1. Placenta Pathology From Term Born Neonates With Normal or Adverse Outcome
- Author
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Louis Bont, Hein W. Bruinse, Hens Aa Brouwers, Ewoud Schuit, Annemieke C. C. Evers, Anneke Kwee, Peter G. J. Nikkels, and Michiel L. Houben
- Subjects
Male ,medicine.medical_specialty ,Placenta Diseases ,Term Birth ,Adverse outcomes ,Perinatal Death ,Placenta ,Umbilical cord ,Pathology and Forensic Medicine ,Pregnancy ,Parenchyma ,Odds Ratio ,medicine ,Humans ,Prospective Studies ,reproductive and urinary physiology ,Netherlands ,business.industry ,Obstetrics ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,General Medicine ,Stillbirth ,Prognosis ,Term (time) ,Logistic Models ,medicine.anatomical_structure ,Case-Control Studies ,embryonic structures ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
Background The incidence of umbilical cord or placental parenchyma abnormalities associated with mortality or morbidity of term infants is lacking. Methods Placentas of 55 antepartum stillbirths (APD), 21 intrapartum stillbirths (IPD), 12 neonatal deaths (ND), and 80 admissions to a level 3 neonatal intensive care unit (NS) were studied and compared with 439 placentas from neonates from normal term pregnancies and normal outcome after vaginal delivery (NPVD) and with 105 placentas after an elective caesarian sections (NPEC). Results NPVD and NPEC placentas showed no or one abnormality in 70% and placentas from stillbirth showed two or more abnormalities in 80% of cases. APD placentas more frequently had a low weight and less formation of terminal villi. Hypercoiling was more often present in all study groups. Severe chronic villitis was almost exclusively present in APD placentas. Chorioamnionitis was significantly more frequent in APD, IPD and NS placentas and funisitis was more often observed in IPD and NS placentas. Conclusion Multiple placental abnormalities are significantly more frequent in placentas from term neonates with severe perinatal morbidity and mortality. These placental abnormalities are thought to be associated with disturbed oxygen transfer or with inflammation.
- Published
- 2021