14. Placental findings accompanying fetal and maternal disease

2019 ◽  
pp. 373-424
Keyword(s):  
Maternal Disease

scholarly journals Pregnancy Outcomes and SARS-CoV-2 Infection: The Spanish Obstetric Emergency Group Study

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 853
Author(s):  
Sara Cruz Melguizo ◽  
María Luisa de la Cruz Conty ◽  
Paola Carmona Payán ◽  
Alejandra Abascal-Saiz ◽  
Pilar Pintando Recarte ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Preterm Births ◽  
Hypertensive Disorder ◽  
Obstetric Emergency ◽  
Increased Risk ◽  
Emergency Group ◽  
Adverse Perinatal Outcomes ◽  
Maternal Disease ◽  
The Relationship

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

scholarly journals Effects of Environmental Conditions on Nephron Number: Modeling Maternal Disease and Epigenetic Regulation in Renal Development

2021 ◽  
Vol 22 (8) ◽  
pp. 4157
Author(s):  
Lars Fuhrmann ◽  
Saskia Lindner ◽  
Alexander-Thomas Hauser ◽  
Clemens Höse ◽  
Oliver Kretz ◽  
...  
Keyword(s):  
Environmental Conditions ◽  
High Glucose ◽  
Culture Conditions ◽  
Renal Development ◽  
Organ Cultures ◽  
Renal Growth ◽  
Epigenetic Modifiers ◽  
Metabolic Conditions ◽  
Renal Size ◽  
Maternal Disease

A growing body of evidence suggests that low nephron numbers at birth can increase the risk of chronic kidney disease or hypertension later in life. Environmental stressors, such as maternal malnutrition, medication and smoking, can influence renal size at birth. Using metanephric organ cultures to model single-variable environmental conditions, models of maternal disease were evaluated for patterns of developmental impairment. While hyperthermia had limited effects on renal development, fetal iron deficiency was associated with severe impairment of renal growth and nephrogenesis with an all-proximal phenotype. Culturing kidney explants under high glucose conditions led to cellular and transcriptomic changes resembling human diabetic nephropathy. Short-term high glucose culture conditions were sufficient for long-term alterations in DNA methylation-associated epigenetic memory. Finally, the role of epigenetic modifiers in renal development was tested using a small compound library. Among the selected epigenetic inhibitors, various compounds elicited an effect on renal growth, such as HDAC (entinostat, TH39), histone demethylase (deferasirox, deferoxamine) and histone methyltransferase (cyproheptadine) inhibitors. Thus, metanephric organ cultures provide a valuable system for studying metabolic conditions and a tool for screening for epigenetic modifiers in renal development.

Cost Analysis of Maternal Disease Associated With Suboptimal Breastfeeding

2013 ◽  
Vol 122 (1) ◽  
pp. 111-119 ◽  
Author(s):  
Melissa C. Bartick ◽  
Alison M. Stuebe ◽  
Eleanor Bimla Schwarz ◽  
Christine Luongo ◽  
Arnold G. Reinhold ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Suboptimal Breastfeeding ◽  
Maternal Disease

scholarly journals Hepatitis C Virus in Pregnancy: Case Reports and Literature Review

1995 ◽  
Vol 3 (6) ◽  
pp. 248-251 ◽  
Author(s):  
Gary M. Joffe
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Vertical Transmission ◽  
Case Reports ◽  
Sexual Transmission ◽  
Severity Of Illness ◽  
The United States ◽  
Maternal Disease ◽  
In Pregnancy

Background: Hepatitis C virus (HCV) is now recognized as the cause of 90% of non-A, non-B (NANB) hepatitis. This virus is responsible for a large percentage of chronic persistent and chronic active hepatitis in the United States. Parenteral and sexual transmission are well described, so a significant population of pregnant patients is at risk. Vertical transmission of the virus to the fetus is dependent upon the level of maternal viremia.Case: The cases described in the following report demonstrate that fulminant disease may present in pregnancy. They also demonstrate the cofactors promoting the severity of illness, methods of diagnosis, potential treatment, and outcome of the infection.Conclusion: HCV may be encountered in pregnancy. Although most acute-phase illness will be self limiting, some patients will manifest liver failure during gestation. Because vertical transmission to the fetus is possible, the pediatrician should be informed of the maternal disease. Chronic hepatitis is almost the rule rather than the exception, so patients require close postpartum follow-up. Interferon, which may alter the course of the chronic disease, has been used on rare occasions in pregnancy.

Neonatal Emergencies and Other Problems, by John Black, M.D., F.R.C.P. New York: Appleton-Century-Crofts, 1973, 282 pp., $14.45

PEDIATRICS ◽  
1974 ◽  
Vol 53 (6) ◽  
pp. 959-959
Author(s):  
Victor Chernick
Keyword(s):  
At Risk ◽  
New York ◽  
General Practitioner ◽  
Newborn Infant ◽  
Day Care ◽  
Congenital Malformations ◽  
Metabolic Disorders ◽  
House Officer ◽  
Prenatal Factors ◽  
Maternal Disease

Although not implicit in the title, this book presents a synopsis of perinatology. The publisher indicates it will be of interest to the house officer, general practitioner and midwife but the author states "the book is intended primarily for those who have the responsibility of the day-to-day care of the newborn infant." The former objective may have been realized but not the latter. There are twenty-two chapters, beginning with prenatal factors which may influence the newborn infant such as maternal disease, drugs, the infant at risk because of previous abnormal pregnancies, metabolic disorders, and congenital malformations.

scholarly journals Understanding and Managing Pregnancy in Patients with Lupus

2015 ◽  
Vol 2015 ◽  
pp. 1-18 ◽  
Author(s):  
Guilherme Ramires de Jesus ◽  
Claudia Mendoza-Pinto ◽  
Nilson Ramires de Jesus ◽  
Flávia Cunha dos Santos ◽  
Evandro Mendes Klumb ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Fetal Loss ◽  
Systemic Lupus ◽  
Close Collaboration ◽  
Risk Condition ◽  
Pregnancy And Delivery ◽  
Maternal Disease ◽  
Active Disease

Systemic lupus erythematosus (SLE) is a chronic, multisystemic autoimmune disease that occurs predominantly in women of fertile age. The association of SLE and pregnancy, mainly with active disease and especially with nephritis, has poorer pregnancy outcomes, with increased frequency of preeclampsia, fetal loss, prematurity, growth restriction, and newborns small for gestational age. Therefore, SLE pregnancies are considered high risk condition, should be monitored frequently during pregnancy and delivery should occur in a controlled setting. Pregnancy induces dramatic immune and neuroendocrine changes in the maternal body in order to protect the fetus from immunologic attack and these modifications can be affected by SLE. The risk of flares depends on the level of maternal disease activity in the 6–12 months before conception and is higher in women with repeated flares before conception, in those who discontinue useful medications and in women with active glomerulonephritis at conception. It is a challenge to differentiate lupus nephritis from preeclampsia and, in this context, the angiogenic and antiangiogenic cytokines are promising. Prenatal care of pregnant patients with SLE requires close collaboration between rheumatologist and obstetrician. Planning pregnancy is essential to increase the probability of successful pregnancies.

scholarly journals Maternal and neonatal response to COVID-19

2020 ◽  
Vol 319 (2) ◽  
pp. E315-E319 ◽  
Author(s):  
Thea N. Golden ◽  
Rebecca A. Simmons
Keyword(s):  
Preterm Birth ◽  
Severe Acute Respiratory Syndrome ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Placental Infection ◽  
Neonatal Response ◽  
Maternal Disease ◽  
Maternal And Newborn

The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to maternal and newborn health has yet to be determined. Several reports suggest pregnancy does not typically increase the severity of maternal disease; however, cases of preeclampsia and preterm birth have been infrequently reported. Reports of placental infection and vertical transmission are rare. Interestingly, despite lack of SARS-CoV-2 placenta infection, there are several reports of significant abnormalities in placenta morphology. Continued research on pregnant women infected with SARS-CoV-2 and their offspring is vitally important.

scholarly journals Early Onset Severe Hypertensive Disease in Pregnancy and Screening for Antiphospholipid Syndrome

2020 ◽  
Vol 10 (01) ◽  
pp. e32-e36
Author(s):  
Nasim C. Sobhani ◽  
Rachel Shulman ◽  
Erin E. Tran ◽  
Juan M. Gonzalez
Keyword(s):  
Antiphospholipid Syndrome ◽  
Professional Organizations ◽  
Categorical Variables ◽  
Hypertensive Disease ◽  
Wilcoxon Rank Sum Test ◽  
Chi Squared ◽  
Fetal Complications ◽  
Gestational Age At Delivery ◽  
Maternal Disease ◽  
Diagnostic Criterion

Abstract Objective Although preterm delivery (PTD) before 34 weeks for severe hypertensive disease is a diagnostic criterion for antiphospholipid syndrome (APS), there is no consensus regarding testing for antiphospholipid antibodies (aPL) in this setting. We aim to describe the frequency of and the characteristics associated with inpatient aPL testing in this population. Study Design In this retrospective study of PTD before 34 weeks for severe hypertensive disease, charts were reviewed for aPL testing, gestational age at delivery, fetal complications, and severity of maternal disease. Wilcoxon rank-sum test, Fisher's exact, and chi-squared tests were used for analyses of continuous and categorical variables, and multivariate logistic regression for adjusted odds ratios. Results Among 133 cases, 14.3% had APS screening via aPL testing. Screened patients delivered earlier than unscreened patients (28.9 vs. 31.7 weeks, p <0.001). Each additional week of gestation was associated with a 39% decrease in the odds of screening (95% confidence interval: 0.43–0.85). There were no other differences between the groups. Conclusion APS screening after PTD for severe hypertensive disease is uncommon but more likely with earlier PTD. Despite conflicting recommendations from professional organizations, prior studies demonstrate contraceptive, obstetrical, and long-term risks associated with APS, suggesting that we should increase our screening efforts.

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