Placental pathology in antiphospholipid syndrome

Lupus ◽  
1998 ◽  
Vol 7 (2_suppl) ◽  
pp. 81-85 ◽  
Author(s):  
RA Levy ◽  
E Avvad ◽  
J Oliveira ◽  
LC Porto
Keyword(s):  
Differential Diagnosis ◽  
Antiphospholipid Syndrome ◽  
Fetal Loss ◽  
Fetal Outcome ◽  
Histopathological Study ◽  
Pregnancy Induced Hypertension ◽  
Placental Pathology ◽  
Induced Hypertension ◽  
Immunohistochemical Studies ◽  
Acute Atherosis

One of the major targets of antiphospholipid antibodies (aPL) is the placenta, the evolution of which during pregnancy has been well documented. Histopathological findings are related to gestational age, and several physiologic and pathologic alterations that occur during its development. The major findings in placentae from aPL positive patients are thrombosis, acute atherosis, a decreased number of syncytio-vascular membranes, increased number of syncytial knots and obliterative arteriopathy. These findings are not specific to the antiphospholipid syndrome (APS) and sometimes do not correlate with the fetal outcome. Histopathological study of placentae may elucidate mechanisms of action of aPL in fetal loss and other obstetric complications. In addition, it may assist in the investigation of the differential diagnosis between APS and pregnancy-induced hypertension. Immunohistochemical studies of local placental proteins contribute to this differential diagnosis.

scholarly journals Birth Outcomes among Diabetic Mothers Who Delivered in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bajrond Eshetu ◽  
Yitagesu Sintayehu ◽  
Bazie Mekonnen ◽  
Woreknesh Daba
Keyword(s):  
Diabetes Mellitus ◽  
Preterm Delivery ◽  
Birth Outcomes ◽  
Fetal Outcome ◽  
Maternal Outcomes ◽  
Pregnancy Induced Hypertension ◽  
Class I Obesity ◽  
Induced Hypertension ◽  
History Of ◽  
Diabetic Mothers

Introduction. Diabetes develops in 4% of all the pregnancies worldwide, and its prevalence ranges from 1 to 14%, and 7% are complicated and results in prenatal morbidity and mortality. The disease affects women and their babies during pregnancy, labor, and delivery. However, little is known about its prevalence, birth outcomes, and associated factors in the study setting. Method. A facility-based retrospective cross-sectional study was done on all deliveries attended from January 1, 2015, to December 31, 2017, to determine the prevalence of diabetes and birth outcome. The mothers who had complete data record were identified and consecutively reviewed. The data were entered in EpiData Version 4.2 and exported to SPSS Version 23.0 for analysis. Results. Of the 14039 women who gave birth during the study period, 2.6% of them had diabetes mellitus, and from reviewed data, 54.6% had gestational diabetes and 45.4% had pregestational diabetes. Out of the diabetic mothers, 57.8% delivered by cesarean section, 39.9% by spontaneous vaginal delivery, and 26% of the pregnancies ended up with pregnancy-induced hypertension. Regarding the fetal outcome, 17.9% were preterm delivery, 17.6% macrocosmic, 9.2% respiratory distress, 10.1% low birth weight, and 65% admitted to neonatal intensive care unit. Class I obesity and history of PIH were associated with adverse maternal outcomes at aOR = 95%CI 3.8 (1.29, 8.319) and aOR = 95%CI 2.1 (1.03, 4.399), respectively. Being a house wife and preterm deliveries were associated with adverse fetal outcomes at aOR = 95%CI 2.117 (1.315, 3.405) and aOR = 95%CI 9.763 (4.560, 20.902), respectively. Conclusion. The prevalence of diabetes mellitus delivered in the hospital was 2.6%. Class I obesity and previous history of pregnancy-induced hypertension were significantly associated with adverse maternal outcomes, whereas preterm delivery and being housewife were associated with adverse fetal outcome.

scholarly journals Doppler ultrasound of umbilical artery in prediction of fetal outcome in pregnancy induced hypertension Sudanese population

2019 ◽  
Vol 8 (1) ◽  
pp. 96
Author(s):  
Rihab A. Yousif ◽  
Awadia G. Suliman ◽  
Raga A. Aburaida ◽  
Ibrahim M. Daoud ◽  
Naglaa E. Mohammed
Keyword(s):  
Flow Velocity ◽  
Umbilical Artery ◽  
Fetal Outcome ◽  
Fetal Mortality ◽  
Pregnancy Induced Hypertension ◽  
Diastolic Flow ◽  
Induced Hypertension ◽  
The Mean ◽  
Doppler Indices ◽  
In Pregnancy

The pregnancy induced hypertension increase the fetal mortality and morbidity and the using of Doppler umbilical artery indices decrease the fetal mortality and morbidity however, there is few complete data about the most frequently altered Doppler US parameters to predict fetal outcome in pregnancy induced hypertension . Methods This ia cohort prospective study done in two hundred and six women of second and third trimester presenting to antenatal clinic in Soba University Hospital at the department of Obstetrics & Gynecology, in the fetus unit and critical pregnancy in the period From June 2008 to April 2013 to assess the Doppler indices of umbilical artery in pregnancy induced hypertension for prediction of prenatal outcome; 105 pregnancy induced hypertension patients and 101 women with uneventful pregnancies as normal control group included in this study . Baseline investigations and color Doppler of umbilical artery were done. Statistical analysis of data were done using SPSS, Receiver Operating Characteristic (ROC) curve analysis was performed and the area under the curve (AUC) used to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of umbilical artery Doppler indices to predict fetal outcome.Results The study determine that there was significant difference in Doppler indices in PIH and control group ( p<0.01, the mean indices of umbilical artery is higher in PIH group compared with normal pregnancy group , the mean different of S/D ratio was 0.40, mean difference of RI was 0.06 and the mean different of PI index was 0.16, high percentage of adverse fetal outcome had been reported in in Pregnancy Induced Hypertension group than in control , which was more in absent and reversed flow velocity in umbilical artery in Pregnancy Induced Hypertension compared with group of Pregnancy Induced Hypertension with present end diastolic flow velocity. Systolic/Diastolic ratio was most accurate in predicting adverse outcome in pregnancy induced hypertension patients, followed by the Pulastility index then the Resistance index (75%, 66% and 57% respectively).ConclusionThis study concluded that pregnancy induced hypertension leads to worsen placental insufficiently, which appears on the higher Doppler indices of umbilical artery to PIH patients when compared with normal pregnancy. A low diastolic flow and higher indices characterized the pregnancies with abnormal outcomes. Doppler of the umbilical artery was useful to predict fetal well being in PIH patients, high percentage of adverse fetal outcome had been reported in absent and reversed end diastolic flow velocity in umbilical artery compared with group of present flow velocity.

scholarly journals Placental Pathology in Pregnancy-Induced hypertension

2020 ◽  
Vol 3 (1) ◽  
pp. 13-18
Author(s):  
Amany M. Mohamed ◽  
Abd El-Naser.A. Ali ◽  
Magda H. Nasreldin
Keyword(s):  
Pregnancy Induced Hypertension ◽  
Placental Pathology ◽  
Induced Hypertension ◽  
In Pregnancy

scholarly journals PLACENTAL PATHOLOGY IN PREGNANCY INDUCED HYPERTENSION

2014 ◽  
Vol 3 (35) ◽  
pp. 9272-9278
Author(s):  
Sreechithra Kartha ◽  
Usha Poothiode ◽  
Jayalakshmy P S
Keyword(s):  
Pregnancy Induced Hypertension ◽  
Placental Pathology ◽  
Induced Hypertension ◽  
In Pregnancy

scholarly journals Histopathological Study of Placenta in Pregnancy Induced Hypertension

2019 ◽  
Vol 8 (1) ◽  
pp. 97-105
Author(s):  
Sharvani R. Setty ◽  
◽  
Sonam S. Nandyal ◽  
Narayan Murthy C. ◽  
Rekha B. Puranik ◽  
...  
Keyword(s):  
Histopathological Study ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
In Pregnancy

scholarly journals The Effect of Lupus Nephritis on Pregnancy Outcome and Fetal and Maternal Complications

2010 ◽  
Vol 37 (4) ◽  
pp. 754-758 ◽  
Author(s):  
DAFNA D. GLADMAN ◽  
ANU TANDON ◽  
DOMINIQUE IBAÑEZ ◽  
MURRAY B. UROWITZ
Keyword(s):  
Lupus Nephritis ◽  
Renal Disease ◽  
Pregnancy Outcome ◽  
Repeated Measures ◽  
Fetal Outcome ◽  
Pregnancy Induced Hypertension ◽  
Maternal Complications ◽  
Induced Hypertension ◽  
Fetal Complications ◽  
In Pregnancy

Objective.To evaluate the effect of lupus nephritis on pregnancy with respect to fetal outcome, maternal complications, and lupus activity.Methods.All pregnancies seen between 1970 and 2003 in the Lupus Clinic were evaluated for the 3 outcomes. Renal disease was defined as the presence of nephrotic syndrome, dialysis, renal transplant, serum creatinine > 120 mmol/l, proteinuria, sterile hematuria and pyuria, or the presence of casts. Fetal complications were evaluated in pregnancies resulting in either live births or stillbirths. Generalized estimating equations were used to test for differences in outcomes between pregnancies with and without the presence of active renal disease. Repeated measures adjustments were made in the model for multiple pregnancies in the same mother.Results.There were 193 pregnancies in 104 women. Of these, 81 occurred in the presence of active renal disease during the study period, defined as 6 months prior to conception until the date of pregnancy outcome. One hundred twelve pregnancies were defined as nonrenal. No statistical difference was found in pregnancy outcome. Fetal complications were not different between the 2 groups with the exception of low birth weight and congenital malformations, which were observed more frequently in the renal group. Pregnancy-induced hypertension was more frequent in pregnancies with renal disease. Lupus flares were also more likely to occur in pregnancies with renal disease compared to those without.Conclusion.Lupus nephritis in pregnancy does not lead to worsened pregnancy or fetal outcomes. Active renal disease, however, is associated with pregnancy-induced hypertension, as well as a flare of lupus activity during pregnancy.

scholarly journals Relationship between Maternal Immunological Response during Pregnancy and Onset of Preeclampsia

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Alicia Martínez-Varea ◽  
Begoña Pellicer ◽  
Alfredo Perales-Marín ◽  
Antonio Pellicer
Keyword(s):  
Immune Tolerance ◽  
Immunological Response ◽  
Immunological Tolerance ◽  
Egg Donation ◽  
Pregnancy Induced Hypertension ◽  
Placental Pathology ◽  
Mortality And Morbidity ◽  
Induced Hypertension ◽  
Unrelated Donors

Maternofetal immune tolerance is essential to maintain pregnancy. The maternal immunological tolerance to the semiallogeneic fetus becomes greater in egg donation pregnancies with unrelated donors as the complete fetal genome is allogeneic to the mother. Instead of being rejected, the allogeneic fetus is tolerated by the pregnant woman in egg donation pregnancies. It has been reported that maternal morbidity during egg donation pregnancies is higher as compared with spontaneous orin vitrofertilization pregnancies. Particularly, egg donation pregnancies are associated with a higher incidence of pregnancy-induced hypertension and placental pathology. Preeclampsia, a pregnancy-specific disease characterized by the development of both hypertension and proteinuria, remains the leading cause of maternal and perinatal mortality and morbidity. The aim of this review is to characterize and relate the maternofetal immunological tolerance phenomenon during pregnancies with a semiallogenic fetus, which are the spontaneously conceived pregnancies andin vitrofertilization pregnancies, and those with an allogeneic fetus or egg donation pregnancies. Maternofetal immune tolerance in uncomplicated pregnancies and pathological pregnancies, such as those with preeclampsia, has also been assessed. Moreover, whether an inadequate maternal immunological response to the allogenic fetus could lead to a higher prevalence of preeclampsia in egg donation pregnancies has been addressed.

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