Placental surface shape, function, and effects of maternal and fetal vascular pathology.

Placental surface shape, function, and effects of maternal and fetal vascular pathology.

MedLine Citation:	PMID: 20933281 Owner: NLM Status: MEDLINE
Abstract/OtherAbstract:	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.

Authors:	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: 2011-11-01
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.
Affiliation:	Placental Analytics, LLC, 93 Colonial Avenue, Larchmont, NY 10538, USA. Carolyn.salafia@gmail.com
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MeSH Terms
Descriptor/Qualifier:	Algorithms Chorion Cohort Studies Female Fetal Weight Humans Image Processing, Computer-Assisted Organ Size Photography Placenta / anatomy & histology, blood supply, physiology, physiopathology Placental Circulation / physiology* Placentation Pregnancy Severity of Illness Index Term Birth Umbilical Cord Vascular Diseases / pathology*, physiopathology
Grant Support
ID/Acronym/Agency:	K23MH06785/MH/NIMH NIH HHS
Comments/Corrections
Comment In:	Placenta. 2010 Nov;31(11):943 [PMID: 20952057 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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