Preterm labor: placental pathology and clinical correlation

Germaín, A; Carvajal, Jorge; Sánchez, Marta; Valenzuela, Guillermo J.; Tsunekawa, Harumi; Chuaqui, B

doi:10.1016/s0029-7844(99)00324-5

Cited by 67 publications

(46 citation statements)

References 15 publications

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“…Regardless of these inconsistencies, these few reports implicate that PGE2 may play a role in regulating trophoblast cellular function and that dysregulation of PGE2 production at the gestational compartment may affect trophoblast invasion and migration that are critical for proper placentation (Pijnenborg et al , 1983; Pijnenborg et al , 1980). Moreover, dysregulation of PGE2 production within the gestational compartment has been linked to adverse birth outcomes such as intrauterine growth restriction, preeclampsia and preterm birth (Germain et al , 1999; Ness and Sibai, 2006). Because improper placentation is associated with adverse obstetrical complications (Brosens, 1977; Hustin et al , 1983; Kim et al , 2003), further investigation will be needed to ascertain the potential relevance of BDE-47 stimulation of PGE2 on trophoblast invasion and placental function.…”

Section: Discussionmentioning

confidence: 99%

“…Of these, prostaglandin E2 (PGE2) is one of the most extensively studied prostaglandins, and has been shown to play critical roles in processes required in successful pregnancy, for example, implantation (Psychoyos et al , 1995; Yee et al , 1993), immunoprotection of the semiallogenic conceptus (Parhar et al , 1988), and parturition (Keelan et al , 2003). Dysregulation of PGE2 production within the gestational compartment has been linked to adverse birth outcomes such as intrauterine growth restriction, preeclampsia and preterm birth (Germain et al , 1999; Ness and Sibai, 2006). Although it is not fully understood how dysregulated prostaglandin pathways lead to these adverse impacts, it is suggested that PGE2 regulates trophoblast cellular functions that are critical for successful placentation (Biondi et al , 2006; Horita et al , 2007a; Nicola et al , 2005a).…”

Section: Introductionmentioning

confidence: 99%

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Protective effect of (±)α-tocopherol on brominated diphenyl ether-47-stimulated prostaglandin pathways in human extravillous trophoblasts in vitro

Park

Loch‐Caruso

2015

Toxicology in Vitro

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Brominated diphenyl ether (BDE)-47 is a prevalent flame retardant chemical found in human tissues and is linked to adverse pregnancy outcomes in humans. Because dysregulation of the prostaglandin pathway is implicated in adverse pregnancy outcomes, the present study investigates BDE-47 induction of prostaglandin synthesis in a human extravillous trophoblast cell line, HTR-8/SVneo, examining the hypothesis that BDE-47 increases generation of reactive oxygen species (ROS) to stimulate the prostaglandin response. Treatment with 20 μM BDE-47 significantly increased mRNA expression of prostaglandin-endoperoxide synthase 2 (PTGS2) at 4, 12 and 24 h, and 24-h treatment significantly increased cyclooxygenase (COX)-2 cellular protein expression and prostaglandin E2 (PGE2) concentration in culture medium. The BDE-47-stimulated PGE2 release was inhibited by the COX inhibitors indomethacin and NS398, implicating COX activity. Exposure to 20 μM BDE-47 significantly increased ROS generation as measured by carboxydichlorofluorescein fluorescence, and this response was blocked by cotreatment with the peroxyl radical scavenger (±)-α-tocopherol. (±)-α-Tocopherol cotreatment suppressed BDE-47-stimulated increases of PGE2 release without significant effects on COX-2 mRNA and protein expression, implicating a role for ROS in post-translational regulation of COX activity. Because prostaglandins regulate trophoblast functions necessary for placentation and pregnancy, further investigation is warranted of BDE-47 impacts on trophoblast responses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Protective effect of (±)α-tocopherol on brominated diphenyl ether-47-stimulated prostaglandin pathways in human extravillous trophoblasts in vitro

Park

Loch‐Caruso

2015

Toxicology in Vitro

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“…Our current findings of higher blood pressure, higher lipids, and higher IMT are consistent with postpartum studies of women following pregnancies complicated by preeclampsia. 32,33 A third of normotensive PTBs are associated with placental abnormalities commonly found in preeclampsia, 34,35 suggesting some shared pathophysiology between these pregnancy complications that may be related to excess maternal CVD risk. In contrast to our current findings, Fraser et al recently reported that higher blood pressure assessed 18 years after preterm vs. term births in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort in England was explained by hypertension in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Prior Preterm Birth and Maternal Subclinical Cardiovascular Disease 4 to 12 Years After Pregnancy

Catov

Dodge

Barinas‐Mitchell

et al. 2013

Journal of Women's Health

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Background: We considered that women with prior preterm birth (PTB) would have evidence of subclinical atherosclerosis, endothelial dysfunction, and arterial stiffness. Methods: Four to 12 years after pregnancy, blood pressure and fasting lipids were analyzed, and women underwent evaluation, following standardized protocols, of carotid intima-media thickness (IMT), brachial flowmediated dilation (FMD), and pulse wave velocity (PWV). Women with prior preterm (< 37 weeks, n = 181) or term births (> = 37 weeks, n = 306) were compared. Those with preeclampsia or term small-for-gestational-age (SGA) births were excluded. Results: Women with a prior preterm vs. term birth had higher blood pressure, on average, and a more atherogenic lipid profile. They also had marginally higher IMT (0.579 standard error [SE] 0.005-vs. 0.567 [0.004] mm, p = 0.06), adjusted for body size, demographics, and smoking. IMT differences were greater among those with non-preeclamptic-indicated PTB (0.034 mm, p = 0.05) and PTB < 34 weeks (0.024 mm, p = 0.04) compared to those with term births. These differences appeared to be explained in part by the atherogenic lipid elevations in women with preterm birth. Women with prior PTB < 34 weeks tended to have lower FMD, but results were not statistically significant. PWV did not differ according to PTB. Conclusions: In the decade following pregnancy, women with non-preeclamptic-indicated PTB or PTB delivered before 34 weeks had higher blood pressure, atherogenic lipids, and IMT compared to women with term births. There may be subgroups of women with a prior PTB with excess cardiovascular risk that is detectable before overt clinical disease.

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“…It could differentiate between the very high risk which needs close fetal testing or even a more aggressive approach for intervention, versus a lower-risk population which does not need that intensive monitoring, as it is currently being used. An additional advantage is that this new method may be able to characterize changes in the fetoplacental blood flow and may provide additional information about the pathophysiology of conditions like, for example, preterm labor which might be associated with placental insufficiency [26]. Ongoing studies are now aimed at identifying obstetrical subgroups that may benefit the most from this new approach.…”

Section: Discussionmentioning

confidence: 99%

Spectral Doppler Index Mapping of the Umbilicoplacental Circulation and Pregnancy Outcome

Haberman

Bracero

Byrne³

2004

Gynecol Obstet Invest

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Objective: To determine the value of Doppler measurements obtained by a new multigate Doppler modality, the spectral Doppler index mapping (SDIM) technique, to predict adverse outcome among pregnant women with normal conventional umbilical artery (UA) Doppler indices. Design: A cross-sectional prospective cohort study. Subjects: 183 women with well-dated singleton pregnancies who underwent prenatal ultrasound examination between 18 and 40 weeks of gestation were included in the study. At the time of the initial Doppler examination, all patients had normal UA and uterine artery Doppler indices, size appropriate for gestational age, no evidence of fetal anomalies or fetal distress. Methods: SDIM data included the distribution curves of the pulsatility indices (PI) as well as the mean of the PI detected in the placenta and in the umbilical cord. The mean PI values were also calculated using conventional spectral Doppler sonography. Logistic regression analysis was used to control for gestational age while assessing various Doppler variables in predicting outcome. Results: Adverse outcomes occurred in 26.6% of the pregnancies. In pregnancies with adverse outcome, the umbilicoplacental PI gradient was significantly lower (0.10 vs. 0.28, p < 0.003), the maximum intraplacental PI value was higher (1.28 vs. 1.16, p = 0.031), and there was a greater proportion with skewed UA distribution curves. Using forward stepwise logistic regression to compare the predictive value of the conventional Doppler ultrasound with SDIM, we found that the most accurate predictors of adverse outcome were the maximum intraplacental PI value (p < 0.028), skewed distributions (p = 0.002) and the gradient between the umbilical and intraplacental PI distributions (p = 0.006). Conclusions: Our results suggest that the SDIM system may enhance the ability of Doppler technology to predict obstetrical outcomes in patients with normal UA Doppler indices.

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Preterm labor: placental pathology and clinical correlation

Abstract: Preterm labor resulting from infection or ischemia is associated with a higher perinatal complication rate than idiopathic preterm labor.

Cited by 67 publications

References 15 publications

Protective effect of (±)α-tocopherol on brominated diphenyl ether-47-stimulated prostaglandin pathways in human extravillous trophoblasts in vitro

Protective effect of (±)α-tocopherol on brominated diphenyl ether-47-stimulated prostaglandin pathways in human extravillous trophoblasts in vitro

Prior Preterm Birth and Maternal Subclinical Cardiovascular Disease 4 to 12 Years After Pregnancy

Spectral Doppler Index Mapping of the Umbilicoplacental Circulation and Pregnancy Outcome

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