engelbach, John A; Nelson, D Michael; Sadovsky, Yoel

    2010-02-01

    We assessed the use of magnetic resonance imaging (MRI) to define placental hypoxic injury associated with fetal growth restriction. On embryonic day 18.5 (E18.5) we utilized dynamic contrast-enhanced (DCE)-MRI on a 4.7-tesla small animal scanner to examine the uptake and distribution of gadolinium-based contrast agent. Quantitative DCE parameter analysis was performed for the placenta and fetal kidneys of three groups of pregnant C57BL/6 mice: 1) mice that were exposed to Fi(O(2)) = 12% between E15.5 and E18.5, 2) mice in normoxia with food restriction similar to the intake of hypoxic mice between E15.5 and E18.5, and 3) mice in normoxia that were fed ad libitum. After imaging, we assessed fetoplacental weight, placental histology, and gene expression. We found that dams exposed to hypoxia exhibited fetal growth restriction (weight reduction by 28% and 14%, respectively, P < 0.05) with an increased placental-to-fetal ratio. By using MRI-based assessment of placental contrast agent kinetics, referenced to maternal paraspinous muscle, we found decreased placental clearance of contrast media in hypoxic mice, compared with either control group (61%, P < 0.05). This was accompanied by diminished contrast accumulation in the hypoxic fetal kidneys (23%, P < 0.05), reflecting reduced transplacental gadolinium transport. These changes were associated with increased expression of placental Phlda2 and Gcm1 transcripts. Exposure to hypoxia near the end of mouse pregnancy reduces placental perfusion and clearance of contrast. MRI-based DCE imaging provides a novel tool for dynamic, in vivo assessment of placental function.

  16. Calcium-phospholipid enhanced protein phosphorylation in human placenta

    SciTech Connect

    Moore, J.J.; Moore, R.; Cardaman, R.C.

    1986-07-01

    Calcium-activated, phospholipid-dependent protein phosphorylation has not been studied in placenta. Human placental cytosol was subjected to an endogenous protein phosphorylation assay using (..gamma..-/sup 32/P)ATP in the presence of calcium and phosphatidylserine. Protein phosphorylation was assessed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography. When compared to basal levels, calcium (10/sup -6/ M) in combination with phosphatidylserine (50 ..mu..g/ml) significantly enhanced (P < 100) /sup 32/P incorporation into phosphoproteins having mol wt 47,000, 43,000, and 37,000. Half-maximal /sup 22/P incorporation was observed with 3.5 x 10/sup -7/ M Ca/sup 2 +/ in the presence of phosphatidylserine (50 ..mu..g/ml). The effect of phosphatidylserine was biphasic. In the presence of Ca 10/sup -6/ M, /sup 32/P incorporation increased to a maximum at 70 /sup +/g/ml of phosphatidylserine. The increase was suppressed at 150 ..mu..g/ml. Tetracaine caused a dose-dependent inhibition of calcium-activated, phospholipid-dependent enhancement of the three phosphoproteins. Calcium in the absence of phospholipid enhanced the phosphorylation of a protein of 98,000 mol wt. Phosphatidylserine suppressed this enhancement. Calmodulin (10/sup -6/ M) had no detectable effect upon phosphorylation beyond that of calcium alone, but the calmodulin inhibitor R-24571 specifically inhibited the calcium-stimulated 98,000 mol wt phosphoprotein. Calcium-activated, phospholipid-dependent phospholipid-dependent phosphoproteins are present in human placental cytosol; whether calcium-activated, calmodulin-dependent phosphoproteins also are present remains a question.

  17. Tumor-homing peptides as tools for targeted delivery of payloads to the placenta

    PubMed Central

    King, Anna; Ndifon, Cornelia; Lui, Sylvia; Widdows, Kate; Kotamraju, Venkata R.; Agemy, Lilach; Teesalu, Tambet; Glazier, Jocelyn D.; Cellesi, Francesco; Tirelli, Nicola; Aplin, John D.; Ruoslahti, Erkki; Harris, Lynda K.

    2016-01-01

    The availability of therapeutics to treat pregnancy complications is severely lacking mainly because of the risk of causing harm to the fetus. As enhancement of placental growth and function can alleviate maternal symptoms and improve fetal growth in animal models, we have developed a method for targeted delivery of payloads to the placenta. We show that the tumor-homing peptide sequences CGKRK and iRGD bind selectively to the placental surface of humans and mice and do not interfere with normal development. Peptide-coated nanoparticles intravenously injected into pregnant mice accumulated within the mouse placenta, whereas control nanoparticles exhibited reduced binding and/or fetal transfer. We used targeted liposomes to efficiently deliver cargoes of carboxyfluorescein and insulin-like growth factor 2 to the mouse placenta; the latter significantly increased mean placental weight when administered to healthy animals and significantly improved fetal weight distribution in a well-characterized model of fetal growth restriction. These data provide proof of principle for targeted delivery of drugs to the placenta and provide a novel platform for the development of placenta-specific therapeutics. PMID:27386551

  18. Analysis of placenta vascularization in patients with uterine altered artery Doppler flow velocity exams.

    PubMed

    Gilio, Daniel Bruno; Miranda Corrêa, Rosana Rosa; Souza de Oliveira Guimarães, Camila; Peres, Luiz Cesar; Marques Salge, Ana Karina; Cavellani, Camila Lourencini; de Paula Antunes Teixeira, Vicente; Costa da Cunha Castro, Eumenia

    2009-08-01

    One of the frequent questions in obstetric practice is to determine placental vascular changes that may account for abnormal Doppler flow velocity alterations in maternal uterine vessels from women and fetuses without pregnancy pathology. A retrospective morphometric study was realized using 27 placentas from patients submitted for Doppler flow velocity exam during pregnancy. The placentas were morphologically examined using hematoxylin-eosin staining. Measurements of villi were made with the use of a video camera coupled to a common light microscope and a computer with automatic image analyzing software. Of the 27 placentas, 13 (48%) were of patients showing unaltered Doppler and 14 (52%) showing altered Doppler. The number of stem villi vessels was significantly larger in the placentas of patients with Doppler exam alterations (P = 0.003). This group also presented greater stem villi vessel thickness, although without significant difference. The number of intermediary and terminal villi vessels was greater in the placentas of patients with altered Doppler exams (P < 0.001), and a greater terminal villi area was observed in these cases (P < 0.001). The morphological proof that uterine artery Doppler flow velocity exam alterations are associated with placental vascular alterations demonstrates the importance of this exam during prenatal care, even in the absence of maternal-fetal alterations.

  19. Histopathological localization of cadmium in rat placenta by LA-ICP-MS analysis.

    PubMed

    Yamagishi, Yoshikazu; Furukawa, Satoshi; Tanaka, Ayano; Kobayashi, Yoshiyuki; Sugiyama, Akihiko

    2016-10-01

    In order to clarify the histological localization of cadmium (Cd) in the placenta, we analyzed paraffin sections of placentas from rats with a single Cd exposure on gestation day 18 by the LA-ICP-MS imaging method compared with the histopathological changes. The placentas were sampled at 1 hour, 2 hours, 3 hours, 6 hours, and 24 hours after treatment. Histopathologically, the trophoblasts in the labyrinth zone of the Cd group showed swelling at 1 hour. At 2 and 3 hours, the trophoblasts showed swelling and vacuolar degeneration. At 6 and 24 hours, the syncytiotrophoblasts selectively underwent necrosis/apoptosis, resulting in a decrease in number. Remarkable metallothionein expression was observed in the trophoblastic septa, particularly cytotrophoblasts at 24 hours. The LA-ICP-MS analysis detected the localization of Cd in the fetal part of the placenta from 1 hour onwards. In particular, the intensity of Cd was prominent in the labyrinth zone and tended to increase with the progression of trophoblastic septa damages. The LA-ICP-MS analysis using the paraffin sections detected the localization of Cd in the fetal part of the placenta, and this methodology will be one of the valuable tools to detect heavy metals in toxicological pathology.

  20. Proteomic Profile of Mabuya sp. (Squamata: Scincidae) Ovary and Placenta During Gestation.

    PubMed

    Hernández-Díaz, Nathaly; Torres, Rodrigo; Ramírez-Pinilla, Martha Patricia

    2017-06-01

    Reptiles are one of the most diverse groups of vertebrates, providing an integrated system for comparative studies on metabolic, animal physiology, and developmental biology. However, the molecular data available are limited and only recently have started to call attention in the "omics" sciences. Mabuya sp. is a viviparous placentrotrophic skink with particular reproductive features, including microlecithal eggs, early luteolysis, prolonged gestation, and development of a highly specialized placenta. This placenta is responsible for respiratory exchange and the transference of all nutrients necessary for embryonic development. Our aim was to identify differentially expressed proteins in the ovary and placenta of Mabuya sp. during early, mid, and late gestation; their possible metabolic pathways; and biological processes. We carried out a comparative proteomic analysis during gestation in both tissues by sodium dodecyl sulfate polyacrylamide gel electrophoresis, two-dimensional gel electrophoresis, and matrix-assisted laser desorption/ionization. Differential protein expression in both tissues (Student's t-test P < 0.05) was related to several processes such as cell structure, cell movement, and energy. Proteins found in ovary are mainly associated with follicular development and its regulation. In the placenta, particularly during mid and late gestation, protein expression is involved in nutrient metabolism, transport, protein synthesis, and embryonic development. This work provides new insights about the proteins expressed and their physiological mechanisms in Mabuya sp. placenta and ovary during gestation. © 2017 Wiley Periodicals, Inc.

  1. Gas chromatographic and mass spectrometric analysis of polychlorinated biphenyls in human placenta and cord blood

    SciTech Connect

    Ando, M.; Saito, H.; Wakisaka, I.

    1986-10-01

    Gas chromatographic and mass spectrometric analyses of polychlorinated biphenyls (PCBs) in placenta, maternal blood, cord blood, and milk were carried out. Trichlorobiphenyl, tetrachlorobiphenyl, pentachlorobiphenyls, and hexachlorobiphenyls were identified by the mass chromatogram and the mass spectra. Some minor peaks of PCBs were identified by gas chromatography. The relationship between the PCB concentration in placenta and that in milk is different in each PCB congener. The higher the chlorine content of the PCB congener, the more significant the correlation. No significant but a low negative correlation exists between the concentration of some PCB congeners in the placenta and that in cord blood. On the other hand, a significant linear correlation exists between the concentration of hexachlorobenzene in the placenta and that in cord blood. The transplacental transport of each PCB congener varied depending upon its chemical nature. Trichlorobiphenyl and tetrachlorobiphenyl were more transferable than hexachlorobiphenyls. The results show that the placenta and cord blood are useful human samples to analyze the body burden of environmental pollutants and to estimate their transfer from mother to fetus.

  2. Only humans have human placentas: molecular differences between mice and humans.

    PubMed

    Schmidt, André; Morales-Prieto, Diana M; Pastuschek, Jana; Fröhlich, Karolin; Markert, Udo R

    2015-04-01

    The placenta is one of the organs with the highest evolutionary diversity among animal species. In consequence, an animal model that reflects human placentation exactly does not exist. However, the mouse is the most frequently used animal model for placenta and pregnancy research. It possesses a hemochorial placenta, which is similar, but also different from the human placenta. The question whether the similarities are sufficient for the achievement of useful results with regard to human pregnancy was debated recently at the 11th Congress of the European Society for Reproductive Immunology (Budapest, Hungary). Here, we discuss the molecular features of the human placenta that are restricted to primates or even to humans. Many of the primate-specific genetic novelties, e.g., the large microRNA cluster on chromosome 19, have been detected during the last 10-15 years and could not be referred to in earlier discussions. Now, in the light of recent findings and a better understanding of interspecies differences, we conclude that the mouse model is often overvalued. Owing to the increasing number of known human-specific factors in human placentation we consider that many aspects of human placentation can only be understood on the basis of experiments on human cells and tissues in combination with data collections from human subject studies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Immunolocalization of leptin and its receptor in the placenta of cats.

    PubMed

    Dall'Aglio, Cecilia; Polisca, Angela; Boiti, Cristiano; Ceccarelli, Piero

    2012-11-01

    The aim of the present study was to investigate the presence and the distribution of leptin (Ob) and its receptor (ObR) in the feline placenta at term by means of immunohistochemical techniques. A few Ob-positive cells were observed scattered in the lamellae of the labyrinthine placenta. These cells had the morphological characteristics typical of the very abundant cells in the placenta of cats that can be considered as being decidual and, in some cases, syncytiotrophoblastic cells. A few ObR-positive cells were observed in the same placental portion and were mainly localized in the lamellae, showing morphological features typical of decidual and syncytiotrophoblastic cells. No other structure of the placenta or the uterine wall showed positive reaction to the antibodies used. Our results confirm what has already been demonstrated in humans and laboratory animals, but not in domestic animals. Together with other emerging data on the secretory activities of the feline placenta, our study underlines its relevance in the production of molecules long known to be involved in appetite control and, probably, with potential effects on the developing fetus.

  4. Isolation and characterisation of mesenchymal stem cells derived from human placenta tissue

    PubMed Central

    Vellasamy, Shalini; Sandrasaigaran, Pratheep; Vidyadaran, Sharmili; George, Elizabeth; Ramasamy, Rajesh

    2012-01-01

    AIM: To explore the feasibility of placenta tissue as a reliable and efficient source for generating mesenchymal stem cells (MSC). METHODS: MSC were generated from human placenta tissue by enzymatic digestion and mechanical dissociation. The placenta MSC (PLC-MSC) were characterized for expression of cell surface markers, embryonic stem cell (ECS) gene expression and their differentiation ability into adipocytes and osteocytes. The immunosuppressive properties of PLC-MSC on resting and phytohemagglutinin (PHA) stimulated allogenic T cells were assessed by means of cell proliferation via incorporation of tritium thymidine (3H-TdR). RESULTS: The generated PLC-MSC appeared as spindle-shaped cells, expressed common MSC surface markers and ESC transcriptional factors. They also differentiated into adipogenic and osteogenic lineages when induced. However, continuous cultivation up to passage 15 caused changes in morphological appearance and cellular senescence, although the stem cell nature of their protein expression was unchanged. In terms of their immunosuppressive properties, PLC-MSC were unable to stimulate resting T cell proliferation; they inhibited the PHA stimulated T cells in a dose dependent manner through cell to cell contact. In our study, MSC generated from human placenta exhibited similar mesenchymal cell surface markers; MSC-like gene expression pattern and MSC-like differentiation potential were comparable to other sources of MSC. CONCLUSION: We suggest that placenta tissues can serve as an alternative source of MSC for future experimental and clinical studies. PMID:22993662

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

    PubMed Central

    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

  6. Iron overload in Plasmodium berghei-infected placenta as a pathogenesis mechanism of fetal death

    PubMed Central

    Penha-Gonçalves, Carlos; Gozzelino, Raffaella; de Moraes, Luciana V.

    2014-01-01

    Plasmodium infection during gestation may lead to severe clinical manifestations including abortion, stillbirth, intrauterine growth retardation, and low birth weight. Mechanisms underlying such poor pregnancy outcomes are still unclear. In the animal model of severe placental malaria (PM), in utero fetal death frequently occurs and mothers often succumb to infection before or immediately after delivery. Plasmodium berghei-infected erythrocytes (IEs) continuously accumulate in the placenta, where they are then phagocytosed by fetal-derived placental cells, namely trophoblasts. Inside the phagosomes, disruption of IEs leads to the release of non-hemoglobin bound heme, which is subsequently catabolized by heme oxygenase-1 into carbon monoxide, biliverdin, and labile iron. Fine-tuned regulatory mechanisms operate to maintain iron homeostasis, preventing the deleterious effect of iron-induced oxidative stress. Our preliminary results demonstrate that iron overload in trophoblasts of P. berghei-infected placenta is associated with fetal death. Placentas which supported normally developing embryos showed no iron accumulation within the trophoblasts. Placentas from dead fetuses showed massive iron accumulation, which was associated with parasitic burden. Here we present preliminary data suggesting that disruption of iron homeostasis in trophoblasts during the course of PM is a consequence of heme accumulation after intense IE engulfment. We propose that iron overload in placenta is a pathogenic component of PM, contributing to fetal death. The mechanism through which it operates still needs to be elucidated. PMID:25071574

  7. Full-thickness skin wound healing using human placenta-derived extracellular matrix containing bioactive molecules.

    PubMed

    Choi, Ji Suk; Kim, Jae Dong; Yoon, Hyun Soo; Cho, Yong Woo

    2013-02-01

    The human placenta, a complex organ, which facilitates exchange between the fetus and the mother, contains abundant extracellular matrix (ECM) components and well-preserved endogenous growth factors. In this study, we designed a new dermal substitute from human placentas for full-thickness wound healing. Highly porous, decellularized ECM sheets were fabricated from human placentas via homogenization, centrifugation, chemical and enzymatic treatments, molding, and freeze-drying. The physical structure and biological composition of human placenta-derived ECM sheets dramatically supported the regeneration of full-thickness wound in vivo. At the early stage, the ECM sheet efficiently absorbed wound exudates and tightly attached to the wound surface. Four weeks after implantation, the wound was completely closed, epidermic cells were well arranged and the bilayer structure of the epidermis and dermis was restored. Moreover, hair follicles and microvessels were newly formed in the ECM sheet-implanted wounds. Overall, the ECM sheet produced a dermal substitute with similar cellular organization to that of normal skin. These results suggest that human placenta-derived ECM sheets provide a microenvironment favorable to the growth and differentiation of cells, and positive modulate the healing of full-thickness wounds.

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

    PubMed

    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.

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

    PubMed Central

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

    2015-01-01

    Objective: To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus. Methods: 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. Results: 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. Conclusion: A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus. PMID:26101491

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

    PubMed

    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.

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

    PubMed

    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.

  12. Acute and massive bleeding from placenta previa and infants' brain damage.

    PubMed

    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 at<26 weeks of gestation and placenta 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 <25mmHg. However, none of the 5 PVL infants showed umbilical arterial acidemia with pH<7.2, an abnormal fetal heart rate monitoring pattern, or neonatal hypotension. Our descriptive study showed that acute and massive bleeding from 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.

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

    PubMed

    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.

  14. Residential proximity to major roads and placenta/birth weight ratio.

    PubMed

    Yorifuji, Takashi; Naruse, Hiroo; Kashima, Saori; Murakoshi, Takeshi; Tsuda, Toshihide; Doi, Hiroyuki; Kawachi, Ichiro

    2012-01-01

    Exposure to air pollution has been demonstrated to increase the risk of preterm birth and low birth weight. We examined whether proximity to major roads (as a marker of exposure to air pollution) is associated with increased placenta/birth weight ratio (as a biomarker of the placental transport function). Data on parental characteristics and birth outcomes were extracted from the database maintained by a major hospital in Shizuoka Prefecture, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,189). Using geocoded residential information, each birth was classified according to proximity to major roads. We examined the association between proximity to major roads and the placenta/birth weight ratio, using multiple linear regression. Proximity to major roads was associated with higher placenta/birth weight ratio. After adjusting for potential confounders, living within 200 m of a major road increased the ratio by 0.48% (95% CI = 0.15 to 0. 80). In addition, proximity to major roads was associated with lower placenta weight and birth weight. These observed associations were stronger among participants living closer to major roads. Exposure to traffic-related air pollution is associated with higher placenta/birth weight ratio. Impaired placental oxygen and nutrient transport function might be a mechanism for explaining the observed association between air pollution and low birth weight as well as preterm birth. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Histological characteristics of singleton placentas delivered before the 28th week of gestation

    PubMed Central

    Hecht, Jonathan L.; Allred, Elizabeth N.; Kliman, Harvey J.; Zambrano, Eduardo; Doss, Barbara J.; Husain, Aliya; Pflueger, Solveig M. V.; Chang, Chung-ho; Livasy, Chad A.; Roberts, Drucilla; Bhan, Ina; Ross, Dennis W.; Senagore, Patricia Kaman; Leviton, Alan

    2010-01-01

    Summary Aims The placenta is a record of the fetal environment and its examination may provide information about the baby’s subsequent growth and development. We describe the histological characteristics of 947 singleton placentas from infants born between 23 and 27 weeks gestation. Methods Consent was obtained from mothers who delivered before 28 weeks (clinical estimate). We evaluated the gross and histopathological features of the placenta and assessed pair-wise correlations between variables. Results Lesions of uteroplacental circulation (abruption, extensive infarction or thrombosis, marked basal or perivillous fibrin deposition, increased syncytial knots) were inversely related to those associated with inflammation of the membranes and cord. Earlier age favoured inflammatory variables, while older age favoured characteristics attributed to impaired blood flow. We observed inflammation of the chorionic plate in 43%, the cord in 19%, and of chorionic plate vessels in 30%. Of the placentas with umbilical cord inflammation, 8% had no inflammation of the chorionic plate. Conclusions This study population is unique in its size and recruitment by gestational age rather than birth weight. Inflammation occurred frequently, but not in placentas that had characteristics of vasculopathy. The prevalence of inflammation decreased with increasing gestational age, while vasculopathy increased. Funisitis need not be accompanied by chorionic inflammation. PMID:18446627

  16. Apoptosis in normal and Coxiella burnetii-infected placentas from Alaskan northern fur seals (Callorhinus ursinus).

    PubMed

    Myers, E; Ehrhart, E J; Charles, B; Spraker, T; Gelatt, T; Duncan, C

    2013-07-01

    In 2010, Coxiella burnetii was identified in 75% of northern fur seal placentas from a single rookery in Alaska, but nothing was known about the significance of this organism in the population. Although many infectious organisms cause increased cell death, C. burnetii has been shown to suppress apoptosis of the host macrophages as an intracellular survival mechanism. To determine if infection induces a similar functional change in the placenta, immunohistochemistry for antibodies to cleaved caspase-3 (activated caspase-3) and the (TDT)-mediated dUTP-digoxigenin nick end labeling (TUNEL) technique were used to compare the amount of placental apoptosis in infected and noninfected placentas. There was a statistically significant difference in the frequency of apoptotic cells between infected and uninfected placentas, with more apoptosis identified in the uninfected placentas. This finding suggests that the survival mechanism of C. burnetii in host macrophages to reduce apoptosis may also be utilized in trophoblasts. The significance of decreased trophoblastic apoptosis for the northern fur seal fetus requires further investigation.

  17. Oxidative Stress, Gene Expression, and Protein Changes Induced in the Human Placenta during Labor

    PubMed Central

    Cindrova-Davies, Tereza; Yung, Hong-Wa; Johns, Jemma; Spasic-Boskovic, Olivera; Korolchuk, Svitlana; Jauniaux, Eric; Burton, Graham J.; Charnock-Jones, D. Stephen

    2007-01-01

    Malperfusion of the placenta has been implicated as a cause of oxidative stress in complications of human pregnancy, leading to release of proinflammatory cytokines and anti-angiogenic factors into the maternal circulation. Uterine contractions during labor are known to be associated with intermittent utero-placental perfusion. We therefore tested whether oxidative stress, proinflammatory cytokines, and angiogenic regulators were increased in placentas subjected to short (<5 hours) and long (>15 hours) labor compared with nonlabored controls delivered by cesarean section. In addition, broader changes in gene transcripts were assessed by microarray analysis. Oxidative stress, activation of the nuclear factor-κB pathway, tumor necrosis factor-α and interleukin 1β all increased in placental tissues after labor. Stabilization of hypoxia-inducible factor-1α and increased vascular endothelial growth factor soluble receptor-1 were also observed. By contrast, tissue levels of placenta growth factor decreased. Apoptosis was also activated in labored placentas. The magnitude of these changes related to the duration of labor. After labor, 55 gene transcripts were up-regulated and 35 down-regulated, and many of these changes were reflected at the protein level. In conclusion, labor is a powerful inducer of placental oxidative stress, inflammatory cytokines, and angiogenic regulators. Our findings are consistent with intermittent perfusion being the initiating cause. Placentas subjected to labor do not reflect the normal in vivo state at the molecular level. PMID:17823277

  18. Placental sharing, birthweight discordance, and vascular anastomoses in monochorionic diamniotic twin placentas.

    PubMed

    Lewi, Liesbeth; Cannie, Mieke; Blickstein, Isaac; Jani, Jacques; Huber, Agnes; Hecher, Kurt; Dymarkowski, Steven; Gratacós, Eduard; Lewi, Paul; Deprest, Jan

    2007-12-01

    The purpose of this study was to examine the relationship between placental territory and birthweight discordance and vascular anastomoses in monochorionic diamniotic twin placentas from pregnancies that were not complicated by twin-to-twin transfusion syndrome with 2 liveborn twins. Placentas originated from a prospective follow-up study of monochorionic diamniotic twins included in the first trimester. After injection with dyed barium sulphate, a digital x-ray angiography and high-resolution digital photograph were taken. The 2 venous territories were delineated on the angiogram. The diameter of each arterioarterial anastomosis and of each vein that participated in an arteriovenous anastomosis was measured on the digital photograph. Net transfusion over the arteriovenous anastomoses was calculated as the difference between the total venous diameters of the 2 placental parts. One hundred placentas were analyzed. Birthweight discordance increased with placental territory discordance (P < .0001). Arterioarterial diameter (P < .01), net arteriovenous transfusion (P < .001), and total anastomotic diameter (P < .01) increased with placental territory discordance. On the other hand, birthweight discordance for a given placental territory discordance decreased with increasing arterioarterial diameter (P < .01), net arteriovenous transfusion (P < .001), and total anastomotic diameter (P < .01). In unequally shared placentas, the 2 fetal circulations are more tightly linked than in equally shared placentas, which may reduce the birthweight discordance for a given placental territory discordance.

  19. Review: Sexual dimorphism in the formation, function and adaptation of the placenta.

    PubMed

    Kalisch-Smith, J I; Simmons, D G; Dickinson, H; Moritz, K M

    2016-12-08

    Exposure of the embryo or fetus to perturbations in utero can result in intrauterine growth restriction, a primary risk factor for the development of adult disease. However, despite similar exposures, males and females often have altered disease susceptibility or progression from different stages of life. Fetal growth is largely mediated by the placenta, which, like the fetus is genetically XX or XY. The placenta and its associated trophoblast lineages originate from the trophectoderm (TE) of the early embryo. Rodent models (rat, mouse, spiny mouse), have been used extensively to examine placenta development and these have demonstrated the growth trajectory of the placenta in females is generally slower compared to males, and also shows altered adaptive responses to stressful environments. These placental adaptations are likely to depend on the type of stressor, duration, severity and the window of exposure during development. Here we describe the divergent developmental pathways between the male and female placenta contributing to altered differentiation of the TE derived trophoblast subtypes, placental growth, and formation of the placental architecture. Our focus is primarily genetic or environmental perturbations in rodent models which show altered placental responsiveness between sexes. We suggest that perturbations during early placental development may have greater impact on viability and growth of the female fetus whilst those occurring later in gestation may preferentially affect the male fetus. This may be of great relevance to human pregnancies which result from assisted reproductive technologies or complications such as pre-eclampsia and diabetes.

  20. Oxidative stress, gene expression, and protein changes induced in the human placenta during labor.

    PubMed

    Cindrova-Davies, Tereza; Yung, Hong-Wa; Johns, Jemma; Spasic-Boskovic, Olivera; Korolchuk, Svitlana; Jauniaux, Eric; Burton, Graham J; Charnock-Jones, D Stephen

    2007-10-01

    Malperfusion of the placenta has been implicated as a cause of oxidative stress in complications of human pregnancy, leading to release of proinflammatory cytokines and anti-angiogenic factors into the maternal circulation. Uterine contractions during labor are known to be associated with intermittent utero-placental perfusion. We therefore tested whether oxidative stress, proinflammatory cytokines, and angiogenic regulators were increased in placentas subjected to short (<5 hours) and long (>15 hours) labor compared with nonlabored controls delivered by cesarean section. In addition, broader changes in gene transcripts were assessed by microarray analysis. Oxidative stress, activation of the nuclear factor-kappaB pathway, tumor necrosis factor-alpha and interleukin 1beta all increased in placental tissues after labor. Stabilization of hypoxia-inducible factor-1alpha and increased vascular endothelial growth factor soluble receptor-1 were also observed. By contrast, tissue levels of placenta growth factor decreased. Apoptosis was also activated in labored placentas. The magnitude of these changes related to the duration of labor. After labor, 55 gene transcripts were up-regulated and 35 down-regulated, and many of these changes were reflected at the protein level. In conclusion, labor is a powerful inducer of placental oxidative stress, inflammatory cytokines, and angiogenic regulators. Our findings are consistent with intermittent perfusion being the initiating cause. Placentas subjected to labor do not reflect the normal in vivo state at the molecular level.

  1. Impact of maternal diabetes type 1 on proliferative potential, differentiation and apoptotic activity in villous capillaries of term placenta.

    PubMed

    Jirkovská, Marie; Kučera, Tomáš; Dvořáková, Veronika; Jadrníček, Martin; Moravcová, Milena; Žižka, Zdeněk; Krejčí, Vratislav

    2016-04-01

    Maternal diabetes mellitus changes morphology and impairs function of placental capillaries. Here, quantitative parameters characterizing cell proliferation using detection of Ki67, differentiation reflected by nestin expression and apoptosis in placental capillary bed with active caspase 3 as a marker were compared in normal term placentas and placentas from pregnancies complicated by Type 1 maternal diabetes mellitus. Specimens of sixteen diabetic placentas and eight control placentas were collected by systematic uniform random sampling. Immunohistochemical detections of Ki67, nestin, and active caspase 3 were performed in histological sections of five haphazardly chosen blocks per placenta. Twenty fields of view per section, i.e. one hundred fields of view per placenta, were used for analysis of proliferation as well as of apoptosis, and in approximately 70 capillary cross-sections per placenta the nestin-positive segments of their circumference were measured. The percentage of Ki67-positive cells counted in the capillary wall was significantly lower in diabetic group. The counts of Ki67-labelled nuclei per villous area unit were significantly lower in cytotrophoblast and capillary wall of terminal villi in diabetic placenta. The proportion of nestin-labeled segments of capillary circumference was significantly higher in placentas of diabetic group. No differences in the numbers of apoptotic cells were found between studied groups. The results show that the term placenta in Type 1 diabetes has lower potential to enlarge the surface area of structures involved in maternofetal transport, and that the villous capillary bed displays delayed differentiation. Those factors may participate in decreased ability of diabetic placenta to comply with fetal requirements in the final stage of pregnancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. The viral theory of schizophrenia revisited: abnormal placental gene expression and structural changes with lack of evidence for H1N1 viral presence in placentae of infected mice or brains of exposed offspring.

    PubMed

    Fatemi, S Hossein; Folsom, Timothy D; Rooney, Robert J; Mori, Susumu; Kornfield, Tess E; Reutiman, Teri J; Kneeland, Rachel E; Liesch, Stephanie B; Hua, Kegang; Hsu, John; Patel, Divyen H

    2012-03-01

    , schizophrenia, and autism. Placentas from infected mice showed a number of morphological abnormalities including presence of thrombi and increased presence of immune cells. Additionally, we searched for presence of H1N1 viral-specific genes for M1/M2, NA, and NS1 in placentas of infected mice and brains of exposed offspring and found none. Our results demonstrate that prenatal viral infection disrupts structure and gene expression of the placenta, hippocampus, and prefrontal cortex potentially explaining deleterious effects in the exposed offspring without evidence for presence of viral RNAs in the target tissues. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. [Results of conservative and surgical treatment for placenta praevia (author's transl)].

    PubMed

    Sadauskas, W M; Maksimaitiene, D A; Butkewiczius, S S

    1982-01-01

    Modified cervix cerclage was applied to 75 women with placenta praevia, between the 16th and 36th weeks of pregnancy. Results obtained from conservative treatment of patients for placenta praevia are compared with those obtained from surgical treatment. Pregnancy was extended 38.4 days on average by cervix cerclage. Complaints were removed by surgery from 50.6 per cent of the patients who were dismissed from hospital. They showed neither bleeding nor any sings of imminent premature birth. Perinatal mortality went down to 6.45 per cent. Average extension of pregnancy by conservative treatment was 12.8 days. Only 7.3 per cent of the patients could be dismissed from hospital. Perinatal mortality went up to the order of 19.1 per cent. These data are interpreted as providing evidence to the advantage of surgical treatment of placenta praevia, as perinatal mortality is reduced.

  4. Uterine Rupture with Massive Late Postpartum Hemorrhage due to Placenta Percreta Left Partially In Situ

    PubMed Central

    Salman, Mehmet Coskun; Calis, Pinar; Deren, Ozgur

    2013-01-01

    Placental adhesive disorders involve the growth of placental tissue into or through the uterine wall. Among these disorders, placenta percreta is the rarest one. However, it may cause significant complications. This report aimed to report a neglected patient with placenta percreta who developed uterine rupture with life-threatening late postpartum intra-abdominal hemorrhage. On admission, the patient had acute abdomen with moderate abdominal distention and was subjected to emergency laparotomy. A full-thickness defect of the anterior uterine wall involving the hysterotomy site was seen. Placental tissues occupied both sides of the incision and posterior bladder wall was also invaded by placenta. Total abdominal hysterectomy with partial resection of the posterior bladder wall was performed. PMID:24392232

  5. A case of placenta percreta with massive hemorrhage during cesarean section.

    PubMed

    Kume, Katsuyoshi; M Tsutsumi, Yasuo; Soga, Tomohiro; Sakai, Yoko; Kambe, Noriko; Kawanishi, Ryosuke; Hamaguchi, Eisuke; Kawahara, Tomiya; Kasai, Asuka; Nakaji, Yoshimi; T Horikawa, Yousuke; Nakayama, Souichiro; Kaji, Takashi; Irahara, Minoru; Tanaka, Katsuya

    2014-01-01

    We describe a case of a 39-year-old woman diagnosed with placenta percreta complicated by massive hemorrhage during a cesarean section. At 27 weeks of gestation, she underwent an emergency cesarean section under general anesthesia for vaginal bleeding and an intrauterine infection. Soon after delivery, a massive hemorrhage was encountered while attempting to separate the placenta percreta from the bladder wall. Although total abdominal hysterectomy and partial cystectomy were performed, massive hemorrhaging persisted. Bleeding was finally controlled following bilateral internal iliac artery embolization. We used a cell salvage device and a rapid infuser for hemodynamics stabilization. Total blood loss was 47,000 mL, and anesthesia time was 12 h and 47 min. The patient was discharged on the 32(nd) postoperative day without major complications. Placenta accreta can be associated with life-threatening hemorrhage and it is vital to plan accordingly preoperatively.

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

    PubMed

    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.

  7. The Placenta as a Mediator of Stress Effects on Neurodevelopmental Reprogramming

    PubMed Central

    Bronson, Stefanie L; Bale, Tracy L

    2016-01-01

    Adversity experienced during gestation is a predictor of lifetime neuropsychiatric disease susceptibility. Specifically, maternal stress during pregnancy predisposes offspring to sex-biased neurodevelopmental disorders, including schizophrenia, attention deficit/hyperactivity disorder, and autism spectrum disorders. Animal models have demonstrated disease-relevant endophenotypes in prenatally stressed offspring and have provided unique insight into potential programmatic mechanisms. The placenta has a critical role in the deleterious and sex-specific effects of maternal stress and other fetal exposures on the developing brain. Stress-induced perturbations of the maternal milieu are conveyed to the embryo via the placenta, the maternal–fetal intermediary responsible for maintaining intrauterine homeostasis. Disruption of vital placental functions can have a significant impact on fetal development, including the brain, outcomes that are largely sex-specific. Here we review the novel involvement of the placenta in the transmission of the maternal adverse environment and effects on the developing brain. PMID:26250599

  8. Learning brain aneurysm microsurgical skills in a human placenta model: predictive validity.

    PubMed

    de Oliveira, Marcelo Magaldi Ribeiro; Ferrarez, Carlos Eduardo; Ramos, Taise Mosso; Malheiros, Jose Augusto; Nicolato, Arthur; Machado, Carla Jorge; Ferreira, Mauro Tostes; de Oliveira, Fellype Borges; de Sousa, Cecília Félix Penido Mendes; Costa, Pollyana Helena Vieira; Gusmao, Sebastiao; Lanzino, Giuseppe; Maestro, Rolando Del

    2017-03-24

    OBJECTIVE Surgery for brain aneurysms is technically demanding. In recent years, the process to learn the technical skills necessary for these challenging procedures has been affected by a decrease in the number of surgical cases available and progressive restrictions on resident training hours. To overcome these limitations, surgical simulators such as cadaver heads and human placenta models have been developed. However, the effectiveness of these models in improving technical skills is unknown. This study assessed concurrent and predictive validity of brain aneurysm surgery simulation in a human placenta model compared with a "live" human brain cadaveric model. METHODS Two human cadaver heads and 30 human placentas were used. Twelve neurosurgeons participated in the concurrent validity part of this study, each operating on 1 human cadaver head aneurysm model and 1 human placenta model. Simulators were evaluated regarding their ability to simulate different surgical steps encountered during real surgery. The time to complete the entire aneurysm task in each simulator was analyzed. The predictive validity component of the study involved 9 neurosurgical residents divided into 3 groups to perform simulation exercises, each lasting 6 weeks. The training for the 3 groups consisted of educational video only (3 residents), human cadaver only (3 residents), and human placenta only (3 residents). All residents had equivalent microsurgical experience with superficial brain tumor surgery. After completing their practice training, residents in each of the 3 simulation groups performed surgery for an unruptured middle cerebral artery (MCA) aneurysm, and their performance was assessed by an experienced vascular neurosurgeon who watched the operative videos. RESULTS All human cadaver heads and human placentas were suitable to simulate brain aneurysm surgery. In the concurrent validity portion of the experiment, the placenta model required a longer time (p < 0.001) than cadavers

  9. Incidental leiomyosarcoma found at the time of cesarean hysterectomy for morbidly adherent placenta.

    PubMed

    Hand, Lauren C; Gimovsky, Alexis C; Chan, Joanna S Y; Rosenblum, Norman G; Kim, Christine H

    2017-05-01

    Incidental leiomyosarcoma (LMS) is a rare diagnosis in pregnancy or in the puerperium. To our knowledge, this is the first case reported in the literature of incidental LMS after cesarean hysterectomy for morbidly adherent placenta. We present a case of a cesarean hysterectomy performed for a suspected morbidly adherent placenta in a patient with three prior cesarean deliveries, an anterior placenta previa and a fundal fibroid. Subsequent pathology identified a LMS on final specimen. The patient declined bilateral oophorectomy and removal of her remaining cervix. No chemotherapy or radiation was given for her presumed stage IB disease. An incidental finding of a LMS is infrequent; the risk of recurrence is > 50% even if the sarcoma is removed in its entirety.

  10. The Fascinating and Complex Role of the Placenta in Pregnancy and Fetal Well-being.

    PubMed

    Latendresse, Gwen; Founds, Sandra

    2015-01-01

    Existing evidence implicates the placenta as the origin of some common pregnancy complications. Moreover, some maternal conditions, such as inadequate nutrition, diabetes, and obesity, are known to adversely affect placental function, with subsequent negative impact on the fetus and newborn. The placenta may also contribute to fetal programming with health consequences into adulthood, such as cardiovascular, metabolic, and mental health disorders. There is evidence that altered placental development, specifically impaired trophoblast invasion and spiral artery remodeling in the first trimester, is the origin of preeclampsia. Prenatal care providers who understand the relationships between placental health and maternal-newborn health can better inform and guide women to optimize health early in pregnancy and prior to conception. This article reviews the current understanding of placental function; placental contributions to normal fetal brain development and timing of birth; and impact of maternal nutrition, obesity, and diabetes on the placenta.

  11. Endoplasmic reticulum stress is induced in the human placenta during labour

    PubMed Central

    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. PMID:25434970

  12. Endoplasmic reticulum stress is induced in the human placenta during labour.

    PubMed

    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.

  13. Na⁺, K⁺-ATPase and Ca²⁺-ATPase activities in basal and microvillous syncytiotrophoblast membranes from preeclamptic human term placenta.

    PubMed

    Abad, Cilia; Vallejos, Catalina; De Gregorio, Nicole; Díaz, Paula; Chiarello, Delia I; Mendoza, Mariana; Piñero, Sandy; Proverbio, Teresa; Botana, Desirée; Rojas, Próspero; Riquelme, Gloria; Proverbio, Fulgencio; Marín, Reinaldo

    2015-02-01

    The aim of this study is to evaluate the effect of preeclampsia on the level of lipid peroxidation, activity and expression of both plasma membrane Ca(2+)- and Na(+), K(+)-ATPases in syncytiotrophoblast. The level of lipid peroxidation was estimated by measuring TBARS. ATPase activities were quantified by a colorimetric method measuring the amount of inorganic phosphate during the assay. Expression of Ca(2+)- and Na(+), K(+)-ATPases in syncytiotrophoblast plasma membranes and term placenta tissue sections was investigated using Western blot and immunohistochemistry, respectively. Our results show a higher level of lipid peroxidation of syncytiotrophoblast plasma membranes from preeclamptic, as compared to uncomplicated pregnant women. Preeclampsia also significantly reduced the activity of Ca(2+)- and Na(+), K(+)-ATPases; however, expression of both ATPases was unaffected. Our findings suggest that the reduction of Ca(2+)- and Na(+), K(+)-ATPase activities during preeclampsia could be at least partially due to an increased level of lipid peroxidation of the syncytiotrophoblast plasma membranes.

  14. 40 CFR 26.305 - Protections applicable, after delivery, to the placenta, the dead fetus, or fetal material.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., to the placenta, the dead fetus, or fetal material. 26.305 Section 26.305 Protection of Environment... Protections for Pregnant Women and Fetuses Involved as Subjects in Observational Research Conducted or Supported by EPA § 26.305 Protections applicable, after delivery, to the placenta, the dead fetus, or fetal...

  15. 40 CFR 26.305 - Protections applicable, after delivery, to the placenta, the dead fetus, or fetal material.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., to the placenta, the dead fetus, or fetal material. 26.305 Section 26.305 Protection of Environment... Protections for Pregnant Women and Fetuses Involved as Subjects in Observational Research Conducted or Supported by EPA § 26.305 Protections applicable, after delivery, to the placenta, the dead fetus, or fetal...

  16. 40 CFR 26.305 - Protections applicable, after delivery, to the placenta, the dead fetus, or fetal material.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Protections applicable, after delivery, to the placenta, the dead fetus, or fetal material. 26.305 Section 26.305 Protection of Environment... Supported by EPA § 26.305 Protections applicable, after delivery, to the placenta, the dead fetus, or fetal...

  17. A 30-Year-Old Female Found to Have a Couvelaire Uterus With Placenta Accreta During Planned Cesarean Delivery.

    PubMed

    Uwagbai, Omici N; Wittich, Arthur C

    2017-03-01

    A case of Couvelaire uterus with placenta accreta found during scheduled repeat low transverse Cesarean section will be discussed within this article. First described in the 1900s, Couvelaire syndrome, also known as uteroplacental apoplexy, is a rare form of nonfatal placenta abruption complication. The case involves a 30-year-old gravida 3 para 2 otherwise healthy female with an uncomplicated pregnancy and two previous cesarean deliveries without complication. She received routine prenatal care. During her pregnancy, she did not experience any symptoms such as vaginal bleeding or abdominal pain. After delivering a healthy female, there were several unsuccessful attempts to remove the placenta from the uterus. Upon inspection, the uterus was found have dark purple patches with ecchymosis and indurations, diagnostic of Couvelaire uterus. Furthermore, there was high clinical suspicion for placenta accreta as the 30-minute mark approached without placenta detachment. A telephonic emergency review with the wet desk radiologist of the 18-week ultrasound revealed high suspicion for placenta accreta. A Cesarean hysterectomy was performed for prevention of significant hemorrhage. This case report may be the first documented association of Couvelaire uterus with placenta accreta. Providers should be vigilant in monitoring for antenatal bleeding, timing of placenta separation, and postpartum hemorrhage.

  18. 40 CFR 26.305 - Protections applicable, after delivery, to the placenta, the dead fetus, or fetal material.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Protections applicable, after delivery, to the placenta, the dead fetus, or fetal material. 26.305 Section 26.305 Protection of Environment... Supported by EPA § 26.305 Protections applicable, after delivery, to the placenta, the dead fetus, or...

  19. 40 CFR 26.305 - Protections applicable, after delivery, to the placenta, the dead fetus, or fetal material.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Protections applicable, after delivery, to the placenta, the dead fetus, or fetal material. 26.305 Section 26.305 Protection of Environment... Supported by EPA § 26.305 Protections applicable, after delivery, to the placenta, the dead fetus, or...

  20. Early preterm delivery due to placenta previa is an independent risk factor for a subsequent spontaneous preterm birth.

    PubMed

    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 < .001). Among patients with 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.

  1. Genome, transcriptome, and secretome analysis of wood decay fungus Postia placenta supports unique mechanisms of lignocellulose conversion

    Treesearch

    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,...

  2. ENDOCANNABINOID CROSSTALK BETWEEN PLACENTA AND MATERNAL FAT IN A BABOON MODEL (Papio spp.) OF OBESITY

    PubMed Central

    Brocato, Brian; Zoerner, Alexander A; Janjetovic, Zorica; Skobowiat, Cezary; Gupta, Sonali; Moore, Bob; Slominski, Andrzej; Zhang, Jie; Schenone, Mauro; Phinehas, Ramona; Ferry, Robert J.; Dick, Edward; Hubbard, Gene B.; Mari, Giancarlo; Schlabritz-Loutsevitch, Natalia

    2013-01-01

    Introduction Maternal obesity (MO) remains a serious obstetric problem with acute and chronic morbidities for both mothers and offspring. The mechanisms underlying these adverse consequences of MOremain unknown. Endocannabinoids (ECB) are neuromodulatory lipids derived from adipocytes. Metabolic crosstalk between placenta and adipocytes may mediate sequelae of MO. The goal of this study was to elucidate placental and systemic ECBs in MO. Material and methods Placentas, serum, and subcutaneous fat were collected at Cesarean sections performed near term (0.9 G) in four non-obese (nOB) and four obese (OB) baboons (Papio spp.). Concentrations of anandamide (AEA) and 2-arachidonoylglycerol (2-AG) were measured by liquid chromatography coupled to tandem mass spectrometry. AEA and 2-AG pathways were characterized in placentas by Q-RT-PCR, Western blot, and immunohistochemistry. Results Placental 2-AG levels were lower and maternal fat AEA levels were higher in OB (1254.1 ± 401.3 nmol/kg and 17.3 ± 4 nmol/kg ) vs. nOB (3124.2 ± 557.3 nmol/kg and 3.1 ± 0.6 nmol/kg) animals. Concentrations of 2-AG correlated positively between maternal fat and placenta (r=0.82, p=0.013), but correlated negatively with maternal leptin concentrations (r=−0.72, p=0.04 and r=−0.83, p=0.01, respectively). Conclusion This is the first study to demonstrate differential ECB pathway regulation in maternal fat and placenta in MO. Differential regulation and function exist for AEA and 2-AG as the major ECB pathways in placenta. PMID:24008071

  3. Review: The placenta and developmental programming: balancing fetal nutrient demands with maternal resource allocation.

    PubMed

    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. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Endocannabinoid crosstalk between placenta and maternal fat in a baboon model (Papio spp.) of obesity.

    PubMed

    Brocato, B; Zoerner, A A; Janjetovic, Z; Skobowiat, C; Gupta, S; Moore, B M; Slominski, A; Zhang, J; Schenone, M; Phinehas, R; Ferry, R J; Dick, E; Hubbard, G B; Mari, G; Schlabritz-Loutsevitch, N

    2013-11-01

    Maternal obesity (MO) remains a serious obstetric problem with acute and chronic morbidities for both mothers and offspring. The mechanisms underlying these adverse consequences of MO remain unknown. Endocannabinoids (ECB) are neuromodulatory lipids released from adipocytes and other tissues. Metabolic crosstalk between placenta and adipocytes may mediate sequelae of MO. The goal of this study was to elucidate placental and systemic ECB in MO. Placentas, sera, and subcutaneous fat were collected at Cesarean sections performed near term (0.9 G) in four non-obese (nOB) and four obese (OB) baboons (Papio spp.). Concentrations of anandamide (AEA) and 2-arachidonoylglycerol (2-AG) were measured by liquid chromatography coupled to tandem mass spectrometry. AEA and 2-AG pathways were characterized in placentas by Q-RT-PCR, Western blot and immunohistochemistry. Placental 2-AG levels were lower and maternal fat AEA levels were higher in OB (1254.1 ± 401.3 nmol/kg and 17.3 ± 4 nmol/kg) vs. nOB (3124.2 ± 557.3 nmol/kg and 3.1 ± 0.6 nmol/kg) animals. Concentrations of 2-AG correlated positively between maternal fat and placenta (r = 0.82, p = 0.013), but correlated negatively with maternal leptin concentrations (r = -0.72, p = 0.04 and r = -0.83, p = 0.01, respectively). This is the first study to demonstrate differential ECB pathway regulation in maternal fat and placenta in MO. Differential regulation and function exist for AEA and 2-AG as the major ECB pathways in placenta. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. The effect of morphine consumption on plasma corticosteron concentration and placenta development in pregnant rats

    PubMed Central

    Kazemi, Masoomeh; Sahraei, Hedayat; Azarnia, Mahnaz; Dehghani, Leila; Bahadoran, Hossein; Tekieh, Elaheh

    2011-01-01

    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. PMID:25587250

  6. Structure and Steroidogenesis of the Placenta in the Antarctic Minke Whale (Balaenoptera bonaerensis)

    PubMed Central

    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

  7. Role of the placenta in fetal programming: underlying mechanisms and potential interventional approaches.

    PubMed

    Jansson, Thomas; Powell, Theresa L

    2007-07-01

    Adverse influences during fetal life alter the structure and function of distinct cells, organ systems or homoeostatic pathways, thereby 'programming' the individual for an increased risk of developing cardiovascular disease and diabetes in adult life. Fetal programming can be caused by a number of different perturbations in the maternal compartment, such as altered maternal nutrition and reduced utero-placental blood flow; however, the underlying mechanisms remain to be fully established. Perturbations in the maternal environment must be transmitted across the placenta in order to affect the fetus. Here, we review recent insights into how the placenta responds to changes in the maternal environment and discuss possible mechanisms by which the placenta mediates fetal programming. In IUGR (intrauterine growth restriction) pregnancies, the increased placental vascular resistance subjects the fetal heart to increased work load, representing a possible direct link between altered placental structure and fetal programming of cardiovascular disease. A decreased activity of placental 11beta-HSD-2 (type 2 isoform of 11beta-hydroxysteroid dehydrogenase) activity can increase fetal exposure to maternal cortisol, which programmes the fetus for later hypertension and metabolic disease. The placenta appears to function as a nutrient sensor regulating nutrient transport according to the ability of the maternal supply line to deliver nutrients. By directly regulating fetal nutrient supply and fetal growth, the placenta plays a central role in fetal programming. Furthermore, perturbations in the maternal compartment may affect the methylation status of placental genes and increase placental oxidative/nitrative stress, resulting in changes in placental function. Intervention strategies targeting the placenta in order to prevent or alleviate altered fetal growth and/or fetal programming include altering placental growth and nutrient transport by maternally administered IGFs (insulin

  8. Structure and steroidogenesis of the placenta in the Antarctic minke whale (Balaenoptera bonaerensis).

    PubMed

    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.

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

    PubMed

    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 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.

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

    PubMed Central

    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 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). Conclusion 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. PMID:26263014

  11. Differential expression of imprinted genes in normal and IUGR human placentas.

    PubMed

    Diplas, Andreas I; Lambertini, Luca; Lee, Men-Jean; Sperling, Rhoda; Lee, Yin Leng; Wetmur, James; Chen, Jia

    2009-05-16

    Genomic imprinting refers to silencing of one parental allele in the zygotes of gametes depending upon the parent of origin. Loss of imprinting (LOI) is the gain of function from the silent allele that can have a maximum effect of doubling the gene dosage. LOI may play a significant role in the etiology of intrauterine growth restriction (IUGR). Using placental tissue from ten normal and seven IUGR pregnancies, we conducted a systematic survey of the expression of a panel of 74 "putatively" imprinted genes using quantitative RT-PCR. We found that 52/74 ( approximately 70%) of the genes were expressed in human placentas. Nine of the 52 (17%) expressed genes were significantly differentially expressed between normal and IUGR placentas; five were upregulated (PHLDA2, ILK2, NNAT, CCDC86, PEG10) and four downregulated (PLAGL1, DHCR24, ZNF331, CDKAL1). We also assessed LOI profile of 14 imprinted genes in 14 normal and 24 IUGR placentas using a functional and sensitive assay developed in our laboratory. Little LOI was observed in any placentas for five of the genes (PEG10, PHLDA2, MEG3, EPS15, CD44). With the 149 heterozygosities examined, 40 (26.8%) exhibited LOI >3%. Some genes exhibited frequent LOI in placentas regardless of the disease status (IGF2, TP73, MEST, SLC22A18, PEG3), while others exhibited LOI only in IUGR placentas (PLAGL1, DLK1, H19, SNRPN). Importantly, there was no correlation between gene expression and LOI profile. Our study suggests that genomic imprinting may play a role in IUGR pathogenesis, but mechanisms other than LOI may contribute to dysregulation of imprinted genes.

  12. Anesthetic management of placenta accreta in a low-resource setting: a case series.

    PubMed

    Muñoz, L A; Mendoza, G J; Gomez, M; Reyes, L E; Arevalo, J J

    2015-11-01

    Current recommendations for the anesthetic management of placenta accreta support a conservative approach with neuraxial anesthesia and uterine artery embolization. These are based on case series from experienced centers in developed countries. The aim of this study was to describe the anesthetic management of placenta accreta in a low-resource setting. A retrospective case note review was performed. From 1 August 2006 to 31 July 2011 placentas from cases of suspected placenta accreta were reassessed histologically to confirm the diagnosis. Patient charts were reviewed and information on anesthetic technique, monitoring, blood transfusion, maternal and fetal outcomes was extracted. Thirty-nine cases were identified. Mean (± SD) maternal age was 33 ± 5.4 years. Hysterectomy was performed at the time of cesarean section in all cases. Thirty-four patients received neuraxial anesthesia, of whom 15 required conversion to general anesthesia. Invasive blood pressure monitoring was used in all patients and a central venous catheter was inserted in 33 cases. Complications associated with monitoring occurred in five patients. Median [IQR] blood loss was 2000 [1100-2700] mL and the median [IQR] number of units of red blood cell transfused was 2 [0-6]. Vasoactive medication was used in 14 patients and 15 patients were transferred to the intensive care unit postoperatively. No maternal or newborn deaths occurred. A multidisciplinary approach can prove valuable when placenta accreta is suspected before delivery. In low-resource settings, lack of interventional radiology services and prenatal diagnostic capability may have an impact on anesthetic management in patients with placenta accreta. However, other than greater blood loss, our study demonstrated that good maternal and neonatal outcomes are possible in spite of limited resources. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Human placenta: a human organ for developmental toxicology research and biomonitoring.

    PubMed

    Myllynen, P; Pasanen, M; Pelkonen, O

    2005-05-01

    Pregnant mothers are exposed to a wide variety of foreign chemicals. This exposure is most commonly due to maternal medication, lifestyle factors, such as smoking, drug abuse, and alcohol consumption, or occupational and environmental sources. Foreign compounds may interfere with placental functions at many levels e.g. signaling, production and release of hormones and enzymes, transport of nutrients and waste products, implantation, cellular growth and maturation, and finally, at the terminal phase of placental life, i.e. delivery. Placental responses may also be due to pharmaco-/toxicodynamic responses to foreign chemicals, e.g. hypoxia. On the other hand, placental xenobiotic-metabolizing enzymes can detoxify or activate foreign chemicals, and transporters either enhance or prevent cellular accumulation and transfer across the placenta. The understanding of what xenobiotics do to the placenta and what the placenta does to the xenobiotics should provide the basis for the use of placenta as a tool to investigate and predict some aspects of developmental toxicity. This review aims to give an update of the fate and behavior of xenobiotics in the placenta from the viewpoint of xenobiotic-metabolizing enzymes and transporters. Their response levels will be described according to gestational status and methods used. The effects of foreign chemicals on placental metabolizing enzymes will be discussed. Also, interactions in the transporter protein level will be covered. The role of the placenta in contributing to developmental effects and fetotoxicity will be examined. The toxicological effects of maternal medications, smoking, and environmental exposures (dioxins, pesticides) as well as some possibilities for biomonitoring will be highlighted.

  14. Heat shock protein 27 is spatially distributed in the human placenta and decreased during labor.

    PubMed

    Abdulsid, Akrem; Fletcher, Alexander; Lyall, Fiona

    2013-01-01

    Placental oxidative stress is a feature of human labor. Heat shock proteins (HSPs) play a key role in cellular stress. We hypothesized that placental expression of the small HSP 27 would be altered during labor and expression would vary in different regions of the placenta. Six women in labor who delivered vaginally and 6 women not in labor, who were delivered by Cesarean section, were recruited. Four equally spaced pieces were sampled from the inner, middle and outer regions of each placenta (total 12 samples per placenta). HSP 27 expression was investigated by Western blot analysis and RT-PCR. For non-labor, there was less HSP 27 protein in the inner placenta region compared with both the middle region (p<0.05) and outer region (p<0.05). For labor, there was also less HSP 27 protein in the inner region compared with both the middle (p<0.02) and outer region (p<0.01). When the 3 regions of the placenta were compared for non-labor versus labor there was less HSP 27 in the labor group at both the inner (p<0.05) and middle regions (p<0.005) compared to non-labor. Similar to HSP 27 protein, there was less HSP 27 mRNA in the labor group in both the inner region (p<0.05) and middle region (p<0.02) compared to non-labor. This study suggests that placental HSP 27 may play a role in labor and is spatially controlled. The results have important implications for how data obtained from studies in the placenta can be influenced by sampling methods.

  15. Heat Shock Protein 27 Is Spatially Distributed in the Human Placenta and Decreased during Labor

    PubMed Central

    Abdulsid, Akrem; Fletcher, Alexander; Lyall, Fiona

    2013-01-01

    Placental oxidative stress is a feature of human labor. Heat shock proteins (HSPs) play a key role in cellular stress. We hypothesized that placental expression of the small HSP 27 would be altered during labor and expression would vary in different regions of the placenta. Six women in labor who delivered vaginally and 6 women not in labor, who were delivered by Cesarean section, were recruited. Four equally spaced pieces were sampled from the inner, middle and outer regions of each placenta (total 12 samples per placenta). HSP 27 expression was investigated by Western blot analysis and RT-PCR. For non-labor, there was less HSP 27 protein in the inner placenta region compared with both the middle region (p<0.05) and outer region (p<0.05). For labor, there was also less HSP 27 protein in the inner region compared with both the middle (p<0.02) and outer region (p<0.01). When the 3 regions of the placenta were compared for non-labor versus labor there was less HSP 27 in the labor group at both the inner (p<0.05) and middle regions (p<0.005) compared to non-labor. Similar to HSP 27 protein, there was less HSP 27 mRNA in the labor group in both the inner region (p<0.05) and middle region (p<0.02) compared to non-labor. This study suggests that placental HSP 27 may play a role in labor and is spatially controlled. The results have important implications for how data obtained from studies in the placenta can be influenced by sampling methods. PMID:23990930

  16. Recurrent Placenta-Mediated Complications in Women With Three Consecutive Deliveries.

    PubMed

    Hiersch, Liran; Shinar, Shiri; Melamed, Nir; Aviram, Amir; Hadar, Eran; Yogev, Yariv; Ashwal, Eran

    2017-03-01

    To estimate the risk of placenta-mediated complications in women in their third delivery according to their obstetric history in the first and second deliveries. A retrospective cohort study of all women with singleton pregnancies who delivered their first three consecutive deliveries in a single medical center over a 20-year period (1994-2013). The risk of placenta-mediated complications in the third delivery, that is, hypertensive disorders such as preeclampsia or gestational hypertension, placental abruption, and small for gestational age (SGA less than the 10th percentile), was assessed according to the presence or absence of complications in previous deliveries. Pregnancies complicated by multiple gestations or fetal anomalies were excluded. Of the 121,728 deliveries during the study period, 4,472 women (13,416 deliveries [11.0%]) met inclusion criteria. The rate of placenta-mediated complications in the third delivery was 5.9% (n=264). The most prevalent placenta-mediated complication was SGA. The risk of each placenta-mediated complication was greater the higher the incidence of placenta-mediated complications in prior pregnancies. In multivariate analysis, that risk was significantly associated with the number and order of complications in previous deliveries in a dose-dependent pattern: with no complications in either their first or second deliveries as a reference (n=3,650), the adjusted odds ratio (and 95% confidence intervals) was 4.35 (3.03-6.24) for complications in the first delivery but not the second delivery (n=532); 6.41 (3.95-10.38) for complications in the second delivery but not the first delivery (n=179); and 8.28 (4.72-14.58) for complications in both first and second deliveries (n=111), (P<.001). The number and order of previous placenta-mediated complications in the first two deliveries are major risk factors for recurrence in the third delivery. Previous SGA was the strongest risk factor for recurrence of SGA and other placenta

  17. Glucocorticoid stimulates expression of corticotropin-releasing hormone gene in human placenta.

    PubMed Central

    Robinson, B G; Emanuel, R L; Frim, D M; Majzoub, J A

    1988-01-01

    Primary cultures of purified human cytotrophoblasts have been used to examine the expression of the corticotropin-releasing hormone (CRH) gene in placenta. We report here that glucocorticoids stimulate placental CRH synthesis and secretion in primary cultures of human placenta. This stimulation is in contrast to the glucocorticoid suppression of CRH expression in hypothalamus. The positive regulation of CRH by glucocorticoids suggests that the rise in CRH preceding parturition could result from the previously described rise in fetal glucocorticoids. Furthermore, this increase in placental CRH could stimulate, via adrenocorticotropic hormone, a further rise in fetal glucocorticoids, completing a positive feedback loop that would be terminated by delivery. Images PMID:2839838

  18. Application of the steepest slope model reveals different perfusion territories within the mouse placenta.

    PubMed

    Remus, C C; Sedlacik, J; Wedegaertner, U; Arck, P; Hecher, K; Adam, G; Forkert, N D

    2013-10-01

    The steepest slope model is a numerically robust and fast method for perfusion quantification. The purpose of this study was to evaluate if the steepest slope model can be used for quantifying placental perfusion in mice based on dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) datasets. T1-weighted DCE MRI was performed in 5 pregnant BALB/c mice on gestation day (gd) 14.5 and in 5 mice on gd 16.5 using a 7T small animal MRI scanner. The placentas were manually delineated in the DCE datasets and the arterial input function (AIF) was selected from the kidney hilus. Placental perfusion was determined on a voxel-by-voxel basis using the steepest slope model. Perfusion was averaged over the entire placenta as well as separately calculated for the high-flow compartment within the central labyrinth zone and for the remaining low-flow placenta tissue. The AIF selection was independently performed by two observers for assessment of inter-observer differences. Mean perfusion on gd 14.5 was 135 ml/min/100 ml (standard deviation SD: 29 ml/min/100 ml placenta) and 112 ml/min/100 ml on gd 16.5 for the whole placenta (SD: 32 ml/min/100 ml). Perfusion in the high flow compartment in the central labyrinth was significantly higher (p ≤ 0.002) than in the low-flow compartment including the remaining placenta tissue: 184 ml/min/100 ml (SD: 39 ml/min/100 ml) vs. 119 ml/min/100 ml (SD 28 ml/min/100 ml) on gd 14.5 and 158 ml/min/100 ml (SD: 58 ml/min/100 ml) vs. 114 ml/min/100 ml (SD: 52 ml/min/100 ml of placenta) on gd 16.5. The mean relative inter-rater observer difference was 6%. The steepest slope model is a computationally simple method, which allows perfusion quantification in the mouse placenta. Furthermore, the results of this work indicate that the different placental compartments should be analyzed separately to prevent biased results due to averaging. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Alcohol-induced premature permeability in mouse placenta-yolk sac barriers in vivo.

    PubMed

    Haghighi Poodeh, S; Salonurmi, T; Nagy, I; Koivunen, P; Vuoristo, J; Räsänen, J; Sormunen, R; Vainio, S; Savolainen, M J

    2012-10-01

    Acute alcohol exposure induces malformation and malfunction of placenta-yolk sac tissues in rodents, reducing the labyrinth zone in the placenta and altering the permeability and fluidity of the cell membrane. During normal mouse placentation the cells line up in an optimal way to form a hemotrichorial placenta where layers II and III are connected through gap junctions. These act as molecular sieves that limit the passage of large molecules. PlGF is a developmentally regulated protein that controls the passage of molecules in the vasculosyncytial membranes and media of large blood vessels in the placental villi. In addition to the chorioallontoic placenta, rodents also have another type of placenta that consists of Reichert's membrane within the trophoblast cell layer on the maternal side and the parietal endodermal cells on the embryonic site. This forms a separate materno-fetal transport system. We study here whether alcohol affects these two placental barriers, leading to placental malfunction that in turn diminishes the nutrient supply to the embryo. CD-1 mice received two intraperitoneal injections of 3 g/kg ethanol at 4 h intervals at 8.75 days post coitum (dpc). The placentas were collected on 9.5, 11.5 and 14.5 dpc and used for histopathological protein studies. Hemotrichorial cell layer structure interactions through connective tissue and gap junction were analyzed by electron microscopy. The permeability of the feto-maternal barrier was visualized with Evans Blue. VEGF, a permeability inducer, was found to be up-regulated in the mouse placenta after acute alcohol exposure, and permeability was also affected by altered structures in the barriers that separate the feto-maternal blood circulation which destroyed the gap junctions in the hemotrichorial cell layer, reduced the thickness of Reichert's membrane and interfered with with Reichert's trophoblast/Reichert's parietal interaction. These defects together could have caused the permeability malfunction

  20. The Human Placenta Project: placental structure, development, and function in real time.

    PubMed

    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. Published by Elsevier Ltd.

  1. Glucocorticoid stimulates expression of corticotropin-releasing hormone gene in human placenta

    SciTech Connect

    Robinson, B.G.; Emanuel, R.L.; Frim, D.M.; Majzoub, J.A. )

    1988-07-01

    Primary cultures of purified human cytotrophoblasts have been used to examine the expression of the corticotropin-releasing hormone (CRH) gene in placenta. The authors report here that glucocorticoids stimulate placental CRH synthesis and secretion in primary cultures of human placenta. This stimulation is in contrast to the glucocorticoid suppression of CRH expression in hypothalamus. The positive regulation of CRH by glucocorticoids suggests that the rise in CRH preceding parturition could result from the previously described rise in fetal glucocorticoids. Furthermore, this increase in placental CRH could stimulate, via adrenocorticotropic hormone, a further rise in fetal glucocorticoids, completing a positive feedback loop that would be terminated by delivery.

  2. Evaluating DNA methylation and gene expression variability in the human term placenta.

    PubMed

    Avila, L; Yuen, R K; Diego-Alvarez, D; Peñaherrera, M S; Jiang, R; Robinson, W P

    2010-12-01

    Obtaining representative samples from a term placenta for gene-expression studies is confounded by both within placental heterogeneity and sampling effects such as sample location and processing time. Epigenetic processes involved in the regulation of gene expression, such as DNA methylation, may show similar variability, but are less well studied. Therefore, we investigated the nature of within and between- placenta variation in gene expression and DNA methylation of genes that were chosen for being differentially expressed or methylated by cell type within the placenta. In total, two or more samples from each of 38 normal term placentae were utilized. The expression levels of CDH1, CDH11, ID2, PLAC1 and KISS1 were evaluated by real-time PCR. DNA methylation levels of LINE1 elements and CpGs within the promoter regions of KISS1, PTPN6, CASP8, and APC were similarly quantified by pyrosequencing. Despite considerable sample-to-sample variability within each placenta, the within-placenta correlation for both gene expression and methylation was significant for each studied gene. Most of this variability was not due to sample location. However, between placental differences in gene expression were inflated by the dramatic effect of processing time (0-24 h) on mRNA levels, particularly for PLAC1 and KISS1 (both expressed in the apical syncytiotrophoblast). In contrast, DNA methylation levels remained relatively constant over this same time period. Due to extensive site-to-site variability, multiple sampled sites are needed to accurately represent a placenta for molecular studies. Furthermore, mRNA quantitation of some genes may be hampered by its rapid degradation post-delivery (and possibly perinatally) and thus processing time should be considered in such analyses. Within-placenta correlations in expression and methylation from unrelated genes raise the possibility that methylation and expression variation may potentially reflect cell composition differences between

  3. Survival by self-destruction: A role for autophagy in the placenta?

    PubMed Central

    Bildirici, I; Longtine, MS; Chen, B; Nelson, DM

    2012-01-01

    Autophagy is a burgeoning area of research from yeast to humans. Although previously described as a death pathway, autophagy is now considered an important survival phenomenon in response to environmental stressors to which most organs are exposed. Despite an ever expanding literature in non-placental cells, studies of autophagy in the placenta are lagging. We review the regulation of autophagy, summarize available placental studies of autophagy, and highlight potential areas for future research. We believe that such studies will yield novel insights into how placentas protect the survival of the species by “self-eating”. PMID:22652048

  4. Survival by self-destruction: a role for autophagy in the placenta?

    PubMed

    Bildirici, I; Longtine, M S; Chen, B; Nelson, D M

    2012-08-01

    Autophagy is a burgeoning area of research from yeast to humans. Although previously described as a death pathway, autophagy is now considered an important survival phenomenon in response to environmental stressors to which most organs are exposed. Despite an ever expanding literature in non-placental cells, studies of autophagy in the placenta are lagging. We review the regulation of autophagy, summarize available placental studies of autophagy, and highlight potential areas for future research. We believe that such studies will yield novel insights into how placentas protect the survival of the species by "self-eating".

  5. Inflammatory infiltration into placentas of Neospora caninum challenged cattle correlates with clinical outcome of pregnancy

    PubMed Central

    2014-01-01

    Infection with Neospora caninum stimulates host cell-mediated immune responses, which may be responsible for placental damage leading to bovine abortion. The aim of this study was to compare immune responses in the bovine placenta, following experimental infection in different stages of pregnancy. Placentomes were examined by immunohistochemistry and inflammation in early gestation was generally moderate to severe, particularly in the placentas carrying non-viable foetuses, whereas it was milder in later stages, mainly characterised by the presence of CD3+, CD4+ and γδ T-cells. This distinctive cellular immune response may explain the milder clinical outcome observed when animals are infected in later gestation. PMID:24484200

  6. [Morphofunctional characteristics of the placenta of women living in extreme conditions of the Aral cost line].

    PubMed

    Ataniiazova, O A; Ezhova, L S; Kondrikov, N I

    1994-01-01

    Morphologic examination of the placenta from 41 puerperants living near the Aral sea revealed an increase of its mass and changes in other parameters. The detected pathologic processes: hemodynamic disorders and dystrophic changes--are not specific and contribute to the development of placental insufficiency. The majority (85.6%) of newborns were born in asphyxia. Morphofunctional features of the placentas of multiparous women and the status of their children permit regarding this population as the best adapted to pregnancy and delivery of viable children under the said extreme conditions.

  7. Anticoagulants to prevent recurrent placenta-mediated pregnancy complications: Is it time to put the needles away?

    PubMed

    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.

  8. Profiling gene expression in human placentae of different gestational ages: an OPRU Network and UW SCOR Study.

    PubMed

    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.

  9. Evaluation of 5-HT7 receptor expression in the placentae of normal and pre-eclamptic women.

    PubMed

    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.

  10. [Risk factors of pregnancy termination at second and third trimester in women with scarred uterus and placenta previa].

    PubMed

    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 (P<0.05). Patients with previous cesarean section ≥ 13 years were more likely to require cesarean section than those <13 years (P<0.05). The placenta 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

  11. Effect of maternal hypokalaemia on unidirectional maternofetal and net potassium fluxes across the placenta of the anaesthetized rat.

    PubMed

    Mohammed, T; Stulc, J; Sibley, C P; Boyd, R D

    1992-01-01

    Potassium (K+) fluxes across the placenta of rats, at 21 days gestation, fed a low K+ diet or a control diet were studied. The rats on the low K+ diet had a significantly (P less than 0.001) lower arterial plasma K+ concentration compared to those on the control diet (1.95 +/- 0.12 and 2.93 +/- 0.06 mmol/l respectively; mean +/- s.e., n = 17). Fetal umbilical arterial plasma K+ concentration was unaltered in maternal hypokalaemia and was significantly (P less than 0.001) higher than that of maternal plasma (4.58 +/- 0.15 and 4.66 +/- 0.12 mmol/l in low K+ and control groups respectively). Net K+ flux across the placentas (as measured by fetal accretion between days 20 and 21 of gestation) of hypokalaemic mothers (0.106 +/- 0.02 mumol/min/g placenta, n = 6) was not different to that in controls (0.104 +/- 0.01 mumol/min/g placenta, n = 8). Unidirectional maternofetal flux (Jmf) across the placentas, measured as the accumulation of 42K in the fetuses after injection of the radioisotope into maternal blood, was also not significantly different between the hypokalaemic and control mothers (0.5 +/- 0.08 mumol/min/g placenta, n = 8 versus 0.63 +/- 0.06 mumol/min/g placenta, n = 7, respectively). However, measurement of Jmf by perfusion of the placentas through their fetal circulations yielded a higher value than the accumulation method and in this analysis was significantly (P less than 0.02) lower in the low K+ than in the control group (0.75 +/- 0.10 mumol/min/g placenta, n = 11, and 1.27 +/- 0.14 mumol/min/g placenta, n = 9, respectively). These results show that net placental K+ fluxes are unaltered during maternal hypokalaemia but suggest that unidirectional maternofetal fluxes may be reduced.

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

    PubMed

    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

  13. Homocysteine transport by systems L, A and y+L across the microvillous plasma membrane of human placenta

    PubMed Central

    Tsitsiou, Eleni; Sibley, Colin P; D'Souza, Stephen W; Catanescu, Otilia; Jacobsen, Donald W; Glazier, Jocelyn D

    2009-01-01

    Elevated maternal plasma levels of homocysteine (Hcy) are associated with pregnancy complications and adverse neonatal outcomes, suggesting placental transport of Hcy may impact on fetal development. However, such transport mechanisms have not been defined. In this study we characterise Hcy transport mechanisms across the microvillous plasma membrane (MVM) of the syncytiotrophoblast, the transporting epithelium of human placenta. Three candidate transport systems, systems L, A and y+L, were examined utilising competitive inhibition to investigate the effects of Hcy on the uptake of well-characterised radiolabelled substrates for each system into isolated MVM vesicles, and that of model substrates on 10 μm[35S]l–Hcy uptake. System L activity was inhibited by both l-Hcy and dl–Hcy, comparable to model substrates including 2–aminobicyclo[2.2.1]heptane-2-carboxylic acid (BCH). System L constituted the major transport mechanism, with significant BCH inhibition (∼69%) of [35S]l–Hcy uptake. System A activity was also inhibited by l–Hcy and dl-Hcy with a smaller contribution (∼21%) to [35S]l–Hcy uptake. Inhibition by l–Hcy and dl–Hcy of system y+L activity was Na+ sensitive with a significant inhibition constant (Ki) shift observed following K+ replacement; l–arginine reduced [35S]l–Hcy uptake by ∼19%. Kinetic modelling of [35S]l–Hcy uptake resolved two, Na+-independent, transport components (Km 72 μm and 9.7 mm). This study provides evidence for the involvement of systems L, A and y+L in placental Hcy transport. Such transport, by competing with endogenous amino acids for transporter activity, could have major implications for syncytiotrophoblast metabolism and function as well as fetal development. PMID:19564394

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

    USDA-ARS?s Scientific Manuscript database

    Classical scrapie is a natural prion disease of sheep in which the immediate postpartum period and, in particular, the placenta have long been known to play key roles in natural horizontal transmission. Goats, too, are a natural host of classical scrapie and are frequently raised with sheep; but the...

  15. Measures of blood loss and red cell transfusion targets for caesarean delivery complicated by placenta praevia.

    PubMed

    Boyle, Rhonda K; Waters, Barbara A; O'Rourke, Peter K

    2010-06-01

    The objective of this study was to assess the association between transfusion, per cent drop in haemoglobin (Hb), and estimated blood loss during the delivery and the first postoperative week following caesarean delivery for placenta praevia. Clinical data predictive of an objective laboratory test for risk of haemorrhage and the need for transfusion were investigated. Transfusions outside national Guidelines were noted. Retrospective observational study of patients with placenta praevia, who were delivered consecutively by caesarean section at Royal Brisbane and Women's Hospital from 1999 to 2005. University-affiliated tertiary hospital. All caesareans were performed by one or more consultant obstetricians, gynaecology oncology surgeons and registrar assistants. Seventy-one (28.9%) of 246 patients with placenta praevia were transfused, with 45 of these receiving three or more red cell units. The antenatal Hb fell by a mean of 20.2% (SD 13.5). The average operative haemorrhage was estimated as 1225 mL (SD 996). No patient or surgical factors were significantly associated with changes in Hb. There was a significant association between per cent fall in antenatal Hb and both transfusion P < 0.001 and estimated loss P = 0.002. After transfusion, the Hb of 19 patients was higher than that recommended by Guidelines. Whether transfusion is necessary, but not the number of red cell units, can be planned by the effect of haemorrhage on antenatal Hb during delivery by caesarean section complicated by placenta praevia.

  16. Molecular cloning and characterization of heparanase mRNA in porcine placenta throughout gestation

    USDA-ARS?s Scientific Manuscript database

    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...

  17. Draft genome sequence of a monokaryotic model brown-rot fungus Postia (Rhodonia) placenta SB12

    Treesearch

    Jill Gaskell; Phil Kersten; Luis F. Larrondo; Paulo Canessa; Diego Martinez; David Hibbett; Monika Schmoll; Christian P. Kubicek; Angel T. Martinez; Jagjit Yadav; Emma Master; Jon Karl Magnuson; Debbie Yaver; Randy Berka; Kathleen Lail; Cindy Chen; Kurt LaButti; Matt Nolan; Anna Lipzen; Andrea Aerts; Robert Riley; Kerrie Barry; Bernard Henrissat; Robert Blanchette; Igor V. Grigoriev; Dan Cullen

    2017-01-01

    We report the genome of Postia (Rhodonia) placenta MAD-SB12, a homokaryotic wood decay fungus (Basidiomycota, Polyporales). Intensively studied as a representative brown rot decayer, the gene complement is consistent with the rapid depolymerization of cellulose but not lignin.

  18. Thyrotropin-releasing hormone metabolism and extraction by the perfused guinea pig placenta

    SciTech Connect

    Nogimori, T.; Alex, S.; Baker, S.; Emerson, C.H.

    1985-08-01

    This report describes the extraction of synthetic TRH and its metabolic conversion in the perfused guinea pig placenta. These studies were performed to obtain an estimate of fractional fetal TRH losses through the placenta and to determine if some of these losses are due to TRH metabolism. Experiments were performed in which the perfusion buffer contained 0.01, 1, and 10 micrograms/ml or no synthetic TRH. In experiments in which TRH was perfused, the perfusion reservoir contents and placental effluent fractions were counted for TH, and TRH and deamido-TRH were determined by RIA. Similarly, cyclo(His-Pro) was measured when 10 micrograms/ml TRH were perfused. When synthetic TRH was perfused, steady state TRH concentrations were achieved in placental effluent fractions by 20-30 min. The single pass extraction of TRH by the placenta was 11.4 +/- 2.6% (mean +/- SE) compared to 56.9 +/- 7.0% for TH22O. No significant difference was detected regardless of whether 10, 1, or 0.01 micrograms/ml TRH were perfused. A portion of the TRH that perfused the placenta was converted to deamido-TRH at all concentrations of perfused TRH. The conversion of TRH to TRH-OH was 4.2 +/- 0.7% in a single pass. When the perfusion buffer was devoid of synthetic TRH, a small but significant increase in the content of TRH immunoreactivity was noted in the placental effluent compared to that in the perfusion reservoir.

  19. Identification and localization of netrin-4 and neogenin in human first trimester and term placenta.

    PubMed

    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. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  20. Differential transferrin expression in placentae from normal and abnormal pregnancies: a pilot study

    PubMed Central

    Kralova, Alena; Svetlikova, Marta; Madar, Jindrich; Ulcova-Gallova, Zdena; Bukovsky, Antonin; Peknicova, Jana

    2008-01-01

    Background The placenta is an important site for iron metabolism in humans. It transfers iron from the mother to the fetus. One of the major iron transport proteins is transferrin, which is a blood plasma protein crucial for iron uptake. Its localization and expression may be one of the markers to distinguish placental dysfunction. Methods In the experimental study we used antibody preparation, mass spectrometric analysis, biochemical and immunocytochemical methods for characterization of transferrin expression on the human choriocarcinoma cell line JAR (JAR cells), placental lysates, and cryostat sections. Newly designed monoclonal antibody TRO-tf-01 to human transferrin was applied on human placentae from normal (n = 3) and abnormal (n = 9) pregnancies. Results Variations of transferrin expression were detected in villous syncytiotrophoblast, which is in direct contact with maternal blood. In placentae from normal pregnancies, the expression of transferrin in the syncytium was significantly lower (p < 0.001) when compared to placentae from abnormal ones (gestational diabetes, pregnancy induced hypertension, drug abuse). Conclusion These observations suggest that in the case of abnormal pregnancies, the fetus may require higher levels of transferrin in order to prevent iron depletion due to the stress from the placental dysfunction. PMID:18597674

  1. Review: Public perspectives on the utilization of human placentas in scientific research and medicine.

    PubMed

    Yoshizawa, R S

    2013-01-01

    Placental tissues are frequently utilized by scientists studying pregnancy and reproduction and in diverse fields including immunology, stem cell research, genetics, cancer research, and tissue engineering, as well as by clinicians in many therapies. Though the utilization of the human placenta in science and medicine has benefitted many people, little is known about public perspectives of this phenomenon. This review addresses placental donation, collection, and utilization in science and medicine, focusing on public perspectives. Cultural values and traditions, ethical paradigms and concerns, public understandings of science and medicine, and political considerations may impact perceptions of the utilization of the placenta in science and medicine, but systematic study is lacking. It is argued that knowledge of public views gained from empirical investigation may underpin the development of collection protocols and research projects that are more responsive to public will, spur more extensive utilization in science and medicine of this unique organ, and/or aid in the realization of the mobilization of knowledge about the placenta for clinical and educational ends. New avenues for research on public perspectives of the placenta are proposed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. How Prenatal Depression, Anxiety, and Stress May Affect Child Outcome: The Placenta and Child Development

    ERIC Educational Resources Information Center

    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…

  3. The role of autophagy in the placenta as a regulator of cell death.

    PubMed

    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.

  4. Maternal Diet Modulates Placenta Growth and Gene Expression in a Mouse Model of Diabetic Pregnancy

    PubMed Central

    Kappen, Claudia; Kruger, Claudia; MacGowan, Jacalyn; Salbaum, J. Michael

    2012-01-01

    Unfavorable maternal diet during pregnancy can predispose the offspring to diseases later in life, such as hypertension, metabolic syndrome, and obesity. However, the molecular basis for this phenomenon of “developmental programming” is poorly understood. We have recently shown that a diet nutritionally optimized for pregnancy can nevertheless be harmful in the context of diabetic pregnancy in the mouse, associated with a high incidence of neural tube defects and intrauterine growth restriction. We hypothesized that placental abnormalities may contribute to impaired fetal growth in these pregnancies, and therefore investigated the role of maternal diet in the placenta. LabDiet 5015 diet was associated with reduced placental growth, commencing at midgestation, when compared to pregnancies in which the diabetic dam was fed LabDiet 5001 maintenance chow. Furthermore, by quantitative RT-PCR we identify 34 genes whose expression in placenta at midgestation is modulated by diet, diabetes, or both, establishing biomarkers for gene-environment interactions in the placenta. These results implicate maternal diet as an important factor in pregnancy complications and suggest that the early phases of placenta development could be a critical time window for developmental origins of adult disease. PMID:22701643

  5. The fetomaternal interface in the placenta of three species of armadillos (Eutheria, Xenarthra, Dasypodidae).

    PubMed

    Rezende, Lorenna C; Barbeito, Claudio G; Favaron, Phelipe O; Mess, Andrea; Miglino, Maria A

    2012-05-04

    Placental characters vary among Xenarthra, one of four supraordinal clades of Eutheria. Armadillos are known for villous, haemochorial placentas similar to humans. Only the nine-banded armadillo has been well studied so far. Placentas of three species of armadillos were investigated by means of histology, immunohistochemistry including proliferation marker, and transmission and scanning electron microscopy. The gross anatomy differed: Euphractus sexcinctus and Chaetophractus villosus had extended, zonary placentas, whereas Chaetophractus vellerosus had a disk. All taxa had complex villous areas within the maternal blood sinuses of the endometrium. Immunohistochemistry indicated the validity of former interpretations that the endothelium of the sinuses was largely intact. Tips of the villi and the columns entering the maternal tissue possessed trophoblast cell clusters with proliferation activity. Elsewhere, the feto-maternal barrier was syncytial haemochorial with fetal vessels near the surface. Differences among armadillos occurred in regard to the extension of the placenta, whereas the fine structure was similar. Parallels to the human suggest that armadillos are likely to be useful animal models for human placentation.

  6. The fetomaternal interface in the placenta of three species of armadillos (Eutheria, Xenarthra, Dasypodidae)

    PubMed Central

    2012-01-01

    Background Placental characters vary among Xenarthra, one of four supraordinal clades of Eutheria. Armadillos are known for villous, haemochorial placentas similar to humans. Only the nine-banded armadillo has been well studied so far. Methods Placentas of three species of armadillos were investigated by means of histology, immunohistochemistry including proliferation marker, and transmission and scanning electron microscopy. Results The gross anatomy differed: Euphractus sexcinctus and Chaetophractus villosus had extended, zonary placentas, whereas Chaetophractus vellerosus had a disk. All taxa had complex villous areas within the maternal blood sinuses of the endometrium. Immunohistochemistry indicated the validity of former interpretations that the endothelium of the sinuses was largely intact. Tips of the villi and the columns entering the maternal tissue possessed trophoblast cell clusters with proliferation activity. Elsewhere, the feto-maternal barrier was syncytial haemochorial with fetal vessels near the surface. Conclusions Differences among armadillos occurred in regard to the extension of the placenta, whereas the fine structure was similar. Parallels to the human suggest that armadillos are likely to be useful animal models for human placentation. PMID:22559925

  7. Regenerative efficacy of mesenchymal stromal cells from human placenta in sensorineural hearing loss.

    PubMed

    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.

  8. Prevalence of antepartum hemorrhage in women with placenta previa: a systematic review and meta-analysis

    PubMed Central

    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

  9. Human Oocyte-Derived Methylation Differences Persist in the Placenta Revealing Widespread Transient Imprinting

    PubMed Central

    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 t