Document Detail

The placenta in maternal hyperhomocysteinaemia.
MedLine Citation:
PMID:  10426649     Owner:  NLM     Status:  MEDLINE    
It is becoming increasingly apparent that mild or moderate hyperhomocysteinaemia may be associated with adverse perinatal complications and outcomes. The placental pathology in 14 pregnancies from 11 women diagnosed retrospectively to have hyperhomocysteinaemia, following a recent history of intrauterine fetal growth restriction, abruption or of thromboembolic disease, were reviewed. Most of the placental findings indicated abnormal placentation but these were not specific to maternal hyperhomocysteinaemia nor found in every placenta. Features observed included absence of trophoblast-induced physiological vascular changes, acute atherosis, intraluminal endovascular trophoblast in the third trimester, infarction, retroplacental haematoma formation and accelerated villous maturity. Uteroplacental vascular thrombosis was also seen. Three of the women had a subsequent pregnancy where they were treated empirically with folic acid, and these resulted in improved perinatal outcomes. The finding of placental pathology warrants investigation of the woman for hyperhomocysteinaemia. Further randomised controlled trials of folic acid supplementation in preventing pregnancy complications associated with hyperhomocysteinaemia should be conducted.
T Y Khong; W M Hague
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of obstetrics and gynaecology     Volume:  106     ISSN:  0306-5456     ISO Abbreviation:  Br J Obstet Gynaecol     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-08-11     Completed Date:  1999-08-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7503752     Medline TA:  Br J Obstet Gynaecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  273-8     Citation Subset:  AIM; IM    
Department of Histopathology, Adelaide Women's and Children's Hospital, Australia.
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MeSH Terms
Hematoma / etiology
Hyperhomocysteinemia / complications*,  pathology
Placenta / blood supply,  pathology
Placenta Diseases / etiology*
Pregnancy Complications / pathology
Retrospective Studies
Thrombosis / etiology,  pathology

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