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Placenta is developed from syncytiotrophoblast cells after the differentiation of fertilized eggs. The placenta as a transient organ plays an essential role in metabolism, secretion and physical barrier in fetal growth and development. The material exchange between mother and fetus through the placenta is also a communication mechanism, which is the basis of fetal healthy development and maternal normal pregnancy. It has been suggested that ferroptosis as a unique way of cell death is related to the placental physiology and pathology. Especially in pathological pregnancy, with the decrease of antioxidant capacity and lipid peroxidation repair ability, the placenta is gradually damaged, eventually leading to placental diseases. To integrate the current literatures on ferroptosis and placental diseases, we review the effect of ferroptosis on placental diseases so as to provide the possibility of the new treatment and prevention for placental diseases. [ABSTRACT FROM AUTHOR]

Objective: To explore the diagnostic efficacy of prenatal transabdominal gray scale combined with color flow ultrasound for placental implantation diseases. Methods: A total of 62 pregnant women with placenta previa diagnosed by prenatal ultrasound in our hospital from November 2019 -- December 2021, including 44 pregnant women with placenta implantation. All pregnant women underwent transabdominal gray-scale examination, transabdominal color ultrasound and their combination to detect placental implantation diseases. The screening efficiency of transabdominal gray-scale ultrasound combined with color blood flow ultrasound on placental implantation diseases was evaluated by analyzing the screening results of placental implantation diseases. Results: (1) The sensitivity and specificity of detecting placental implantation by gray-scale ultrasound were 73.42 % and 86.54 %; (2) the sensitivity and specificity of detecting placental implantation by color ultrasound were 76.89% and 89.07 %; (3) the sensitivity and specificity of detecting placental implantation by abdominal gray-scale combined with color blood flow ultrasound were 87.79 % and 90.36 %; (4) The positive rates of transabdominal gray scale examination, transabdominal color ultrasound examination and their combined examination in the screening of placental implantation diseases were 56.45 %, 62.90 % and 67.74 % respectively. The positive rates of the two combined examinations in the screening of prenatal placental implantation diseases were significantly higher than those of transabdominal gray scale examination and transabdominal color ultrasound examination (P<0.05). (5) The sensitivity was 72.26 %, the specificity was 90.54 %, the positive ratio was 95.55 %, and the diagnostic odds ratio was 78.89 %. Conclusion: Transabdominal gray scale combined with multi-parameter color flow ultrasound has high sensitivity and specificity in the diagnosis of prenatal placenta implantation diseases, which is worthy of clinical application. [ABSTRACT FROM AUTHOR]

To study the effects of low molecular weight heparin on inflammatory response, liver function and expression of Bcl-2 and Bax proteins in preeclampsia rats. A total of 90 pregnant rats were randomly divided into normal pregnant group, preeclampsia group and treatment group, with 30 rats in each group. The rats in the preeclampsia group and the treatment group were subcutaneously injected with l-nitroarginine methyl ester [200 mg/ (kg d)] on the 13th day of gestation, and the rat model of preeclampsia was established. The normal pregnancy group was injected with the same dose of normal saline. The treatment group was treated with subcutaneous injection of low molecular weight heparin[ 40 滋L/(kg d)], and the rats in the preeclampsia group and normal pregnancy group were given the same dose of normal saline injections. Blood pressure, 24 h proteinuria, liver function index levels, serum inflammatory factor levels, and Bcl-2 and Bax protein expression levels in the placental tissues of the three groups were compared. The blood pressure level of the preeclampsia group and the treatment group on the 15th day of pregnancy and the 21st day of pregnancy was significantly higher than that of the normal pregnancy group, and the 24 h proteinuria on the 21st day of pregnancy was higher than that of the normal pregnancy group. The blood pressure and 24 h proteinuria of the treatment group on the 21st day of pregnancy were lower than those of the preeclampsia group (all P＜0.05). On the 21st day of gestation, alanine aminotransferase (ALT), aminotransferase (AST), interleukin-2 (IL-2), interleukin-6 (IL-6) and 酌-interferon (IFN-酌) in the preeclampsia group and the treatment group were significantly higher than those in the normal pregnancy group, and those in the treatment group were lower than those in the preeclampsia group (all P<0.05). The expression level of Bcl-2 protein in the placental tissues of the preeclampsia group and the treatment group were significantly lower than that of the normal pregnancy group, and the expression level of Bax protein was significantly higher than that of the normal pregnancy group. The expression level of Bcl-2 protein in the treatment group was significantly higher than that of the preeclampsia group, and the expression level of Bax protein was significantly lower than that of the preeclampsia group (all P<0.05). Low molecular weight heparin has a significant effect on blood pressure control in preeclampsia rats, and it is beneficial to improve liver function. The main mechanism may be related to inducing Th1/Th2 balance to develop towards Th2, and regulating Bcl-2 /Bax balance. [ABSTRACT FROM AUTHOR]

Giant placental hemangioma complicated with mirror syndrome is a rare obstetric pathological condition. Its pathogenesis is not clear at present. The disease develops rapidly and poor symptom control often indicates a poor prognosis, which will even endanger the lives of mothers and children. There are few reports on placental hemangioma with mirror syndrome at home and abroad, and there is no clinical guidelines for this disease, leading to insufficient understanding of the disease in clinical practice, delayed diagnosis, and poor treatment. A rare case of giant placental chorionic hemangioma with mirror syndrome is reported here. By learning this case report and literature review, we hope that we can realize the early diagnosis and treatment of such patients and improve the prognosis of mothers and children. [ABSTRACT FROM AUTHOR]

Objective To investigate the treatment strategies of implantable dangerous placenta previa, and to improve the success rate of maternal blood loss. Method The treatment methods of 23 cases from August 2012 to June 2014 with dangerous placenta previa were analyzed retrospectively. Results There was no patients died among this 23 cases. 3 cases of placenta implantation through bladder because of 3 times caesarean operation was given hysterectomy and surgical assist for repair of bladder; 5 cases were given hysterectomy because placenta implantation area is too wide. The remaining cases retained uterus successfully. The average blood loss was (1600 ± 558) mL. Duration of surgery was (94.8 ± 33.2) min. Conclusion Improving prenatal diagnosis rate and combining multi-disciplines, including obstetric anesthesiology, urology, interventional radiology, transfusion department, laboratory, etc. is a safe, effective and comprehensive treatment, and the key to successful operation of security. [ABSTRACT FROM AUTHOR]

Objective: To investigate the pathological characteristics of singleton placenta with abnormal shape and its influence on the outcome of maternal-fetal pregnancy. Methods: The clinicopathological data of singleton placentas with abnormal shape from January 2014 to December 2020 in the Department of Pathology, Haidian Maternal and Children Health Hospital were analyzed retrospectively. Results: There were 130 singleton placentas with abnormal shape in this cohort, including 48 succenturiate placentas, 12 bilobed placentas, 50 marginate placentas, 13 circumvallate placentas, 3 annular placentas, 2 membranous placentas and 2 fenestrated placentas. Gestational age ranged from 29 +5 to 40 +4 weeks. There were 51 cases of premature rupture of membranes, 11 cases of placenta previa, 5 cases of placental abruption, 15 cases of placental adhesion/implantation and 27 cases of postpartum hemorrhage. There were 46 preterm fetuses,28 fetuses with fetal growth restriction, 22 fetuses with intrauterine distress, and 1 fetus with intrauterine death. Grossly, the placental lobules of succenturiate placentas had apparent size difference, while two lobules of bilobate placenta were more consistent. The chorionic plate size was smaller than the bottom plate of circumvallate placenta, the folded fetal membrane in the rim of placenta was thickened (termed marginate placenta if there was no thickening). The membranous placenta was characterized by a thin, large membrane-like shape. Annular placenta showed characteristic hollow cylinder, ring or horseshoe-shape. Fenestrated placenta was characterized by tissue defects near central area. Microscopically, functional/morphologic changes were the main manifestations of inadequate maternal-fetal perfusion, including villous infarction, distal villous dysplasia and excessive villous maturation. Conclusions: The abnormal shaped singleton placentas showed variable extent of inadequate maternal-fetal perfusion, which may lead to adverse pregnancy outcomes such as premature delivery, fetal growth restriction, intrauterine distress or fetal death.

Many cases of placenta previa diagnosed during the early second-trimester have migrated toward the uterine fundus, but a few of them are still present at third-trimester and/or delivery. We name it as persistent placenta previa (PPP). Lots of index can used to predict PPP in second-trimester, such as:os-placenta distance, the low placental edge thickness, placenta localization, the specificity of ultrasound images, etc. But in these index, the os -placenta distance is the most convenient, accurate and feasible. Over all, the single index have limited value in predicting PPP,but the prediction is not much valuable. At present, the model which is combined with a number of indicators to predict PPP is insufficient. In this paper, we assess the predict value of PPP with a single index by ltrasonography, and prospect for the establishment of prediction model with multinomial index for predicting PPP. [ABSTRACT FROM AUTHOR]

Objective: To investigate the diagnostic value of MRI for placenta previa complicated with placenta accreta or not. Methods: A total of 220 placenta previa patients were diagnosed by prenatal ultrasound and MRI in The Second Affiliated Hospital of Wenzhou Medical University from May 2014 to May 2017.The MRI images of 220 placenta previa patients suspicious of placenta previa were interpreted by two radiologists who majored on gynecological radiology. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of two radiologists in diagnosis of placenta accreta were calculated respectively. Kappa test were used to verify the consistency between two doctors, as well as their MRI diagnosis and pathological results. The diagnostic value of MRI and pathological were assessed by Chi - square test and receiver operating characteristic (ROC)curve. Results: The 220 patients were all confirmed with placenta previa by surgical pathology.Out of 220, 71 cases were diagnosed as placenta accreta, and 149 cases were diagnosed without placenta accreta. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value with physician A and physician B were 90.1%/84.5%, 88.6%/89.9%, 89.1%/88.2%, 79.0%/80.0% and 95.0%/92.4%, respectively.The consistency between MRI diagnosis and pathological results was excellent in physician A (κ=0.759), and good in physician B (κ=0.734). However, the sensitivity, specificity and accuracy of diagnosis between two physicians had no significant difference (all P >0.05). The area under the curve (AUC) of ROC in physician A and B were 0.858 and 0.847 ( P =0.980). Conclusion: MRI is feasible for patients with placenta previa, as the sensitivity, specificity and accuracy of MRI are high in assessing whether placenta previa complicated with placenta accreta or not.

The investigation at 19 hospitals in 18 cities showed that the incidence of premature and low-birth-weight (LBW) infant in live births was 4.9% and 5.1% respectively. The mortality rate was as high as 85.5/1000 and 97.7/1000 and the deaths accounted for 45.9% and 54.5% of total neonatal deaths respectively. The male infant's mortality rate was higher than the female; the twins' and triplets' was higher than the single births'. The mortality was mainly attributed to the preterm, LBW and related diseases. The first six causes of deaths were respiratory diseases, prenatal asphyxia, infection, scleredema congenital malformation and intracranial hemorrhage. The approaches for reducing the mortality rate of premature and LBW infants were discussed.

The risk factors of low birth weight infant (LBW) were prospectively studied in 26,941 pregnant women. Investigations included sociodemographic risks, environmental behavioural conditions, medical diseases before pregnancy and current pregnancy complications. The adjusted odds ratios for various risk factors were calculated from multiple logistic regression model. In this analysis, placenta abnormalities uterine malformations and pregnancy-induced hypertension were shown to be the main risk factors. Preterm delivery occurred more frequently in women with diabetes and injuries in the third trimester. Term SGA babies were usually seen in women who had inadequate diet during pregnancy or in women with maternal heart disease. The risk factors of maternal age, educational background, parental smoking etc were less important than maternal diseases or pregnancy complications. The present study indicated prenatal care, started early with regular check-ups was mast important in preventing prematurity and LBW infant in China.