Relationship Between Placental Shape, Cord Insertion, Lobes and Gestational Outcome

Nordenvall, Margareta; Sandstedt, Bengt; Ulmsten, Ulf

doi:10.3109/00016348809004273

Cited by 29 publications

(18 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Abnormal placental shapes, in particular those with irregular outlines (extrachorial and bilobate placenta) have been associated with poor obstetric outcome, in particular poor fetal growth. 119,120 These anomalies are difficult to diagnose in utero by ultrasound scanning and are not routinely investigated in pregnancies complicated by FGR.…”

Section: Abnormalities Of Placentationmentioning

confidence: 99%

“…Umbilical cord anomalies FGR has been associated with abnormalities of the umbilical cord insertion, ie: eccentric, marginal, or velamentous. 119,162 These anomalies are rare and often associated with abnormalities of the placental shape. Thus, there are no data supporting a direct link between the location of the umbilical cord insertion and poor fetal growth.…”

Section: Expert Reviewsmentioning

confidence: 99%

See 1 more Smart Citation

Pathophysiology of placental-derived fetal growth restriction

Burton

Jauniaux

2018

American Journal of Obstetrics and Gynecology

670

475

View full text Add to dashboard Cite

Placental-related fetal growth restriction arises primarily due to deficient remodeling of the uterine spiral arteries supplying the placenta during early pregnancy. The resultant malperfusion induces cell stress within the placental tissues, leading to selective suppression of protein synthesis and reduced cell proliferation. These effects are compounded in more severe cases by increased infarction and fibrin deposition. Consequently, there is a reduction in villous volume and surface area for maternal-fetal exchange. Extensive dysregulation of imprinted and nonimprinted gene expression occurs, affecting placental transport, endocrine, metabolic, and immune functions. Secondary changes involving dedifferentiation of smooth muscle cells surrounding the fetal arteries within placental stem villi correlate with absent or reversed end-diastolic umbilical artery blood flow, and with a reduction in birthweight. Many of the morphological changes, principally the intraplacental vascular lesions, can be imaged using ultrasound or magnetic resonance imaging scanning, enabling their development and progression to be followed in vivo. The changes are more severe in cases of growth restriction associated with preeclampsia compared to those with growth restriction alone, consistent with the greater degree of maternal vasculopathy reported in the former and more extensive macroscopic placental damage including infarcts, extensive fibrin deposition and microscopic villous developmental defects, atherosis of the spiral arteries, and noninfectious villitis. The higher level of stress may activate proinflammatory and apoptotic pathways within the syncytiotrophoblast, releasing factors that cause the maternal endothelial cell activation that distinguishes between the 2 conditions. Congenital anomalies of the umbilical cord and placental shape are the only placental-related conditions that are not associated with maldevelopment of the uteroplacental circulation, and their impact on fetal growth is limited.

show abstract

Section: Abnormalities Of Placentationmentioning

confidence: 99%

Section: Expert Reviewsmentioning

confidence: 99%

Pathophysiology of placental-derived fetal growth restriction

Burton

Jauniaux

2018

American Journal of Obstetrics and Gynecology

670

475

View full text Add to dashboard Cite

show abstract

“…Three theories have been proposed: first is the “blastocyst polarity” theory, which hypothesizes that aberrant insertion site results from malpositioning of the blastocyst during implantation, with consequent defective placental disk orientation [18]; the second is the “abnormal placental development because of decreased chorionic vessel branching” theory, which posits that noncentral insertion results from abnormal vasculogenesis in the placenta [19–21]; and the third one is the “trophotropism/placental migration” theory, which proposes that aberrant insertion develops later on during pregnancy when the placenta migrates toward sites of optimal perfusion [8]. Because of the early appearance of abnormal cord insertion during pregnancy, the latter theory has been excluded [20, 22].…”

Section: Introductionmentioning

confidence: 99%

Influence of the Umbilical Cord Insertion Site on the Optimal Individual Birth Weight Achievement

Brouillet

Dufour

Prot

et al. 2014

BioMed Research International

View full text Add to dashboard Cite

Study Question. To determine whether the umbilical cord insertion site of singleton pregnancies could be linked to the newborn birth weight at term and its individual growth potential achievement. Material and Methods. A cohort study including 528 records of term neonates was performed. Each neonate was assessed for growth adjusted for gestational age according to the infant's growth potential using the AUDIPOG module. We considered two categories of umbilical cord insertions: central and peripheral. Intrauterine growth restriction was defined as birth weight below the 10th percentile. Statistical analysis was performed using Chi-square, Student's t test, Wilcoxon test, ANOVA, and logistic regression. Results. We observed a total of 343 centrally inserted cords versus 185 peripheral cords. There were twice as many smokers in the mothers of the peripheral category compared to the centrally inserted ones. More importantly, we demonstrated that only 17/343 (5.0%) of infants with central cord insertion were growth restricted, compared to 37/185 (20.0%) of the infants born with a peripheral insertion. Neonates with centrally inserted cord were significantly heavier. Conclusion. The umbilical cord insertion site of singleton pregnancies is associated with the newborn's birth weight at term and its individual growth potential achievement.

show abstract

“…[14][15][16][17][18] Such work continues, and new visual morphometric tools are being used to demonstrate how morphologic and pathologic variation of the placenta can influence childhood growth and potentially other outcomes. [19][20][21] Understanding molecular features of cells responsible for placental function, though, holds additional promise in providing fundamental insights into the effects of environmental contaminants and their effects.…”

Section: The Placenta's Role In Dohadmentioning

confidence: 99%

Placental Epigenetics in Children's Environmental Health

Marsit

2015

Semin Reprod Med

View full text Add to dashboard Cite

There is a growing interest in understanding the mechanisms that drive the developmental origins of health and disease, and the role of epigenetic regulation has risen to the forefront of these studies. In particular, the placenta may be a model organ to consider as a mediator of the impact of the environment on developmental programming of children’s health, as this organ plays a critical role in directing development and regulating the fetal environment. Several recent studies have begun to examine how environmental toxicant exposures can impact the placental epigenome, focusing on studies of DNA methylation and microRNA expression. This review highlights several of these studies and emphasizes the potential the placenta may hold on the broader understanding of the impact of the intrauterine environment on long-term health.

show abstract

Relationship Between Placental Shape, Cord Insertion, Lobes and Gestational Outcome

Cited by 29 publications

References 14 publications

Pathophysiology of placental-derived fetal growth restriction

Pathophysiology of placental-derived fetal growth restriction

Influence of the Umbilical Cord Insertion Site on the Optimal Individual Birth Weight Achievement

Placental Epigenetics in Children's Environmental Health

Contact Info

Product

Resources

About