Pregnancy complications recur independently of maternal vascular malperfusion lesions

Christians, Julian K.; Muñoz, Mauricio Pastor

doi:10.1371/journal.pone.0228664

Cited by 15 publications

(8 citation statements)

References 51 publications

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“…Women who had characteristics of MVM identified during placental pathology had poor cardiovascular profiles, including higher blood pressure and atherogenic lipids more than a decade after delivery [32]. Additionally, if lesions occurred in a prior pregnancy, there is an increased likelihood of reoccurrence [33]. The inclusion of both prior preterm preeclamptics and nulliparous study subjects may explain our observed high frequency of any MVM lesion.…”

Section: Discussionmentioning

confidence: 86%

Placental Maternal Vascular Malperfusion Is Associated with Prepregnancy and Early Pregnancy Maternal Cardiovascular and Thrombotic Profiles

et al. 2022

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Characteristics of maternal vascular malperfusion (MVM) are frequently observed in placentas from pregnancies impacted by preeclampsia, intrauterine growth restriction, preterm labor, and intrauterine fetal demise. We sought to evaluate the associations of features of MVM with subclinical measures of cardiovascular health and coagulation potential in healthy young women. Sixty-three healthy young women were recruited and assessed prior to pregnancy on cycle day 9 ± 4, at gestational age 90 ± 6 of early pregnancy, and gestational age 216 ± 5 of late pregnancy. Women were assessed for plasma volume, blood pressure, response to volume loading, cardiac output, and uterine hemodynamics. Platelet-poor plasma was collected to assess thrombin generation on a subset of 33 women at all time points. Following delivery, placentas were collected and analyzed for evidence of MVM. Thrombin generation (TG) was evaluated in the presence of tissue factor (TF) with and without recombinant soluble thrombomodulin (TM). For each, we compared TG lagtime, peak level, and endogenous thrombin potential (ETP). Comparisons were made between dichotomized presence and absence of each individual feature of MVM and cardiovascular and coagulation features. Mean ± standard deviation are presented. Women were 31 ± 4 years of age, body mass index of 24 ± 5 kg/m2, 86% white race, and 80% nulliparous. MVM occurred in 70% of placentas, with infarcts and agglutination (44%), decidual arteriopathy (40%), accelerated villous maturation (32%), placental hypoplasia (29%), and distal villous hypoplasia (17%) documented. Decidual arteriopathy and distal villous hypoplasia were associated with prepregnancy maternal physiology, including decreased plasma volume and subclinical cardiovascular variations. All assessed MVM characteristics had identifiable early pregnancy physiologic characteristics consistent with altered cardiovascular function and decreased uterine response to pregnancy when compared with women who did and did not develop MVM. Accelerated villous maturation was the only MVM feature to differ by thrombin generation parameters in early pregnancy. Thrombin generation potential and blood pressure were elevated in late pregnancy in women who developed decidual arteriopathy. Prepregnancy health status and adaptation to pregnancy play important roles in pregnancy outcomes. Both cardiovascular health and thrombin generation potential may influence early placentation. Longitudinal assessment of subclinical maternal factors may allow for better understanding of the etiologies of MVM lesions, as well as allow for identification of a timeline of the origins of placental pathologies.

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Section: Discussionmentioning

confidence: 86%

Placental Maternal Vascular Malperfusion Is Associated with Prepregnancy and Early Pregnancy Maternal Cardiovascular and Thrombotic Profiles

et al. 2022

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“…Ten studies were marked as high risk of bias, six 41 , 42 , 43 , 44 , 45 , 46 of which failed to control for adequate confounding variables and four 47 , 48 , 49 , 50 which failed to sufficiently define their exposure variables. 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 Thirteen studies 14 , 17 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 were deemed to be of moderate risk of bias, with 16 studies deemed to be of low risk of bias 16 , 18 , 33 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ( Fig. 2 ).…”

Section: Resultsmentioning

confidence: 99%

Diabetic and hypertensive disorders following early pregnancy loss: a systematic review and meta-analysis

Dunne,

Foo,

Dachew

et al. 2024

eClinicalMedicine

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“…Основними патогенетичними механізмами перебігу як ПЕ, так і ожиріння є ендотеліальна дисфункція (ЕД) та системне запалення низької інтенсивності [5]. ЕД проявляється зменшенням вироблення ендотеліального оксиду азоту (NO), що зменшує ендотелій-залежну вазодилятацію, збільшенням оксидативного стресу, ініціюючого фактору ушкодження ендотелію з розвитком характерних симптомів ПЕ [6,7,8].…”

Section: вступunclassified

Peculiarities of Pregnancy Course in Women With Concomitant Obesity Who Take Therapeutic and Prophylactic Complex Aimed to Prevent Preeclampsia

Zelinka-Khobzey

2021

Act. Probl. of the Modern Med.

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The rapid growth in the incidence of overweight and obesity among women of childbearing age is posing specific issues related to their pregnancy, thereupon choosing adequate and effective tactics for the prevention of preeclampsia in women with concomitant obesity who are at high risk group for this complication is of undoubted relevance. The aim of this study is to assess the occurrence and characteristic of obstetric and prenatal complications in women with concomitant obesity, who receive therapeutic and prophylactic complex designed to prevent the development of preeclampsia. We studied the course of pregnancy of 255 women, who were divided into 3 groups according to the class of obesity, and then, in turn, were subdivided into subgroups taking into account the presence of preeclampsia and the therapeutic and prophylactic complex course. The high efficiency of the therapeutic and prophylactic complex including L-arginine and diosmin for obese women enables to reduce the manifestations of endothelial dysfunction, the occurrence of preeclampsia and its severe forms; to lower down the occurrence of other complications during the pregnancy (risks of premature birth, placental insufficiency, distress and foetal growth retardation); to avoid perinatal mortality and improve the condition of the foetus. Applying this pathogenetically grounded therapeutic and prophylactic complex we elaborated (acetylsalicylic acid, L-arginine, calcium supplements and semisynthetic diosmin) to prevent the occurrence of preeclampsia in pregnant women with concomitant obesity, who are at high-risk group, promotes the reduction of occurrence and intensity of obstetric and prenatal complications resulted from endothelial dysfunction. We can suggest the therapeutic and prophylactic complex for pregnant women with concomitant obesity as effective therapy because no cases of severe and early preeclampsia have been registered.

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Pregnancy complications recur independently of maternal vascular malperfusion lesions

Cited by 15 publications

References 51 publications

Placental Maternal Vascular Malperfusion Is Associated with Prepregnancy and Early Pregnancy Maternal Cardiovascular and Thrombotic Profiles

Placental Maternal Vascular Malperfusion Is Associated with Prepregnancy and Early Pregnancy Maternal Cardiovascular and Thrombotic Profiles

Diabetic and hypertensive disorders following early pregnancy loss: a systematic review and meta-analysis

Peculiarities of Pregnancy Course in Women With Concomitant Obesity Who Take Therapeutic and Prophylactic Complex Aimed to Prevent Preeclampsia

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