Frequency of factor VLeiden and prothrombin G20210A in placentas and their relationship with placental lesions

Vern, Tamara Z.; Alles, Ajit J.; Kowal-Vern, Areta; Longtine, Janina A.; Roberts, Drucilla J.

doi:10.1053/hupa.2000.16281

Cited by 79 publications

(57 citation statements)

References 42 publications

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“…Causes of FTV may include vascular stasis (e.g., umbilical cord occlusion or increased fetal venous pressure), damage to the vessel wall (e.g., severe or prolonged chorioamnionitis, villitis, or meconium exposure), or a hypercoagulable state (diabetic pregnancy, antiphospholipid antibody syndrome, and hereditary thrombophilia). A recent study has called attention to an apparent increase in FTV in twin placentas with and without TTT [30].…”

Section: Discussionmentioning

confidence: 99%

Placental Lesions Associated with Abnormal Growth in Twins

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Shah

Sakar

et al. 2001

Pediatric and Developmental Pathology

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Abnormal growth in one or both twins may contribute to the increased morbidity and mortality observed in twin gestation. Our objective in this retrospective study of all twin pregnancies delivered at our hospital (n = 240) over a 2-year period was to study the relationship between placental lesions and abnormal growth. Standardized placental examinations were performed in 192 cases (80%), which constituted the study population. Two growth abnormalities were studied: discordant growth as defined by > 15% difference in birth weight and small-for-gestational-age (SGA) birth as defined by birth weight less-than the 10th percentile for gestational age. The majority of twin pregnancies with either discordant growth (41/57 cases) or SGA birth (26/35 cases) had dichorionic placentas. In monochorionic placentas studied by injection there was no significant relationship between vascular anastomoses and discordant growth. Placental weight for small discordant and SGA twins was equivalent or increased relative to infant weight, a pattern not suggestive of maternal vascular underperfusion. Eight lesions, five considered to represent chronic placental disease and three considered to represent intrauterine adaptation, were studied as possible predictors of abnormal growth. The overall prevalence of these lesions in twin placentas was less than that seen in singleton births. Concordance between twin placentas for most lesions was higher than would be expected, based on their prevalence in singleton placentas. Two lesions were associated with discordant growth in both univariate and multivariate analyses: peripheral cord insertion (OR 3.6, 95% CI 1.7-7.6) and avascular villi (AV; OR 3.2, 95% CI 1.0-10.3). Three placental lesions were associated with SGA infants at the univariate level: peripheral cord insertion, avascular villi, and maternal vascular underperfusion. Only peripheral cord insertion (OR 9.8, 95% CI 4.1-23.4) and AV (OR 3.7, CI 1.0-13.7) were significant in the multivariate analysis. The relative increase in peripheral cord insertion and AV with abnormal growth was observed for both monochorionic and dichorionic placentas. Subgroups of discordant infants with and without SGA were both associated with peripheral cord insertion while only those with SGA had an increase in AV. Both peripheral cord insertion and AV were increased in the subgroup with SGA but no discordancy. In summary, two placental lesions, peripheral cord insertion indicating a spatially limited intrauterine compartment and AV indicating occlusion of fetal vessels in the placenta, were associated with abnormal growth in twins.

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Section: Discussionmentioning

confidence: 99%

Placental Lesions Associated with Abnormal Growth in Twins

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Shah

Sakar

et al. 2001

Pediatric and Developmental Pathology

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“…It is possible that the fetus and/or placenta may be particularly vulnerable to household air pollution exposures. Although most placental pathologic findings in the general population are not quantified, because most placentas do not receive a pathologic examination in the absence of pregnancy complications, one study reported the incidence of fetal thrombotic lesions to be 3% in 169 consecutively examined placentas (Vern et al 2000). In comparison, the frequency with which we observed FTV in the uppermost tertile of both PM 2.5 and CO exposure was remarkably high (15.4% and 21.1% respectively).…”

Section: Discussionmentioning

confidence: 64%

590: Placental pathology associated with household air pollution in a cohort of pregnant women from Dar es Salaam, Tanzania

Wylie

Matechi

Kishashu

et al. 2016

American Journal of Obstetrics and Gynecology

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for their efforts on behalf of the study. We thank the Massachusetts General Hospital (MGH) histology laboratory for help generating some of the slides. We gratefully acknowledge the time of our participants.Work Note to readers with disabilities: EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact ehponline@niehs.nih.gov. Our staff will work with you to assess and meet your accessibility needs within 3 working days. Placental Pathology Associated with Household Air Pollution in a Cohort of Pregnant Women from Dar es Salaam, Tanzania

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“…The second is the inconsistency of thrombophilia testing among studies. Many of the studies were retrospective and were thus limited to tests that had been chosen by the clinicians at the time [1,4,6,8,10,12]. Three studies limited their testing to genetic thrombophilias that could be directly diagnosed by DNA methodology [6,10,16].…”

Section: Discussionmentioning

confidence: 99%

Fetal Thrombotic Vasculopathy

Marsden

Comstock

2015

Journal of Fetal Medicine

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Fetal thrombotic vasculopathy (FTV) is the term used to encompass the histologic findings identified in placentas with fetal thrombotic lesions: occlusive and nonocclusive chorionic vessel thrombi, avascular villi in the distribution of a single villous tree, intramural vascular fibrin, and hemorrhagic endovasculitis. The underlying etiology of FTV is largely unknown though hypercoagulability and circulatory stasis have been the main focuses in the literature to explain the hemostatic abnormalities. This article reviews the literature in both defining and discussing, potential etiologies of FTV, as well as neonatal outcomes.

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Frequency of factor VLeiden and prothrombin G20210A in placentas and their relationship with placental lesions

Cited by 79 publications

References 42 publications

Placental Lesions Associated with Abnormal Growth in Twins

Placental Lesions Associated with Abnormal Growth in Twins

590: Placental pathology associated with household air pollution in a cohort of pregnant women from Dar es Salaam, Tanzania

Fetal Thrombotic Vasculopathy

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