Placenta Accreta Spectrum: Correlation between FIGO Clinical Classification and Histopathologic Findings

2021 ◽  
Author(s):  
Soroush Aalipour ◽  
Bahram Salmanian ◽  
Karin A. Fox ◽  
Steven Leigh Clark ◽  
Amir A. Shamshirsaz ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Wide Spectrum ◽  
Definitive Treatment ◽  
Future Research ◽  
Fisher Exact Test ◽  
Clinical Classification ◽  
Maternal Complications ◽  
Gynecology And Obstetrics ◽  
Placenta Accreta Spectrum ◽  
Histopathologic Findings

Objective Placenta accreta spectrum (PAS) covers a wide spectrum of placental adherence/invasion with varied clinical significance. Histopathologic examination is considered the confirmatory gold standard, but is only obtained sometime after definitive treatment. The International Federation of Gynecology and Obstetrics (FIGO) has published a new clinical classification that can be assigned at delivery, and we aimed to investigate the association between this new FIGO classification and histopathology and also to assess its correlation with maternal outcomes. Study Design We studied a retrospective cohort of 185 subjects with histopathologically proven PAS managed at our referral center between September 2012 and January 2019. Two experienced surgeons retrospectively reviewed charts and assigned the FIGO grading based on findings reported at delivery. A third experienced reviewer adjudicated to determine the classification used for final analysis. Categorical outcomes were compared with the use of chi-squared and the Fisher exact test, as appropriate. A multivariate model was designed to adjust outcomes in different FIGO groups for the involvement of a formal multidisciplinary management team. Results Among 185 subjects, there were 41 (22%) placenta accreta, 44 (24%) placenta increta, and 100 (54%) placenta percreta on histopathology. The inter-rater reliability was found to be substantial with Kappa = 0.661 (p < 0.001), and 95% confidence interval (CI): 0.449–0.872. There was a significant association between all histopathology groupings and the FIGO clinical classification (p < 0.001). However, we found no association between FIGO classifications and maternal complications. Conclusion The new FIGO clinical classification is strongly associated with histopathologic findings. A better understanding of the depth and extent of invasion as afforded by the clinical classification system will help standardize reporting and future research. Key Points

scholarly journals Soluble FMS-Like Tyrosine Kinase-1: Role in placenta accreta spectrum disorder

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 618
Author(s):  
Sarma Lumbanraja ◽  
M Rizki Yaznil ◽  
Andre M Siahaan ◽  
Bancin Berry Eka Parda
Keyword(s):  
Tyrosine Kinase ◽  
Placenta Accreta ◽  
Uterine Wall ◽  
Spectrum Disorder ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Gynecology And Obstetrics ◽  
Placenta Accreta Spectrum ◽  
Multi Center Study

Background: Placenta accreta is a pregnancy condition where the placenta's blood vessels attach too deeply to the uterine wall. Incidence of placenta accreta  is increasingly seen today as the rate of cesarean section increases, however, the exact pathophysiology of this condition is still not fully understood. Soluble fms-like tyrosine kinase-1  (sflt-1) as a protein produced by the placenta was found to be decreased in placenta accreta, Therefore we aim  to see if  sfltsFlt-1 has a role in the development of placenta accreta. Methods: This study involved 40 samples from patients that had been diagnosed with placenta accreta spectrum disorder (case group), and 40 samples from patients with normal pregnancies (control group)  at Rumah Skit Umum Pusat H.Adam Malik (RSUP) Haji Adam Malik Medan, in Indonesia.  Diagnosis of placenta accreta syndrome was based on Placenta Accreta Spectrum  Score (PAS), and International Federation of Gynecology and Obstetrics  (FIGO) classification of placenta accreta spectrum disorder.Analyses  were performed by independent t-test, man Mann-Whitney U test, and Kruskal-Wallis analysis test, with a P-value <0.05  considered as statistically significant (95%CI). Results: Based on this study, we found that the sFlt-1 level in the case group was lower than the control group. Data analysis using the Kruskal-Wallis test showed that there was a difference in sFlt-1 levels in this study group (p = 0.02), which was further evaluated  with post hoc analysis using Mann. -Whitney U test. The results indicated that there were significant differences between the control and PAS 0, PAS1, and PAS 2 (p = 0.043; p = 0.002; p = 0.03). Conclusion: sFlt-1 levels decreased in placental invasive pregnancies compared to normal pregnancies, however, this still needs to be investigated further in a multi-center study, considering that sFlt-1 levels are also influenced by ethnicity and other conditions that cannot be excluded in this study.

scholarly journals Soluble FMS-Like Tyrosine Kinase-1: Role in placenta accreta spectrum disorder

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 618
Author(s):  
Sarma Lumbanraja ◽  
M Rizki Yaznil ◽  
Andre M Siahaan ◽  
Bancin Berry Eka Parda
Keyword(s):  
Tyrosine Kinase ◽  
Placenta Accreta ◽  
Uterine Wall ◽  
Spectrum Disorder ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Gynecology And Obstetrics ◽  
Placenta Accreta Spectrum ◽  
Multi Center Study

Background: Placenta accreta is a pregnancy condition where the placenta's blood vessels attach too deeply to the uterine wall. Incidence of placenta accreta  is increasingly seen today as the rate of cesarean section increases, however, the exact pathophysiology of this condition is still not fully understood. Soluble fms-like tyrosine kinase-1  (sflt-1) as a protein produced by the placenta was found to be decreased in placenta accreta, Therefore we aim  to see if  sfltsFlt-1 has a role in the development of placenta accreta. Methods: This study involved 40 samples from patients that had been diagnosed with placenta accreta spectrum disorder (case group), and 40 samples from patients with normal pregnancies (control group)  at Rumah Skit Umum Pusat H.Adam Malik (RSUP) Haji Adam Malik Medan, in Indonesia.  Diagnosis of placenta accreta syndrome was based on Placenta Accreta Spectrum  Score (PAS), and International Federation of Gynecology and Obstetrics  (FIGO) classification of placenta accreta spectrum disorder.Analyses  were performed by independent t-test, man Mann-Whitney U test, and Kruskal-Wallis analysis test, with a P-value <0.05  considered as statistically significant (95%CI). Results: Based on this study, we found that the sFlt-1 level in the case group was lower than the control group. Data analysis using the Kruskal-Wallis test showed that there was a difference in sFlt-1 levels in this study group (p = 0.02), which was further evaluated  with post hoc analysis using Mann. -Whitney U test. The results indicated that there were significant differences between the control and PAS 0, PAS1, and PAS 2 (p = 0.043; p = 0.002; p = 0.03). Conclusion: sFlt-1 levels decreased in placental invasive pregnancies compared to normal pregnancies, however, this still needs to be investigated further in a multi-center study, considering that sFlt-1 levels are also influenced by ethnicity and other conditions that cannot be excluded in this study.

scholarly journals 588: Placenta accreta spectrum FIGO clinical classification in association with histopathological findings

2020 ◽  
Vol 222 (1) ◽  
pp. S377-S378
Author(s):  
Soroush Aalipour Birgani ◽  
Bahram Salmanian ◽  
Amir A. Shamshirsaz ◽  
Karin Anneliese Fox ◽  
Hadi Erfani ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Clinical Classification ◽  
Histopathological Findings ◽  
Placenta Accreta Spectrum

scholarly journals Soluble FMS-Like Tyrosine Kinase: Role in placenta accreta spectrum disorder

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 618
Author(s):  
Sarma Lumbanraja ◽  
M Rizki Yaznil ◽  
Andre M Siahaan ◽  
Bancin Berry Eka Parda
Keyword(s):  
Tyrosine Kinase ◽  
Placenta Accreta ◽  
Uterine Wall ◽  
Spectrum Disorder ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Gynecology And Obstetrics ◽  
Placenta Accreta Spectrum ◽  
Multi Center Study

Background: Placenta accreta is a pregnancy condition where the placenta's blood vessels attach too deeply to the uterine wall. Incidence of placenta accreta  is increasingly seen today as the rate of cesarean section increases, however, the exact pathophysiology of this condition is still not fully understood. Soluble fms-like tyrosine kinase-1  (sflt-1) as a protein produced by the placenta was found to be decreased in placenta accreta, Therefore we aim  to see if  sflt-1 has a role in the development of placenta accreta. Methods: This study involved 40 samples from patients that had been diagnosed with placenta accreta spectrum disorder (case group), and 40 samples from patients with normal pregnancies (control group)  at Rumah Skit Umum Pusat H.Adam Malik (RSUP) Haji Adam Malik Medan, in Indonesia.  Diagnosis of placenta accreta syndrome was based on Placenta Accreta Spectrum  Score (PAS), and International Federation of Gynecology and Obstetrics  (FIGO) classification of placenta accreta spectrum disorder.Analyses  were performed by independent t-test, man Whitney U test, and Kruskal-Wallis analysis test, with a P-value <0.05  considered as statistically significant (95%CI). Results: Based on this study, we found that the sFlt-1 level in the case group was lower than the control group. Data analysis using the Kruskal-Wallis test showed that there was a difference in sFlt-1 levels in this study group (p = 0.02), which was further evaluated  with post hoc analysis using Mann. Whitney U test. The results indicated that there were significant differences between the control and PAS 0, PAS1, and PAS 2 (p = 0.043; p = 0.002; p = 0.03). Conclusion: sFlt-1 levels decreased in placental invasive pregnancies compared to normal pregnancies, however, this still needs to be investigated further in a multi-center study, considering that sFlt-1 levels are also influenced by ethnicity and other conditions that cannot be excluded in this study.

Phytochemical, Pharmacological Activities and Ayurvedic Significances of Magical Plant Mimosa pudica Linn

2020 ◽  
Vol 17 ◽  
Author(s):  
Vijay Kumar
Keyword(s):  
Therapeutic Potential ◽  
Wide Spectrum ◽  
Chemical Constituents ◽  
Future Research ◽  
Mimosa Pudica ◽  
Pharmacological Activities ◽  
Medicinal Uses ◽  
Traditional Medicines ◽  
Crude Extracts ◽  
Anti Cancer

: Mimosa pudica Linn is an integrated part of Traditional Medicines Systems of India, China, Africa, Korea and America. It has been used from centuries in traditional medicines to cure different diseases like fever, diabetes, constipation, jaundice, ulcers, biliousness, and dyspepsia. It is an important ingredient of wide class of herbal formulations. To assess the scientific evidence for therapeutic potential of Mimosa pudica Linn and to identify the gaps for future research. The available information on the ethno-medicinal uses, phytochemistry, pharmacology and toxicology of Mimosa pudica Linn was collected via a library and electronic searches in Sci-Finder, Pub-Med, Science Direct, Google Scholar for the period, 1990 to 2020. In traditional medicinal systems, variety of ethno-medicinal applications of Mimosa pudica Linn has been noticed. Phytochemical investigation has resulted in identification of 40 well known chemical constituents, among which alkaloids, phenols and flavionoids are the predominant groups. The crude extracts and isolates have exhibited a wide spectrum of in vitro and in vivo pharmacological activities including anti-cancer, anti-inflammation, osteoporosis, neurological disorders, hypertension etc.. To quantify the Mimosa pudica Linn and its formulations, analytical techniques like HPLC and HPTLC has shown dominancy with good range of recovery and detection limit. Mimosa pudica Linn is the well-known herb since an ancient time. The pharmacological results supported some of the applications of Mimosa pudica Linn in traditional medicine systems. Perhaps, the predominance of alkaloids, phenols and flavionoids are responsible for the pharmacological activities the crude extracts and isolates of Mimosa pudica Linn. Further, there is need to isolate and evaluate the active chemical constituents of Mimosa pudica Linn having significant medicinal values. In future, it is important to study the exact mechanism associated with the phytochemicals of Mimosa pudica Linn especially on anti-cancer activities. Notably, toxicity studies on Mimosa pudica Linn are limited which are to be explored in future for the safe application of Mimosa pudica Linn and its formulations.

scholarly journals 803 Short interpregnancy interval and placenta accreta spectrum

2021 ◽  
Vol 224 (2) ◽  
pp. S500
Author(s):  
Hannah McLaughlin ◽  
Ashley E. Benson ◽  
Morgan Scaglione ◽  
Jane Saviers-Steiger ◽  
Dana R. Canfield ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Interpregnancy Interval ◽  
Placenta Accreta Spectrum ◽  
Short Interpregnancy Interval

scholarly journals A comprehensive review of the influences of nanoparticles as a fuel additive in an internal combustion engine (ICE)

2020 ◽  
Vol 9 (1) ◽  
pp. 1326-1349
Author(s):  
Siti Nurul Akmal Yusof ◽  
Nor Azwadi Che Sidik ◽  
Yutaka Asako ◽  
Wan Mohd. Arif Aziz Japar ◽  
Saiful Bahri Mohamed ◽  
...  
Keyword(s):  
Combustion Engine ◽  
Wide Spectrum ◽  
High Energy ◽  
Combustion Efficiency ◽  
Fuel Properties ◽  
Future Research ◽  
Biodiesel Fuel ◽  
Fuel Additive ◽  
Engine Combustion ◽  
Research Findings

Abstract Nanofluid is a colloidal mixture consisting of nano-sized particles dispersed in a liquid medium. It improves heat transfer properties and promotes high energy efficiency in a wide spectrum of engineering applications. In recent years, particularly in the automotive industry, the addition of nanofluid in diesel/biodiesel as an additive for ICE has become an attractive approach to promote enhanced combustion efficiency and emission reduction due to their superior thermophysical properties. Many researchers have previously demonstrated that the addition of nanoparticles in diesel/biodiesel fuel improved the overall engine combustion characteristics. As a whole, this study aims to summarize the recent research findings related to the effect of nanoparticles on the fuel properties and engine combustion efficiency. Furthermore, different types of additive blended with varying fuel properties are also compared and discussed. Lastly, the advantages and prospects of using nanofluid as an additive fuel are summarized for future research opportunities.

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