Vitelline Vessel Remnant-Derived Funisitis Is a Sensitive and Specific Predictor of Histological Evidence of Amniotic Fluid Infection

Background 4-11% of umbilical cords contain vitelline vessel remnants (VVRs). A recent study has described neutrophilic inflammation arising from VVRs and suggested an association with amniotic fluid infection (AFI). Methods During routine placental pathology sign-out over a six month period, we identified 70 cords with VVRs. HE-stained sections were re-examined for “VVR-derived funisitis,” which was classified as low or high grade/stage based upon whether neutrophils were present only in Wharton’s jelly near the VVRs or whether neutrophils were also present near the cord’s amniotic surface. The same placentas were also examined for histologic evidence of AFI (maternal response = acute chorionitis or chorioamnionitis vs. fetal response = chorionic vasculitis, umbilical vasculitis, or funisitis vs. both). Results Neutrophilic inflammation arising from VVRs was present in 54.3% (38/70); 15 and 23 lesions were low and high grade/stage, respectively. “VVR-derived funisitis” was strongly associated with histological evidence of AFI elsewhere in the placenta. Its overall sensitivity and specificity were 0.94 and 0.88; when VVR-derived funisitis was high grade/stage or diagnosed in the third trimester, specificity rose to 1.0. Conclusion “VVR-derived funisitis” has a strong association with histological evidence of AFI.

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High-Grade Fetal Vascular Malperfusion Is Associated With Diffuse Chorionic Hemosiderosis

Pediatric and Developmental Pathology ◽

10.1177/10935266211064694 ◽

2021 ◽

pp. 109352662110646

Author(s):

Eoghan E. Mooney ◽

Emma Crotty

Keyword(s):

Perinatal Outcomes ◽

Low Grade ◽

High Grade ◽

Third Trimester ◽

The Third ◽

Term Delivery ◽

Venous Bleeding ◽

Placental Membranes ◽

Adverse Perinatal Outcomes ◽

Cord Length

Introduction Diffuse chorionic hemosiderosis (DCH) is an abnormality of the placental membranes characterized by the deposition of iron pigment. It is usually secondary to recurrent venous bleeding in early pregnancy. In many papers, it is associated with pre-term delivery. Fetal vascular malperfusion (FVM) is an abnormality of the feto-placental circulation that may be seen at any stage of gestation, but most often in the third trimester. It may be graded as low grade (LGFVM) or high grade (HGFVM). No link has been identified in the placental literature between DCH and FVM, but we have noted the 2 co-existing in placentas submitted for analysis. This study explored a possible association of these 2 entities. Methods Laboratory records were searched for singleton cases coded as DCH based on diagnosis on H&E stain over a 6-year period. Of 4478 placentas reported, 66 cases were coded as DCH (1.5%). These were classified as showing HGFVM, LGFVM, or no FVM. Controls (n = 132) were gestational age-matched cases without DCH. Cord length, coiling, insertion, or other abnormalities were noted. Membranes were classified as normal or circumvallate. Results were analyzed using Graphpad. Results Gestation ranged between 16 and 41 weeks gestation. 14/66 (21%) cases of DCH showed HGFVM and 2/66 (3%) showed LGFVM. 16/132 (12%) controls showed HGFVM and 21/132 (15.9%) had LGFVM. Where FVM is present, high-grade FVM is significantly associated with DCH versus controls ( P < .0031 Fischer’s Test). Discussion HGFVM occurs significantly more often in placentas with DCH than in controls. Both FVM and DCH are associated with adverse perinatal outcomes, and a possible relationship between the 2 remains to be clarified.

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Correlation study between increased fetal movement during the third trimester and neonatal outcome

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2637-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Cuiqin Huang ◽

Wei Han ◽

Yajing Fan

Keyword(s):

Amniotic Fluid ◽

Pregnant Women ◽

Gestational Age ◽

Neonatal Outcome ◽

Stress Test ◽

Neonatal Outcomes ◽

Control Group ◽

Third Trimester ◽

The Third ◽

Fetal Movements

Abstract Background We aimed to analyze the correlation between increased fetal movements in the third trimester and neonatal outcomes. Methods We enrolled pregnant women (n = 219) who reported increased/excessive fetal movements in the third trimester in our hospital. A control group of healthy women (n = 278) who had undergone regular childbirth and delivery in our hospital during the same period and did not report abnormal fetal movements were also recruited. All pregnant women underwent fetal non-stress test. We analyzed the neonatal weight, appearance, pulse, grimace, activity, and respiration score, degrees of amniotic fluid contamination, amniotic fluid volume, conditions of umbilical cord around the neck and cord length, and incidence of small for gestational age. In addition, the incidence of preterm delivery, cesarean section rate, postpartum hemorrhage, and other postpartum complications were also analyzed. We then analyzed the correlation between increased/excessive fetal activity and neonatal outcomes. Results Women with complaints of increased/excessive fetal movements exhibited increased fetal movements mainly around 31 and 39 weeks of gestation. Several pregnancy variables, including number of previous delivery, gestational age (less than 34 weeks and more than 37 weeks) and vaginal birth rate, were associated with increased/excessive fetal movements. In addition, women who reported increased/excessive fetal movements had higher odds of large for gestational age (LGA), particularly those with gestational age over 37 weeks. Conclusion Increased/excessive fetal movements may be used to predict adverse neonatal outcome such as LGA.

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Comparison of the amniotic fluid and fetal urine peptidome for biomarker discovery in renal developmental disease

Scientific Reports ◽

10.1038/s41598-020-78730-3 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Camille Fédou ◽

Benjamin Breuil ◽

Igor Golovko ◽

Stéphane Decramer ◽

Pedro Magalhães ◽

...

Keyword(s):

Amniotic Fluid ◽

Biomarker Discovery ◽

Posterior Urethral Valves ◽

Proof Of Concept ◽

Renal Survival ◽

Third Trimester ◽

Urethral Valves ◽

Endogenous Peptides ◽

The Third ◽

Fetal Urine

AbstractProduction of amniotic fluid (AF) is view as predominately driven by excretion of fetal urine (FU). However, the origin of AF peptides, often considered as potential biomarkers of developmental diseases, has never been investigated. Here, we evaluated the FU origin of AF peptides and if the AF peptide content can be used as a surrogate of FU. The abundance of endogenous peptides was analyzed by capillary electrophoresis coupled to mass spectrometry in 216 AF and 64 FU samples. A total of 2668 and 3257 peptides was found in AF and FU respectively. The AF peptidome largely overlapped with the FU peptidome, ranging from 54% in the second pregnancy trimester to 65% in the third trimester. Examination of a subset of 16 paired AF and FU samples revealed that 67 peptides displayed a significant positively correlated abundance in AF and FU, strongly suggesting that their presence in AF was directly associated to FU excretion. As proof-of-concept we showed that measuring the AF abundance of these 67 peptides of FU origin allowed prediction of postnatal renal survival in fetuses with posterior urethral valves. These results demonstrate that the AF peptidome can be considered as a good surrogate of the FU peptidome.

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Pharmacokinetics of ethanol and its metabolite, acetaldehyde, and fetolethality in the third-trimester pregnant guinea pig for oral administration of acute, multiple-dose ethanol

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y86-182 ◽

1986 ◽

Vol 64 (8) ◽

pp. 1060-1067 ◽

Cited By ~ 41

Author(s):

David W. Clarke ◽

Nancy A. E. Steenaart ◽

Christopher J. Slack ◽

James F. Brien

Keyword(s):

Guinea Pig ◽

Amniotic Fluid ◽

Ethanol Concentration ◽

Fetal Brain ◽

Maternal Blood ◽

Time Interval ◽

Gas Liquid Chromatography ◽

Fetal Blood ◽

Third Trimester ◽

The Third

The pharmacokinetics of ethanol and its metabolite, acetaldehyde, were determined in the third-trimester pregnant guinea pig (56–59 days gestation) for oral intubation of four doses of 1 g ethanol/kg maternal body weight, administered at 1-h intervals. Animals (n = 4–7) were sacrificed at each of selected times during the 26-h study. Ethanol and acetaldehyde concentrations were determined by headspace gas-liquid chromatography. The maternal and fetal blood ethanol concentration–time curves were virtually superimposable, which indicated unimpeded bidirectional placental transfer of ethanol in the matemal–fetal unit. The blood and brain ethanol concentrations were similar in each of the maternal and fetal compartments during the study, which indicated rapid equilibrium distribution of ethanol. There was accumulation of ethanol in the amniotic fluid resulting in higher ethanol concentration compared with maternal and fetal blood during the elimination phase, which indicated that the amniotic fluid may serve as a reservoir for ethanol in utero. Acetaldehyde was measurable in all the biological fluids and tissues at concentrations that were at least 1000-fold less than the respective ethanol concentrations and were variable. There was ethanol-induced fetolethality that was delayed and variable among animals, and was 55% at 23 h. At this time interval, the ethanol concentrations in maternal blood and brain, fetal brain, and amniotic fluid were 35- to 53-fold greater and the acetaldehyde concentrations in maternal blood and fetal brain were four- to five-fold higher in the animals with dead fetuses compared with the guinea pigs with live litters. These data indicated that decreased ethanol elimination from the maternal–fetal unit was related temporally to the fetolethality.

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Intrauterine Coxsackie Virus, Group B Type 1, Infection: Viral Cultivation from Amniotic Fluid in the Third Trimester

American Journal of Perinatology ◽

10.1055/s-2007-994407 ◽

1995 ◽

Vol 12 (02) ◽

pp. 78-79 ◽

Cited By ~ 14

Author(s):

Beatrice Strong ◽

Stephen Young

Keyword(s):

Amniotic Fluid ◽

Coxsackie Virus ◽

Third Trimester ◽

The Third ◽

Virus Group ◽

Group B

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The fetal outcome in pregnancies with isolated reduced amniotic fluid volume in the third trimester

Journal of Perinatal Medicine ◽

10.1515/jpme.1998.26.5.390 ◽

1998 ◽

Vol 26 (5) ◽

pp. 390-395 ◽

Cited By ~ 9

Author(s):

Devender Roberts ◽

Ezeki C Nwosu ◽

Stephen A Walkinshaw

Keyword(s):

Amniotic Fluid ◽

Fetal Outcome ◽

Fluid Volume ◽

Third Trimester ◽

The Third ◽

Amniotic Fluid Volume

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Presence of CRH-binding protein in amniotic fluid and in umbilical cord plasma

Acta Endocrinologica ◽

10.1530/acta.0.1250165 ◽

1991 ◽

Vol 125 (2) ◽

pp. 165-169 ◽

Cited By ~ 7

Author(s):

Toshihiro Suda ◽

Mitsutoshi Iwashita ◽

Takashi Sumitomo ◽

Yoriko Nakano ◽

Fumiko Tozawa ◽

...

Keyword(s):

Amniotic Fluid ◽

Umbilical Cord ◽

Peripheral Blood ◽

Binding Protein ◽

Normal Subjects ◽

Normal Adult ◽

Second Trimester ◽

Third Trimester ◽

The Third ◽

Cord Plasma

Abstract. CRH-binding protein was present in the amniotic fluid and in the umbilical cord plasma after 15 weeks and 24 weeks of pregnancy, respectively. The size of the CRH-binding protein was similar to that in the peripheral blood from normal subjects. The level of the binding of CRH-binding protein in the umbilical cord plasma during the third trimester of pregnancy was also similar to that in the peripheral blood of neonates and normal adult subjects. The binding of CRH-binding protein was temporarily decreased at 40 weeks of pregnancy. These results indicate that fetal CRH-binding protein seems to be produced at least in the second trimester of pregnancy.

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