scholarly journals The Association Between Placental Residual Blood Volume and Two Placental Transfusion Methods After Delivery at Term

2021 ◽  
Vol 9 ◽  
Author(s):  
Tai-Ho Hung ◽  
Ya-Chun Chuang ◽  
Lulu Huang
Keyword(s):  
Birth Weight ◽  
Cesarean Delivery ◽  
Blood Volume ◽  
Umbilical Cord ◽  
Mode Of Delivery ◽  
Placental Weight ◽  
Iron Store ◽  
Delayed Cord Clamping ◽  
Beneficial Effects ◽  
Residual Blood

Background: Despite reports of the beneficial effects, such as increasing hemoglobin level and iron store in the neonatal period, of delayed cord clamping, or umbilical cord milking after delivery in healthy term-born infants, the duration of delayed clamping or rounds of milking in most previous reports were determined arbitrarily and varied widely across different studies.Methods: We prospectively recruited 80 women with normal singleton pregnancies at 38–40 weeks' gestation. Participants were classified according to the mode of delivery and randomly assigned to either collecting blood from the placenta by umbilical cord drainage (CD) or cord milking (CM), with the placenta left in the uterus. The volume of blood collected, the duration of CD, and the number of rounds of CM were recorded.Results: Collected placental residual blood volume positively correlated with birth weight, placental weight, and length of the cord. When 80% of the total placental residual blood volume collected was set as the threshold, more than 80% of women who delivered vaginally reached this level within 60 s of CD or seven repetitions of CM. This amount of blood could be obtained within 120 s of CD or after seven repetitions of CM in more than 80% of women who underwent cesarean delivery.Conclusion: In most women, regardless of birth weight and placental weight, more than 80% of placental residual blood volume could be collected by CD within 60 s after vaginal delivery, 120 s after cesarean delivery, and seven repetitions of CM in both vaginal and cesarean deliveries.

scholarly journals Maternal Hematological Parameters and Placental and Umbilical Cord Histopathology in Intrauterine Growth Restriction

2019 ◽  
Vol 28 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Mária Jakó ◽  
Andrea Surányi ◽  
László Kaizer ◽  
Gábor Németh ◽  
György Bártfai
Keyword(s):  
Platelet Count ◽  
Birth Weight ◽  
Umbilical Cord ◽  
Intrauterine Growth Restriction ◽  
Hematological Parameters ◽  
Placental Weight ◽  
Sectional Area ◽  
Cross Sectional ◽  
Intrauterine Growth ◽  
Placental Volume

Objective: To investigate the placental and umbilical cord histopathology in intrauterine growth restriction (IUGR) and their relation to second-trimester maternal hematological parameters. Materials and Methods: Patients were selected for the IUGR group based on estimated fetal weight below the 10th percentile. Patients were recruited into the control group randomly. Patients were followed up with ultrasound, and blood samples were taken between the 20th and 24th gestational weeks. After delivery and formalin fixation, weight and volume of the placenta were recorded and histologic samples were processed. Results: Maternal platelet count strongly correlates with placental weight (r = 0.766). On the other hand, neonatal weight correlates with placental volume (r = 0.572) rather than with placental weight (r = 0.469). Umbilical arterial lumen cross-sectional area correlates with birth weight (r = 0.338). Conclusions: Maternal hematological parameters do not seem to affect neonatal outcome. Our main findings are the correlation of maternal platelet count with placental weight, the correlation of placental volume with birth weight being stronger than the correlation of placental weight with birth weight, and the correlation of umbilical artery lumen cross-sectional area with neonatal weight. Mild histopathologic alterations might occur in normal pregnancies; however, sufficient fetal nutrition can be maintained. This compensatory function of the placenta seems to be insufficient when two or more pathologies are present, which is characteristic for IUGR.

scholarly journals Umbilical cord levels of sclerostin, placental weight, and birth weight are predictors of total bone mineral content in neonates

2013 ◽  
Vol 168 (3) ◽  
pp. 371-378 ◽  
Author(s):  
Kristin Godang ◽  
Kathrine Frey Frøslie ◽  
Tore Henriksen ◽  
Gunhild A Isaksen ◽  
Nanna Voldner ◽  
...  
Keyword(s):  
Birth Weight ◽  
Bone Mineral Content ◽  
Umbilical Cord ◽  
Bone Mineral ◽  
Mineral Content ◽  
Skeletal Development ◽  
Fibroblast Growth Factor 23 ◽  
Wnt Signaling Pathway ◽  
Placental Weight ◽  
Main Role

ContextDuring pregnancy, changes occur in the maternal calcium homeostasis to fulfill fetal demand. We hypothesized that the fibroblast growth factor 23 (FGF23) system and Wnt signaling pathway are important for normal skeletal development in the offspring.AimsCirculating α-klotho, FGF23, sclerostin, and 25-hydroxyvitamin D (25(OH)D) at the fetal and maternal sides of the placenta were measured to investigate associations with newborn bone mass independent of maternal BMI, calcium and phosphate levels, placental weight, and birth weight.MethodsIn a prospective cohort of healthy pregnant women, the total body bone mineral content (BMC) in 202 newborns was measured by dual-energy X-ray absorptiometry. Maternal circulating levels of the biomarkers were measured at gestational weeks 30–32 and in umbilical cord plasma (UCP) at birth.ResultsMean α-klotho and sclerostin concentrations in the UCP were significantly higher than maternal levels (3004 vs 1077 pg/ml;P<0.001 and 629 vs 346 pg/ml;P<0.001 respectively), and mean 25(OH)D was lower (31 vs 45 nmol/l;P<0.001). The UCP and maternal FGF23 levels were similar. No significant effects of maternal biomarkers on BMC were found in regression analyses. Among UCP biomarkers, only UCP sclerostin was significantly associated with BMC in univariate analyses, and the effect remained significant after adjustment for birth weight and other confounders.ConclusionsWe found that UCP sclerostin levels, birth weight, and placental weight were significant predictors of neonatal BMC but found no evidence for a main role of maternal levels of α-klotho, FGF23, sclerostin, or 25(OH)D nor of UCP levels of α-klotho, FGF23, or 25(OH)D.

Residual blood volume in the umbilical cord of extremely premature infants

2014 ◽  
Vol 57 (1) ◽  
pp. 68-71 ◽  
Author(s):  
Shigeharu Hosono ◽  
Kotaro Hine ◽  
Nobuhiko Nagano ◽  
Yosuke Taguchi ◽  
Kayo Yoshikawa ◽  
...  
Keyword(s):  
Blood Volume ◽  
Umbilical Cord ◽  
Premature Infants ◽  
Residual Blood

Gross Placental Structure in a Low-Risk Population of Singleton, Term, First-Born Infants

2009 ◽  
Vol 12 (3) ◽  
pp. 200-210 ◽  
Author(s):  
David A. Coall ◽  
Adrian K. Charles ◽  
Carolyn M. Salafia
Keyword(s):  
Birth Weight ◽  
Surface Area ◽  
Umbilical Cord ◽  
Growth And Development ◽  
Weight Ratio ◽  
Low Risk ◽  
Placental Weight ◽  
Increased Risk ◽  
Umbilical Cord Insertion ◽  
Placental Structure

Suboptimal fetal growth has been associated with an increased risk of adult disease, which may be exacerbated by an increased placental weight–to–fetal weight ratio. Placental weight is a summary measure of placental growth and development throughout pregnancy. However, measures of placental structure, including the chorionic disk surface area and thickness and eccentricity of the umbilical cord insertion, have been shown to account for additional variance in birth weight beyond that explained by placental weight. Little is known of the variability of these placental parameters in low-risk populations; their association with maternal, pregnancy, and neonatal characteristics; and the agreement between manual and digital measures. This study used manual and digital image analysis techniques to examine gross placental anatomy in 513 low-risk, singleton, term, first-born infants. Parametric methods compared groups and examined relationships among variables. Maternal birth weight, prepregnancy weight, and body mass index were associated with increased placental and birth weight (all P < 0.005), but only maternal birth weight was associated with increased placental surface area ( P < 0.0005) and thickness ( P = 0.005). Smoking during pregnancy reduced birth weight and increased the eccentricity of umbilical cord insertion ( P = 0.012 and 0.034, respectively). The variability in these placental parameters was consistently lower than that reported in the literature, and correlations between digital and manual measurements were reasonable ( r = .87–.71). Detailed analyses of gross placental structure can provide biologically relevant information regarding placental growth and development and, potentially, their consequences.

scholarly journals Delayed Umbilical Cord Clamping is Not Associated with Acute Kidney Injury in Very Low Birth Weight Neonates

2019 ◽  
Vol 37 (02) ◽  
pp. 210-215
Author(s):  
Matthew W. Harer ◽  
Ryan M. McAdams ◽  
Mark Conaway ◽  
Brooke D. Vergales ◽  
Dylan M. Hyatt ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Umbilical Cord ◽  
Very Low Birth Weight ◽  
Kidney Diseases ◽  
Kidney Injury ◽  
Delayed Cord Clamping ◽  
Cord Clamping ◽  
Umbilical Cord Clamping

Abstract Objective This study aimed to determine if delayed cord clamping (DCC) is associated with a reduction in neonatal acute kidney injury (AKI). Study Design A retrospective single-center cohort study of 278 very low birth weight (VLBW) neonates was performed to compare the incidence of AKI in the following groups: immediate cord clamping (ICC), DCC, and umbilical cord milking. AKI was diagnosed by the modified neonatal Kidney Diseases and Improving Global Outcomes (KDIGO) definition. Results The incidence of AKI in the first week was 20.1% with no difference between groups (p = 0.78). After adjustment for potential confounders, the odds of developing AKI, following DCC, compared with ICC was 0.93 (confidence interval [CI]: 0.46–1.86) with no reduction in the stage of AKI between groups. Conclusion In this study, DCC was not associated with a reduced rate of AKI in VLBW neonates. However, the data suggest that DCC is also not harmful to the kidneys, further supporting the safety of DCC in VLBW neonates.

scholarly journals The effectiveness of umbilical cord milking/ delayed cord clamping and recombinant human erythropoietin in reducing red blood cell transfusions in extremely and very low birth weight infants

2021 ◽  
Vol 20 (3) ◽  
pp. 36-45
Author(s):  
D. R. Sharafutdinova ◽  
E. N. Balashova ◽  
А. R. Kirtbaya ◽  
A. Yu. Ryndin ◽  
J. M. Golubtsova ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Umbilical Cord ◽  
Very Low Birth Weight ◽  
Delayed Cord Clamping ◽  
Low Birth Weight Infants ◽  
Human Erythropoietin ◽  
Cord Clamping ◽  
Red Blood Cell Transfusions ◽  
Umbilical Cord Milking

Anemia of prematurity is one of the most common and serious problems of neonatology. The main focus is to prevent of anemia in preterm infants. The aim of the study was to assess effectiveness of umbilical cord milking/delayed cord clamping and erythropoietin therapy in reducing red blood cell transfusions in extremely and very low birth weight infants. This clinical study was approved by the Commission on ethics of biomedical research (Protocol No. 12 November 17, 2016) and approved by the Scientific Council of National Medical Research Center for obstetrics, gynecology and perinatology named academician V.I. Kulakov of the ministry of Healthcare of the Russian Federation (Protocol No. 19 of November 29, 2016). Analysis of 482 extremely and very low birth weight infants was conducted (from 2008 to 2018). Umbilical cord milking or delayed umbilical cord clamping, both, and in combination with recombinant human erythropoietin therapy, decreasing the phlebotomy losses significantly reduces the need for transfusions of red blood cells in extremely and very low birth weight infants. The effectiveness of erythropoietin therapy, time of its start and various treatment schemes remain controversial, therefore further researches are necessary.

scholarly journals Probiotic Supplementation Regulates Placental and Fetal Development in C57BL6/J Mice (P20-008-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kate Larson ◽  
Danielle Krout ◽  
Travis Alvine ◽  
Huawei Zeng ◽  
Amy Bundy ◽  
...  
Keyword(s):  
Birth Weight ◽  
Fetal Development ◽  
Agricultural Research ◽  
Placental Weight ◽  
Fetal Weight ◽  
Protective Mechanism ◽  
High Fat ◽  
Probiotic Supplementation ◽  
Fatty Acid Binding ◽  
Beneficial Effects

Abstract Objectives Maternal high-fat (HF) diet predisposes offspring to metabolic syndrome, in part, by inducing alterations during placental development resulting in abnormal fetal development and offspring birth weight. We previously reported in a rat model that a maternal malnutrition diet increases fetal inflammation, and placental vascularization, and decreases offspring birth weight followed by adult-onset obesity. In the current study, we investigated when during gestational development a maternal HF diet induces changes in placental weight, lipid content, and inflammation. We further investigated whether probiotic supplementation offsets HF-diet induced adverse outcomes. Methods Two-month old female C57BL/6 mice were fed diets of 16% fat (normal-fat, NF) or 45% fat (high-fat, HF) for 8 weeks followed by 4 weeks of probiotic (Bifidobacterium animalis subsp. lactis, BB-12) supplementation. Fetuses and placentae were examined mid- (D12) and late- (D19) gestation Results Placental length, width, and weight as well as fetal weight were decreased in the HF group at D12. Probiotic supplementation reversed the HF diet-induced reduction in placental weight at D12. These beneficial effects of probiotic supplementation were absent at D19 as fetal weights from all HF diet fed groups weighed less regardless of probiotic supplementation. Probiotic supplementation reduced placental TNF-alpha mRNA at D12 and IL-10 mRNA at D19. Triacylglyceride concentration was increased at D19 by HF diet, in part, by the preceding increases in lipoprotein lipase (LPL) and plasma membrane-associated fatty-acid binding protein (FABPpm) mRNA expression at D12. Conclusions These findings suggest that maternal HF diet alters placental size and weight as well as fetal weight and that probiotic supplementation renders a protective effect against these changes in mid-gestation. Future studies are needed to determine whether the protective mechanism of probiotic supplementation in mid-gestation has beneficial effects on offspring developmental programming. Funding Sources USDA Agricultural Research Service Project #3062-51000-052-00D.

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