Document Detail


Placental villous hypermaturation is associated with idiopathic preterm birth.
MedLine Citation:
PMID:  23130816     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Pregnancy complications such as intra-amniotic infection, preeclampsia, and fetal intrauterine growth restriction (IUGR) account for most cases of preterm birth (PTB), but many spontaneous PTB cases do not have a clear etiology. We hypothesize that placental insufficiency may be a potential cause of idiopathic PTB.
METHODS: Secondary analysis of 82 placental samples from women with PTB obtained from a multicenter trial of repeat versus single antenatal corticosteroids. Samples were centrally reviewed by a single placental pathologist masked to clinical outcomes. The histopathologic criterion for infection was the presence of acute chorioamnionitis defined as neutrophils marginating into the chorionic plate. Placental villous hypermaturation (PVH) was defined as a predominance of terminal villi (similar to term placenta) with extensive syncytial knotting. Idiopathic PTB comprised a group without another known etiology such as preeclampsia, IUGR or infection.
RESULTS: Acute chorioamnionitis was observed in 33/82 (40%) cases. Other known causes of PTB were reported in 18/82 (22%). The remaining 31/82 (38%) were idiopathic. The frequency of PVH in idiopathic PTB (26/31 = 84%) was similar to cases with IUGR or preeclampsia (16/18 = 89%), but significantly more common than PVH in the group with acute chorioamnionitis (10/33 = 30%) (p < 0.001).
CONCLUSIONS: PVH, which is a histologic marker of relative placental insufficiency, is a common finding in idiopathic PTB.
Authors:
Terry K Morgan; Jorge E Tolosa; Lisa Mele; Ronald J Wapner; Catherine Y Spong; Yoram Sorokin; Donald J Dudley; Alan M Peaceman; Brian M Mercer; John M Thorp; Mary Jo O'Sullivan; Susan M Ramin; Dwight J Rouse; Baha Sibai;
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Publication Detail:
Type:  Case Reports; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2012-12-12
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  26     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-05     Completed Date:  2014-01-09     Revised Date:  2014-07-02    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  647-53     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Chorioamnionitis / pathology
Female
Humans
Placenta / pathology*
Placental Insufficiency* / pathology
Pregnancy
Premature Birth / etiology*,  pathology
Retrospective Studies
Grant Support
ID/Acronym/Agency:
HD21410/HD/NICHD NIH HHS; HD21414/HD/NICHD NIH HHS; HD27860/HD/NICHD NIH HHS; HD27861/HD/NICHD NIH HHS; HD27869/HD/NICHD NIH HHS; HD27905/HD/NICHD NIH HHS; HD27915/HD/NICHD NIH HHS; HD27917/HD/NICHD NIH HHS; HD34116/HD/NICHD NIH HHS; HD34122/HD/NICHD NIH HHS; HD34136/HD/NICHD NIH HHS; HD34208/HD/NICHD NIH HHS; HD36801/HD/NICHD NIH HHS; HD40485/HD/NICHD NIH HHS; HD40500/HD/NICHD NIH HHS; HD40512/HD/NICHD NIH HHS; HD40544/HD/NICHD NIH HHS; HD40545/HD/NICHD NIH HHS; HD40560/HD/NICHD NIH HHS; K12 HD043488/HD/NICHD NIH HHS; M01-RR-000080/RR/NCRR NIH HHS; R24 HD050924/HD/NICHD NIH HHS; U10 HD053118/HD/NICHD NIH HHS; UL1 RR024989/RR/NCRR NIH HHS
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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