A history of placental dysfunction and risk of placental abruption

Rasmussen,; Irgens,; Dalaker,

doi:10.1046/j.1365-3016.1999.00159.x

Cited by 101 publications

(84 citation statements)

References 37 publications

(55 reference statements)

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“…Furthermore, previous caesarean delivery is also known to be associated with an increased risk of abnormal placentation leading to abruption, placenta praevia, and morbid adherence of the placenta. [8][9][10] Stillbirth is associated with a high resistance pattern of uterine artery and umbilical artery blood flow, which may indicate maldevelopment of the villous tree. [32][33][34] The association between previous caesarean and stillbirth might be, therefore, another manifestation of abnormal placentation caused by a uterine scar.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 However, it has also been noted that placental complications, such as abruption and placenta praevia, are more common in women who have previously undergone caesarean section, 8,9 and the association with abruption has been observed in women with no previous history of abruption and is independent of obvious confounders. 10 The effect of previous caesarean delivery on the risk of antepartum perinatal death in subsequent pregnancies is not known. We did a large-scale, retrospective, cohort study to establish whether caesarean delivery in a first pregnancy was associated with an increased risk of antepartum stillbirth in the second.…”

Section: Introductionmentioning

confidence: 99%

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Caesarean section and risk of unexplained stillbirth in subsequent pregnancy

2003

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Glasgow ePrints Servicehttp://eprints.gla.ac.uk SummaryBackground Caesarean section is associated with an increased risk of disorders of placentation in subsequent pregnancies, but effects on the rate of antepartum stillbirth are unknown. We aimed to establish whether previous caesarean delivery is associated with an increased risk of antepartum stillbirth.Methods We linked pregnancy discharge data from the Scottish Morbidity Record (1980-98) and the Scottish Stillbirth and Infant Death Enquiry . We estimated the relative risk of antepartum stillbirth in second pregnancies using timeto-event analyses.Findings For 120 633 singleton second births, there were 68 antepartum stillbirths in 17 754 women previously delivered by caesarean section (2·39 per 10 000 women per week) and 244 in 102 879 women previously delivered vaginally (1·44; p<0·001). Risk of unexplained stillbirth associated with previous caesarean delivery differed significantly with gestational age (p=0·04); the excess risk was apparent from 34 weeks (hazard ratio 2·23 [95% CI 1·48-3·36]). Risk was not attenuated by adjustment for maternal characteristics or outcome of the first pregnancy (2·74 [1·74-4·30]). The absolute risk of unexplained stillbirth at or after 39 weeks' gestation was 1·1 per 1000 women who had had a previous caesarean section and 0·5 per 1000 in those who had not. The difference was due mostly to an excess of unexplained stillbirths among women previously delivered by caesarean section.Interpretation Delivery by caesarean section in the first pregnancy could increase the risk of unexplained stillbirth in the second. In women with one previous caesarean delivery, the risk of unexplained antepartum stillbirth at or after 39 weeks' gestation is about double the risk of stillbirth or neonatal death from intrapartum uterine rupture.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Caesarean section and risk of unexplained stillbirth in subsequent pregnancy

2003

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“…It has been shown that a history of placental dysfunction, identified by previous small for gestational age or preterm birth, is associated with an increased risk of placental abruption. 13 Similarly, a pregnancy following placental abruption has an increased risk of recurrence, with an excess risk of small for gestational age, preterm birth. 14 Placentas of thrombophilic women have been characterized by an increased rate of vascular damage, multiple infarcts and fibrinoid necrosis.…”

Section: Commentmentioning

confidence: 99%

Low birthweight in relation to placental abruption and maternal thrombophilia status

Nath

Ananth

Demarco

et al. 2008

American Journal of Obstetrics and Gynecology

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Objective: To evaluate whether the association between low birthweight and placental abruption is mediated through preterm birth or restricted fetal growth, and if these associations were influenced by maternal thrombophilia status.Study design: Data were derived from the New Jersey-Placental Abruption Study, an ongoing, multicenter, case-control study conducted in New Jersey since August 2002. Abruption cases (n=156) were identified based on a clinical diagnosis, and controls (n=170) were matched to cases based on parity and maternal race. Low birthweight (<2500 g) was stratified based on preterm birth (<37 weeks gestation) and small for gestational age (birthweight <10 th centile for gestational age). Maternal thrombophilia assessment was based on serum evaluation (Protein C and S deficiency, activated Protein C resistance ratio, and anticardiolpin antibodies) as well as genetic polymorphisms (methylenetetrahydrofolate reductase, prothrombin gene, and Factor V Leiden). Associations were expressed based on odds ratio (OR) with 95% confidence interval (CI).Results: Among abruption cases, 60.3% (n=94) were low birthweight in comparison to 11.2% (n=19) of controls (OR 13.7, 95% CI 7.4, 25.2). Furthermore, placental abruption had a significantly increased association with preterm birth in both SGA (OR 17.4, 95% CI 4.6, 64.9) and appropriately grown fetuses (OR 15.8, 95% CI 8.4, 29.8). However, the association between abruption and low birthweight were similar between women with and without thrombophilia. Conclusion:The association between placental abruption and low birthweight is chiefly mediated through preterm birth, and this association does not appear to be modified by maternal thrombophilia status. KeywordsPlacental abruption; fetal growth restriction; preterm birth; maternal thrombophilia Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptAm J Obstet Gynecol. Author manuscript; available in PMC 2009 March 1. NIH-PA Author ManuscriptPlacental abruption is a major cause of perinatal morbidity and mortality, with mortality rates ranging between 2% and 67%, depending on factors such as the gestational age, fetal weight and degree of premature placental separation. 1 Several studies have reported that placental abruption is associated with low birthweight, preterm birth and intrauterine growth restriction. 2-4 However, low birthweight, itself, is a heterogeneous pregnancy endpoint and may be the result of preterm birth or fetal growth restriction. 5Placental abruption has been associated with vascular placental or decidual lesions. ...

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“…It was to become 336 millions by 2030 [2]. Chronic hypertension and diabetes mellitus may cause or aggravate such dysfunction thus causing placental abruption [3]. Placenta is the organ within the uterus by means of which the embryo is attached to the wall of the uterus.…”

Section: Introductionmentioning

confidence: 99%

Histogram Based Classification of Ultrasound Images of Placenta

Malathi¹,

Shanthi²

2010

IJCA

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In this paper, the authors have made an attempt to classify the placenta based on the intensity level of histogram of the ultrasound images of placenta. The medical images are usually low in resolution. Specialized tools are required to assist the medical experts in medical image diagnosis and for further treatment. The image histogram is used to classify the ultrasound images of placenta into normal and abnormal placenta using k nearest neighbor classifier. It is further used to analyze the complications of gestational diabetes mellitus on the growth of the placenta.

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A history of placental dysfunction and risk of placental abruption

Cited by 101 publications

References 37 publications

Caesarean section and risk of unexplained stillbirth in subsequent pregnancy

Caesarean section and risk of unexplained stillbirth in subsequent pregnancy

Low birthweight in relation to placental abruption and maternal thrombophilia status

Histogram Based Classification of Ultrasound Images of Placenta

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