Excessive Subchorionic Fibrinoid Deposition as a Component of Massive Perivillous Fibrin Deposition: A Case With Maternal Immune Thrombocytopenia

2022 ◽  
pp. 109352662110693
Author(s):  
Mana Taweevisit ◽  
Panachai Nimitpanya ◽  
Paul S. Thorner
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Lupus Anticoagulant ◽  
Immune Thrombocytopenia ◽  
Significant Risk ◽  
Unknown Etiology ◽  
Normal Female ◽  
Obstetric Outcome ◽  
Fibrin Deposition ◽  
Immune Mediated

Maternal floor infarction (MFI) and massive perivillous fibrin deposition (MPFD) are overlapping placental disorders of unknown etiology, associated with adverse obstetric outcome, and a significant risk of recurrence. We describe a 31-year-old mother with asymptomatic thrombocytopenia throughout pregnancy and a positive lupus anticoagulant. She delivered a normal female neonate at term, whose weight was small for gestational age, with a placenta weighing less than the 10th percentile. Placental examination showed MPFD together with excessive subchorionic fibrinoid deposition. The placenta showed diffuse C4d deposition and an immune-mediated reaction was postulated for the pathogenesis of the placental changes. We suggest that excessive subchorionic fibrinoid deposition may be part of the morphologic spectrum of MFI/MPFD.

Massive Perivillous Fibrin Deposition Associated With Placental Syphilis: A Case Report

2020 ◽  
pp. 109352662095752 ◽  
Author(s):  
Mana Taweevisit ◽  
Nutchanok Thawornwong ◽  
Paul Scott Thorner
Keyword(s):  
Differential Diagnosis ◽  
Lower Risk ◽  
Significant Risk ◽  
Recurrence Risk ◽  
Unknown Etiology ◽  
Obstetric Outcome ◽  
Fibrin Deposition ◽  
Syphilis Infection ◽  
Male Neonate ◽  
The Right

Massive perivillous fibrin deposition (MPFD) and the related entity of maternal floor infarction (MFI) are uncommon placental disorders of unknown etiology, associated with adverse obstetric outcome and a significant risk of recurrence. We describe a 19-year-old mother with untreated syphilis who delivered a male neonate with low birth weight, skin desquamation, and pneumonia. Placenta examination showed the expected changes for syphilis but unexpectedly, also showed MPFD. To our knowledge, this is the first report of MPFD associated with placental syphilis, thus expanding the list of etiologies that may be related to MPFD/MFI. It is postulated that the syphilis infection in our case led to a hypercoaguable state, eventually resulting in MPFD. In the right clinical setting, syphilis might be considered in the differential diagnosis when MPFD/MFI is observed on placental examination. The recurrence risk of MFPD/MFI associated with infections is believed to be lower than idiopathic cases and, by extrapolation, this lower risk should apply to syphilis as well.

Extensive Perivillous Fibrin and Intervillous Histiocytosis in a SARS-CoV-2 Infected Placenta From an Uninfected Newborn: A Case Report Including Immunohistochemical Profiling

2021 ◽  
pp. 109352662110251
Author(s):  
James Roberts ◽  
Jeanette D Cheng ◽  
Elizabeth Moore ◽  
Carla Ransom ◽  
Minhui Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Immunohistochemical Staining ◽  
Placental Pathology ◽  
Fibrin Deposition ◽  
Placental Infection ◽  
Fetal Infection

Placental infection by SARS-CoV-2 with various pathologic alterations reported. Inflammatory findings, such as extensive perivillous fibrin deposition and intervillous histiocytosis, have been postulated as risk factors for fetal infection by SARS-CoV-2. We describe the placental findings in a case of a 31-year-old mother with SARS-CoV-2 infection who delivered a preterm female neonate who tested negative for SAR-CoV2 infection. Placental examination demonstrated a small for gestational age placenta with extensive intervillous histiocytosis, syncytiotrophoblast karyorrhexis, and diffuse intervillous fibrin deposition. Immunohistochemical staining demonstrated infection of the syncytiotrophoblasts by SARS-CoV-2 inversely related to the presence of intervillous histiocytes and fibrin deposition. Our case demonstrates that despite extensive placental pathology, no fetal transmission of SARS-CoV-2 occurred, as well as postulates a relationship between placental infection, inflammation, and fibrin deposition.

scholarly journals Impact on obstetric outcome of third-trimester screening for small-for-gestational-age fetuses

2015 ◽  
Vol 46 (2) ◽  
pp. 216-220 ◽  
Author(s):  
R. Callec ◽  
C. Lamy ◽  
E. Perdriolle-Galet ◽  
C. Patte ◽  
B. Heude ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Obstetric Outcome ◽  
Third Trimester ◽  
Trimester Screening

scholarly journals Evaluation of cerebral oxygenation and perfusion in small for gestational age neonates and neurodevelopmental outcome at 24–36 months of age

2020 ◽  
Vol 48 (3) ◽  
pp. 280-288
Author(s):  
Eleni Milona ◽  
Dimitrios Rallis ◽  
Georgios Mitsiakos ◽  
Evanthia Goutsiou ◽  
Elias Hatziioannidis ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Cerebral Perfusion ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Late Onset ◽  
Composite Index ◽  
Neurodevelopmental Outcome ◽  
Significant Risk ◽  
Neurodevelopmental Outcomes

AbstractObjectiveTo examine cerebral oxygenation and perfusion in small for gestational age (SGA) compared with appropriate for gestational age (AGA) neonates during the first postnatal week, and to investigate any association with neurodevelopmental outcomes at 24–36 months of age.MethodsA prospective matched case-control study was conducted evaluating cerebral oxygenation and perfusion, using near-infrared spectroscopy (NIRS), between SGA and AGA neonates, during the first postnatal week. A neurodevelopmental assessment with Bayley-III was performed at 24–36 months of age.ResultsForty-eight SGA and 48 AGA neonates of similar gestation (32.8 ± 2.1 vs. 32.5 ± 1.9) were enrolled. On the first postnatal day, the cerebral oxygenation was equal between SGA and AGA neonates (71 ± 7% vs. 72 ± 8%); however, in the subgroup analysis, males had higher oxygenation compared to female SGA neonates (73 ± 7% vs. 69 ± 7%, P = 0.04). Cerebral perfusion was significantly higher in SGA neonates on the first postnatal day (1.4 ± 0.6 vs. 1.1 ± 0.5, P = 0.04), but this difference was diminished on subsequent measurements. There were no significant differences between the SGA and AGA infants regarding the composite cognitive, communication and motor index scores. The length of mechanical ventilation and late-onset sepsis were significant risk factors affecting the cognitive and communication composite index scores, respectively.ConclusionCerebral oxygenation was equal between SGA and AGA neonates, while cerebral perfusion was transiently increased in SGA neonates during the first postnatal day. There was no significant association of cerebral oxygenation and perfusion with neurodevelopmental outcomes.

scholarly journals Pregnancy after Bariatric Surgery: A Nested Case-Control Study of Risk Factors for Small for Gestational Age Babies in AURORA

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1699
Author(s):  
Zainab Akhter ◽  
Nicola Heslehurst ◽  
Dries Ceulemans ◽  
Judith Rankin ◽  
Roger Ackroyd ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Gain ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Case Control Study ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Case Control ◽  
Institute Of Medicine ◽  
Control Study

Bariatric surgery prior to pregnancy is a significant risk factor for small for gestational age (SGA) babies. This case-control study investigated differences between mothers delivering an SGA baby following bariatric surgery, compared to those delivering an appropriate for gestational age (AGA) baby. Out of 129 babies born to mothers in the AURORA cohort study, 25 were SGA (<10th percentile) and 97 were AGA (10th–90th percentile). Higher gestational weight gain (GWG) was significantly associated with decreased odds of SGA (aOR per kg 0.92, 95% CI 0.85–0.99). According to the Institute of Medicine GWG guidelines, 44% of SGA mothers had ‘inadequate’ GWG compared to 17% of AGA mothers. Nearly half of the mothers had ‘excessive’ GWG yet still gave birth to an SGA or AGA baby. Mothers of SGA babies lost more weight following bariatric surgery (45.6 ± 14.4 kg vs. 39.0 ± 17.9 kg). Women who reported receiving nutritional advice following bariatric surgery were significantly less likely to have an SGA baby (aOR 0.15, 95% CI 0.0.4–0.55). Women with a history of bariatric surgery should be provided with specialized support before and during pregnancy to encourage adequate nutritional intake and weight gain to support healthy fetal growth.

Increased Incidence of Villitis in Placentas Exposed to Chemotherapy During Pregnancy: Is There a Correlation?

2019 ◽  
Vol 22 (6) ◽  
pp. 540-545 ◽  
Author(s):  
Diana Kantarovich ◽  
Sydney Archer ◽  
Nasim Khoshnam ◽  
Eman Al-Haddad ◽  
Daniela Moncaleano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Inflammatory Process ◽  
Toxic Effects ◽  
Unknown Etiology ◽  
Second Trimester ◽  
Pathologic Examination ◽  
Inflammatory Changes

We have identified 9 pregnant patients who were diagnosed with malignancy and initiated chemotherapy during their second trimester (cervical cancer [n = 3], leukemia [n = 3], breast cancer [n = 2], and Hodgkin’s lymphoma [n = 1]). Five of the patients’ placentas were small for gestational age (SGA). Pathologic examination revealed inflammatory changes in 4 of the placentas: 2 from the SGA placentas and 2 from non-SGA placentas. Examination revealed 3 placentas with villitis of unknown etiology (VUE) and 1 with intervillositis; all were negative for bacterial and viral cultures and by immunohistochemical (IHC) stains. In the VUE cases, IHC stains showed positivity of CD25+/FOXP3+ with focal positivity and CD3 and CD4 IHC were focally to strongly positive. Literature suggests that the use of chemotherapy during pregnancy can be detrimental to both the mother and the fetus; however, there has been limited focus on the effects of chemotherapy on the placenta. We suggest that the inflammatory process noted in the placentas is due to chemotherapy-induced toxic effects.

Passive smoking and pregnancy outcome in central Poland

1999 ◽  
Vol 18 (4) ◽  
pp. 265-271 ◽  
Author(s):  
W Hanke ◽  
J Kalinka ◽  
E Florek ◽  
W Sobala
Keyword(s):  
Preterm Delivery ◽  
Gestational Age ◽  
Tobacco Smoke ◽  
Small For Gestational Age ◽  
Passive Smoking ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Structured Interview ◽  
Central Poland ◽  
Passive Exposure

1 The present investigation was undertaken to evaluate the effect of environmental tobacco smoke (ETS) on the risk of preterm delivery (PD) and small-for-gestational age (SGA) infants in a female non-smoking population of central Poland. 2 The study group were 1751 women classified as non-smokers in the comprehensive project on 'ocio-economic and environmental risk factors of preterm delivery and small-for-gestational-age babies in cen-tral Poland' conducted on a randomly selected population of 2080 women who gave birth to a child between June 1, 1996 and May 31, 1997. The PD group comprised 95 non-smoking women who delivered before 37 weeks of pregnancy and the SGA group included 111 non-smoking mothers of babies with birthweight below the loth percentile of the standard curves for central Poland. Passive exposure to tobacco smoke was determined based on a structured interview. 3 In the stepwise multiple logistic regression model maternal passive smoke exposure lasting 7 h or more was found to be a significant risk factor for preterm delivery. No significant effect of passive smoking on the risk of SGA was observed. 4 The information about the adverse effects of ETS exposure on pregnancy duration and outcome should be incorporated in the health promotion programmes for women.

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