The role of placental examination and its pathology in obstetric risk management

Lavery, J. Patrick

doi:10.1002/jhrm.5600170304

Cited by 9 publications

(8 citation statements)

References 7 publications

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“…However, with multivariate analysis the placenta weight explains a big part of the variability of birth weight and its inclusion makes factors such as hemoglobin concentration, sex of the newborn, and number of deliveries of the mother, that had been significant in bivariate analysis, disappear. This suggests that the placenta is the means through which these factors have an effect on the birth weight [20].…”

Section: Discussionmentioning

confidence: 99%

Relation between Birth Weight and Placenta Weight

Sanı́n

López

Olivares³

et al. 2001

Neonatology

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With the goal to establish a model that relates birth weight to placenta weight, adjusted for the most documented predictors of birth weight, 300 live newborns were studied, all were products of single gestation. Inclusion criteria were newborns with gestational age of 37 weeks or older according to the date of last menstruation, whose mothers did not have diabetes mellitus, high blood pressure, pre-eclampsia, or eclampsia. The weight of the newborn was identified from the anthropometry data collected by previously trained nursing personnel in each of the participating hospitals. Immediately after delivery, the placenta was weighed. Multiple linear regression was used to see the effect of placenta weight and each variable on birth weight. The mean of birth weight was 3,369 g with a standard deviation (SD) of 445 g. Placenta weight had a mean of 537 g (SD: 96 g). The relation between the weight of the placenta and the birth weight was significant, and we found that for each gram increase in placenta weight, birth weight is increased by 1.98 g (SE = 0.25, p < 0.01) and this relation is not linear, since the quadratic term is significant. Placenta weight has a nonlinear relation to the birth weight and is an important predictor of birth weight. Together with the gestational age and the maternal age and size, it explains 32% of the variability of birth weight. Placenta weight can be a ‘sentinel’ indicator of nutritional and/or environmental problems.

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Section: Discussionmentioning

confidence: 99%

Relation between Birth Weight and Placenta Weight

Sanı́n

López

Olivares³

et al. 2001

Neonatology

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“…Ideally, every placenta should be examined by a pathologist; unfortunately, this is neither practical nor cost-effective. 14 In 1990, a "universal gross examination of the placenta" was suggested by the College of American Pathologists Consensus Conference, as a mechanism to establish pathologic criteria for triage, with extensive pathological studies performed only when the clinical circumstances warranted. 14 According to the Royal College of Pathologists' guideline, PCI should be categorized as central, paracentral, eccentric, marginal, or velamentous on gross examination with no objective measurements necessary.…”

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confidence: 99%

Abnormal Placental Cord Insertion and Adverse Pregnancy Outcomes: Results from a Prospective Cohort Study

et al. 2017

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Objectives To prospectively measure the distance from the placental cord insertion (PCI) site to the placental margin using digital imaging and to examine the association between abnormal PCI and adverse pregnancy outcomes in singleton pregnancies. Study Design This prospective cohort study examined 1,005 placentas from consecutively delivered singleton pregnancies in a tertiary center. Standardized images of each placenta were taken and digital measurement was performed using ImageJ software. Results The rates of velamentous (insertion into the membrane) and marginal (<2 cm from placental margin) cord insertions in a total of 1,005 singleton pregnancies were 3.6% (n = 36; 95% confidence interval [CI] = 2.5–4.9%) and 6.4% (n = 64; 95% CI = 4.9–8.1%), respectively. Abnormal PCI was found to be more common among smokers compared with non-smokers (22.7 vs. 14.8%, p = 0.04). Abnormal PCI was found to be significantly associated with small for gestational age (adjusted odds ratio [OR]: 1.73; 95% CI: 1.01–2.97, p = 0.047) and low birth weight (adjusted OR: 3.87; 95% CI: 1.72–8.71, p = 0.001). Conclusion Digital imaging analysis using ImageJ software mapped the surface of the placenta and provided objective measurement of PCI site. In this large prospective cohort, abnormal PCIs were significantly associated with an increased risk of small for gestational age and low birth weight.

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“…The report suggested that placentas should only be examined when there are significant maternal conditions, such as pre‐eclampsia, or neonatal conditions, such as prematurity and growth restriction. However, placental pathology now plays an important role in obstetric litigation and its role in assisting with medicolegal cases is well described 16,17,20,21 …”

Section: Discussionmentioning

confidence: 99%

“…Placental or umbilical pathology may identify the cause of death in 45–62% of fetal and perinatal autopsies 14,15 . The placenta is now becoming an important part of risk assessment in litigation cases and may provide valuable information regarding potential causes of neurological morbidity in the neonate 16,17 …”

Section: Introductionmentioning

confidence: 99%