Basal Chronic Villitis and Disorders of the Placental Basal Plate: A Possible Immunological Link Between Hypertensive Disorders of Pregnancy and Morbidly Adherent Placenta

2019 ◽  
Vol 22 (4) ◽  
pp. 334-339 ◽  
Author(s):  
Philip J Katzman ◽  
Joseph Blitman ◽  
Leon A Metlay
Keyword(s):  
Clinical History ◽  
Basal Plate ◽  
Intrauterine Fetal Death ◽  
Hypertensive Disorders Of Pregnancy ◽  
Morbidly Adherent Placenta ◽  
Hypertensive Disorders ◽  
Adherent Placenta ◽  
Significant Difference ◽  
History Of ◽  
Chronic Villitis

Background Hypertensive disorders of pregnancy (HDP) are a common cause for preterm delivery. Prior studies showed that chronic villitis (CV) is associated with intrauterine growth restriction, preeclampsia, intrauterine fetal death, and morbidly adherent placenta (MAP). The authors hypothesize that disorders of the placental basal plate, especially basal chronic villitis (BCV), are associated with HDP. Methods The laboratory information system was queried over 12 years to identify placentas with or without the clinical history of HDP and with or without multifocal/focal CV or BCV. As a control for tissue sampling, a similar search was performed over 5 years for placentas evaluated for MAP. Results Of 19,683 placentas identified, 14.8% had CV which was in 18.5% and 14.2% of placentas associated with or without HDP, respectively, a significant difference ( P < .0001). BCV was present in 6.0% and 3.9% of placentas with or without HDP, respectively, also a significant difference ( P < .0001). BCV was more likely than multifocal/focal CV to occur in HDP (32.4% vs 27.4%) when all cases of CV were analyzed ( P = .025). Of 221 placentas with MAP, 64% had multifocal/focal CV and 36% had BCV. Conclusions BCV and CV are more common in placentas with HDP than in normotensive pregnancies. They are also seen in MAP, as supported by another recent study.

scholarly journals Revisiting the Role of First Trimester Homocysteine as an Index of Maternal and Fetal Outcome

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mariano Mascarenhas ◽  
Syed Habeebullah ◽  
M. G. Sridhar
Keyword(s):  
Pregnancy Loss ◽  
First Trimester ◽  
Fetal Outcome ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Serum Homocysteine ◽  
Significant Difference ◽  
History Of ◽  
Meconium Stained Amniotic Fluid

Aim.To revisit the role of first trimester homocysteine levels with the maternal and fetal outcome.Methods.This was a cohort study comprising 100 antenatal women between 8 and 12 weeks of gestation. Serum homocysteine levels were checked after overnight fasting.Results.There were significantly elevated homocysteine levels among women with prior history of hypertensive disorders of pregnancy and prior second or third trimester pregnancy losses. There was no significant difference in homocysteine levels among women with previous gestational diabetes mellitus, preterm deliveries, or fetal malformations. Homocysteine levels were significantly elevated in those who developed hypertensive disorder of pregnancy, oligohydramnios, and meconium stained amniotic fluid, had a pregnancy loss, or delivered a low birth weight baby. There was no significant difference in homocysteine levels for those who developed gestational diabetes mellitus.Conclusions.Increased first trimester serum homocysteine is associated with history of pregnancy losses, hypertensive disorders of pregnancy, and preterm birth. This is also associated with hypertensive disorders of pregnancy, pregnancy loss, oligohydramnios, meconium stained amniotic fluid, and low birth weight in the current pregnancy. This trial is registered with ClinicalTrials.govCTRI/2013/02/003441.

scholarly journals Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study

BMJ ◽  
2017 ◽  
pp. j3078 ◽  
Author(s):  
Ida Behrens ◽  
Saima Basit ◽  
Mads Melbye ◽  
Jacob A Lykke ◽  
Jan Wohlfahrt ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Pregnancy Hypertension ◽  
Hypertensive Disorders ◽  
History Of

Basal Plate Myometrial Fibers and Hypertensive Disorders of Pregnancy: A Case–Control Study

2017 ◽  
Vol 21 (3) ◽  
pp. 296-299 ◽  
Author(s):  
Ann A Wang ◽  
Linda M Ernst ◽  
Emily S Miller
Keyword(s):  
Case Control Study ◽  
Gestational Hypertension ◽  
Case Control ◽  
Basal Plate ◽  
Common Finding ◽  
Pathological Examination ◽  
Chronic Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Control Study

Introduction Basal plate myometrium (BPMYO), the pathological presence of myometrial fibers in the basal plate, is a common finding on pathological examination of the placenta, yet its clinical correlates are not well studied. As myometrial fibers are frequently located in proximity to poorly converted maternal spiral arteries, our objective was to determine whether BPMYO is associated with hypertensive disorders of pregnancy (HDP), a well-known clinical sequela of abnormal maternal artery remodeling. Methods This case–control study included women who delivered a live-born singleton gestation whose placentas were sent for pathological examination. Cases were women with HDP (gestational hypertension, preeclampsia, or HELLP syndrome) as defined by American College of Obstetricians and Gynecologists. Controls were women without HDP. Women with chronic hypertension were excluded. The primary outcome was the presence of BPMYO. Secondary outcomes included the pathologic stage of BPMYO and the incidence of pathologically defined accreta. Each outcome was compared between cases and controls in bivariable and multivariable analyses. Results Of the 306 women who met inclusion criteria, 230 (75%) had HDP. BPMYO was present in 99 (32%) of placentas. Compared to controls, cases were younger, had higher body mass index, and were more likely to have diabetes, be nulliparous, deliver preterm, and have had a prior cesarean. There were no differences in the incidence of BPMYO, stage of BPMYO, or incidence of pathologically defined accreta between cases and controls. These findings persisted after controlling for potential confounders. Conclusions Although BPMYO may be more common in the setting of abnormal placental vasculature, there is no significant association between BPMYO and HDP.

Cardiovascular risk model performance in women with and without hypertensive disorders of pregnancy

Heart ◽  
2018 ◽  
Vol 105 (4) ◽  
pp. 330-336 ◽  
Author(s):  
Veerle Dam ◽  
N Charlotte Onland-Moret ◽  
W M Monique Verschuren ◽  
Jolanda M A Boer ◽  
Laura Benschop ◽  
...  
Keyword(s):  
Risk Model ◽  
Model Performance ◽  
Predictive Performance ◽  
Baseline Risk ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cvd Risk ◽  
Hypertensive Disorders ◽  
Framingham Risk ◽  
History Of ◽  
Score Model

ObjectivesCompare the predictive performance of Framingham Risk Score (FRS), Pooled Cohort Equations (PCEs) and Systematic COronary Risk Evaluation (SCORE) model between women with and without a history of hypertensive disorders of pregnancy (hHDP) and determine the effects of recalibration and refitting on predictive performance.MethodsWe included 29 751 women, 6302 with hHDP and 17 369 without. We assessed whether models accurately predicted observed 10-year cardiovascular disease (CVD) risk (calibration) and whether they accurately distinguished between women developing CVD during follow-up and not (discrimination), separately for women with and without hHDP. We also recalibrated (updating intercept and slope) and refitted (recalculating coefficients) the models.ResultsOriginal FRS and PCEs overpredicted 10-year CVD risks, with expected:observed (E:O) ratios ranging from 1.51 (for FRS in women with hHDP) to 2.29 (for PCEs in women without hHDP), while E:O ratios were close to 1 for SCORE. Overprediction attenuated slightly after recalibration for FRS and PCEs in both hHDP groups. Discrimination was reasonable for all models, with C-statistics ranging from 0.70-0.81 (women with hHDP) and 0.72–0.74 (women without hHDP). C-statistics improved slightly after refitting 0.71–0.83 (with hHDP) and 0.73–0.80 (without hHDP). The E:O ratio of the original PCE model was statistically significantly better in women with hHDP compared with women without hHDP.ConclusionsSCORE performed best in terms of both calibration and discrimination, while FRS and PCEs overpredicted risk in women with and without hHDP, but improved after recalibrating and refitting the models. No separate model for women with hHDP seems necessary, despite their higher baseline risk.

scholarly journals Annual body mass index gain and risk of hypertensive disorders of pregnancy in a subsequent pregnancy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sho Tano ◽  
Tomomi Kotani ◽  
Takafumi Ushida ◽  
Masato Yoshihara ◽  
Kenji Imai ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Body Mass ◽  
Body Weight Gain ◽  
Subsequent Pregnancy ◽  
The Body ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Age Related ◽  
History Of

AbstractWeight gain during interpregnancy period is related to hypertensive disorders of pregnancy (HDP). However, in interpregnancy care/counseling, the unpredictability of the timing of the next conception and the difficulties in preventing age-related body weight gain must be considered while setting weight management goals. Therefore, we suggest considering the annual change in the body mass index (BMI). This study aimed to clarify the association between annual BMI changes during the interpregnancy period and HDP risk in subsequent pregnancies. A multicenter retrospective study of data from 2009 to 2019 examined the adjusted odds ratio (aOR) of HDP in subsequent pregnancies. The aORs in several annual BMI change categories were also calculated in the subgroups classified by HDP occurrence in the index pregnancy. This study included 1,746 pregnant women. A history of HDP (aOR, 16.76; 95% confidence interval [CI], 9.62 − 29.22), and annual BMI gain (aOR, 2.30; 95% CI, 1.76 − 3.01) were independent risk factors for HDP in subsequent pregnancies. An annual BMI increase of ≥ 1.0 kg/m2/year was related to HDP development in subsequent pregnancies for women without a history of HDP. This study provides data as a basis for interpregnancy care/counseling, but further research is necessary to validate our findings and confirm this relationship.

scholarly journals Left ventricular mass and myocardial scarring in women with hypertensive disorders of pregnancy

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001273
Author(s):  
Odayme Quesada ◽  
Ki Park ◽  
Janet Wei ◽  
Eileen Handberg ◽  
Chrisandra Shufelt ◽  
...  
Keyword(s):  
Vascular Dysfunction ◽  
Obstructive Coronary Artery Disease ◽  
Left Ventricular ◽  
Hypertensive Disorders Of Pregnancy ◽  
Similar Frequency ◽  
Hypertensive Disorders ◽  
Lv Mass ◽  
Scar Size ◽  
History Of ◽  
And Function

AimsHypertensive disorders of pregnancy (HDP) predict future cardiovascular events. We aim to investigate relations between HDP history and subsequent hypertension (HTN), myocardial structure and function, and late gadolinium enhancement (LGE) scar.Methods and resultsWe evaluated a prospective cohort of women with suspected ischaemia with no obstructive coronary artery disease (INOCA) who underwent stress/rest cardiac magnetic resonance imaging (cMRI) with LGE in the Women’s Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction study. Self-reported history of pregnancy and HDP (gestational HTN, pre-eclampsia, toxaemia and eclampsia) were collected at enrollment. In our cohort of 346, 20% of women report a history of HDP. HDP history was associated with 3.2-fold increased odds of HTN. Women with a history of both HDP and HTN had higher cMRI measured left ventricular (LV) mass compared with women with HDP only (99.4±2.6 g vs 87.7±3.2 g, p=0.02). While we found a similar frequency of LGE scar, we observed a trend towards increased LGE scar size (5.1±3.4 g vs 8.0±3.4 g, p=0.09) among the women with HDP history compared to women without.ConclusionIn a high-risk cohort of women with suspected INOCA, 20% had a history of HDP. Women with HDP history were more likely to develop HTN. Our study demonstrates higher LV mass in women with HDP and concomitant HTN. Although the presence of LGE scar was not different in women with and without HDP history, we observed a trend towards larger scar size in women with HDP. Future studies are needed to better assess the relationship of HDP and cardiac morphology and LGE scarring in a larger cohort of women.

scholarly journals Fetal Outcome in Hypertensive Disorders of Pregnancy.

2013 ◽  
Vol 12 (1) ◽  
pp. 8-10 ◽  
Author(s):  
Arju Chand Singh ◽  
Sadikchya Singh Rana
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Antihypertensive Drugs ◽  
Gestational Hypertension ◽  
Fetal Outcome ◽  
Intrauterine Fetal Death ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Study Results ◽  
Low Birth Weight Babies

Introduction: Hypertensive disorders are the most common medical complications of pregnancy, affecting approximately 5-10% of pregnancies and the major cause of maternal and infant disease and death worldwide. Very few researches have been done in Nepal to analyze the effect of hypertension in fetus. The aim of this study was to determine the incidence and perinatal morbidity of hypertensive disorders of pregnancy. Methods: This was a hospital based prospective observational study conducted at Paropakar Maternity and Women’s hospital. The study was conducted from 18th October to 22nd December 2007. All primi and multigravid patient with BP ≥140/90 mmHg after 28 weeks of pregnancy were included in the study. Women with a blood pressure ≥140/90mmHg at or before 20 weeks of gestation, previous hypertension or women on antihypertensive drugs and Intrauterine fetal death (IUFD) were excluded from the study. Results: A total of 126 cases of hypertensive disorders of pregnancy were identifi ed among 3819 obstetric cases. The incidence of hypertensive disorders of pregnancy was 3.3%. Among 100 cases who were included in the study, 42 had pre eclampsia and 58 had gestational hypertension. Among 42 preeclamptic patients, 15(35.71%) had low birth weight babies, and 9(15.5%) babies had low birth weight among 58 gestational hypertensive mothers. Conclusions: Preeclampsia increases the risk of intrauterine growth restriction, low birth weight and stillbirth.Medical Journal of Shree Birendra Hospital; January-June 2013/vol.12/Issue1/8-10DOI:http://dx.doi.org/10.3126/mjsbh.v12i1.9083  

scholarly journals Histopathological findings in horses with and without clinical signs of rhabdomyolysis with special reference to polysaccharide storage myopathy

2008 ◽  
Vol 53 (No. 12) ◽  
pp. 660-667 ◽  
Author(s):  
E. Ludvikova ◽  
I.D. Wijnberg ◽  
P. Fictum ◽  
Z. Lukas ◽  
J.H. van der Kolk ◽  
...  
Keyword(s):  
Special Reference ◽  
Clinical Signs ◽  
Size Variation ◽  
Clinical History ◽  
Histopathological Findings ◽  
Exertional Rhabdomyolysis ◽  
Fibre Size ◽  
Significant Difference ◽  
Polysaccharide Storage Myopathy ◽  
History Of

Objective of the study was to assess histopathological changes in horses with a clinical history of exertional rhabdomyolysis (ER) with special reference to polysaccharide storage myopathy and to compare histopathological findings in horses with and without a clinical history of ER. In total 39 muscle samples were collected, from horses with a history of repeated episodes of exertional rhabdomyolysis (test group, 10 horses) and from horses without clinical signs of muscular disorders in their history (control group, 29 horses). Frozen muscle samples were stained with haematoxylin and eosin and periodic acid-Schiff with and without amylase digestion. Histopathologic changes (amylase resistant polysaccharide, subsarcolemmal glycogen, intracytoplasmic masses, subsarcolemmal vacuoles, fibre size variation and internal nuclei) were evaluated. There was a statistically significant difference between groups in the presence of subsarcolemmal amylase sensitive glycogen deposits (P ≤ 0.0001), the risk ratio was 5.22. Statistically significant differences between groups were not found regarding the presence of intracytoplasmic masses, subsarcolemmal vacuoles, amylase resistant polysaccharide, fibre size variation and internal nuclei. Presence of amylase resistant polysaccharide within muscle fibres of apparently healthy horses could be a manifestation of different phenotype expression of PSSM but also the insufficient specificity of this diagnostic criterion.

scholarly journals Reproductive history and blood cell DNA methylation later in life: the Young Finns Study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Emily W. Harville ◽  
Pashupati P. Mishra ◽  
Mika Kähönen ◽  
Emma Raitoharju ◽  
Saara Marttila ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Reproductive History ◽  
Hypertensive Disorders Of Pregnancy ◽  
Birth Registry ◽  
Hypertensive Disorders ◽  
Epigenetic Age ◽  
Epigenetic Age Acceleration ◽  
Epigenetic Methylation ◽  
History Of ◽  
Young Finns Study

Abstract Background Women with a history of complications of pregnancy, including hypertensive disorders, gestational diabetes or an infant fetal growth restriction or preterm birth, are at higher risk for cardiovascular disease later in life. We aimed to examine differences in maternal DNA methylation following pregnancy complications. Methods Data on women participating in the Young Finns study (n = 836) were linked to the national birth registry. DNA methylation in whole blood was assessed using the Infinium Methylation EPIC BeadChip. Epigenome-wide analysis was conducted on differential CpG methylation at 850 K sites. Reproductive history was also modeled as a predictor of four epigenetic age indices. Results Fourteen significant differentially methylated sites were found associated with both history of pre-eclampsia and overall hypertensive disorders of pregnancy. No associations were found between reproductive history and any epigenetic age acceleration measure. Conclusions Differences in epigenetic methylation profiles could represent pre-existing risk factors, or changes that occurred as a result of experiencing these complications.

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