Macroscopic lesions of maternal and fetal vascular malperfusion in stillborn placentas: Diagnosis in the absence of microscopic histopathological examination

Cersonsky, Tess E.K.; Silver, Robert M.; Saade, George R.; Dudley, Donald J.; Reddy, Uma M.; Pınar, Halit

doi:10.1016/j.placenta.2023.07.296

Cited by 2 publications

(1 citation statement)

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“…Placental MVM is associated with stillbirth with an odds ratio of 1.48 (95% CI, 1.30-1.69) in one recent report, 45 with similar results in prior studies [46][47][48] ; however, associated fetal anomalies are not described. Similarly, pregnancies complicated by fetal CHD have a higher risk of stillbirth with an adjusted OR 4.09 (95% CI 1.62-10.33) and one comprehensive study of stillbirths found CHD in 9.4% of the cohort 49 ; unfortunately, placental abnormalities are not reported in these studies, underscoring the disconnect in much of the research in CHD populations and that involving the placenta.…”

Section: High Rate Of Placental Pathologies With Fetal Chdsupporting

confidence: 79%

Interdependence of placenta and fetal cardiac development

Leon,

Bitar,

Rajagopalan

et al. 2024

Prenatal Diagnosis

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The placenta and fetal heart undergo development concurrently during early pregnancy, and, while human studies have reported associations between placental abnormalities and congenital heart disease (CHD), the nature of this relationship remains incompletely understood. Evidence from animal studies suggests a plausible cause and effect connection between placental abnormalities and fetal CHD. Biomechanical models demonstrate the influence of mechanical forces on cardiac development, whereas genetic models highlight the role of confined placental mutations that can cause some forms of CHD. Similar definitive studies in humans are lacking; however, placental pathologies such as maternal and fetal vascular malperfusion and chronic deciduitis are frequently observed in pregnancies complicated by CHD. Moreover, maternal conditions such as diabetes and pre‐eclampsia, which affect placental function, are associated with increased risk of CHD in offspring. Bridging the gap between animal models and human studies is crucial to understanding how placental abnormalities may contribute to human fetal CHD. The next steps will require new methodologies and multidisciplinary approaches combining innovative imaging modalities, comprehensive genomic testing, and histopathology. These studies may eventually lead to preventative strategies for some forms of CHD by targeting placental influences on fetal heart development.

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Section: High Rate Of Placental Pathologies With Fetal Chdsupporting

confidence: 79%