Document Detail

Placental surface shape, function, and effects of maternal and fetal vascular pathology.
MedLine Citation:
PMID:  20933281     Owner:  NLM     Status:  MEDLINE    
GOAL: In clinical practice, variability of placental surface shape is common. We measure the average placental shape in a birth cohort and the effect deviations from the average have on placental functional efficiency. We test whether altered placental shape improves the specificity of histopathology diagnoses of maternal uteroplacental and fetoplacental vascular pathology for clinical outcomes.
MATERIALS AND METHODS: 1225 Placentas from a prospective cohort had chorionic plate digital photographs with perimeters marked at 1-2 cm intervals. After exclusions of pre-term (n = 202) and velamentous cord insertion (n = 44), 979 (95.7%) placentas were analyzed. Median shape and mean perimeter were estimated. The relationship of fetal and placental weight was used as an index of placental efficiency termed "β". The principal placental histopathology diagnoses of maternal uteroplacental and fetoplacental vascular pathologies were coded by review of individual lesion scores. Acute fetal inflammation was scored as a "negative control" pathology not expected to affect shape. ANOVA with Bonferroni tests for subgroup comparisons were used.
RESULTS: The mean placental chorionic shape at term was round with a radius estimated at 9.1 cm. Increased variability of the placental shape was associated with lower placental functional efficiency. After stratifying on placental shape, the presence of either maternal uteroplacental or fetoplacental vascular pathology was significantly associated with lower placental efficiency only when shape was abnormal.
CONCLUSIONS: Quantifying abnormality of placental shape is a meaningful clinical tool. Abnormal shapes are associated with reduced placental efficiency. We hypothesize that such shapes reflect deformations of placental vascular architecture, and that an abnormal placental shape serves as a marker of maternal uteroplacental and/or fetoplacental vascular pathology of sufficiently long standing to impact placental (and by extension, potentially fetal) development.
C M Salafia; M Yampolsky; D P Misra; O Shlakhter; D Haas; B Eucker; J Thorp
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-10-08
Journal Detail:
Title:  Placenta     Volume:  31     ISSN:  1532-3102     ISO Abbreviation:  Placenta     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-26     Completed Date:  2011-02-15     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  8006349     Medline TA:  Placenta     Country:  England    
Other Details:
Languages:  eng     Pagination:  958-62     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
Placental Analytics, LLC, 93 Colonial Avenue, Larchmont, NY 10538, USA.
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MeSH Terms
Cohort Studies
Fetal Weight
Image Processing, Computer-Assisted
Organ Size
Placenta / anatomy & histology*,  blood supply*,  physiology,  physiopathology
Placental Circulation / physiology*
Severity of Illness Index
Term Birth
Umbilical Cord
Vascular Diseases / pathology*,  physiopathology
Grant Support
Comment In:
Placenta. 2010 Nov;31(11):943   [PMID:  20952057 ]

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