Fetal Thrombotic Vasculopathy in the Placenta: A Thrombophilic Connection Between Pregnancy Complications and Neonatal Thrombosis?

Leistra-Leistra, MJ; Timmer, Albertus; Spronsen, van FrancJan; Geven, W.B.; Meer, Jan van der; Erwich, Johannes

doi:10.1016/j.placenta.2004.01.010

Cited by 60 publications

(32 citation statements)

References 23 publications

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“…There was no difference in the presence of chorioamnionitis. 21 Monochorionic placentation with vascular interconnections was more common among the case infants. This finding has been reported to lead to antenatal brain injury, such as antenatal cystic PVL and porencephaly.…”

Section: Benders Et Al Perinatal Arterial Stroke In Preterm Infantsmentioning

confidence: 92%

Maternal and Infant Characteristics Associated With Perinatal Arterial Stroke in the Preterm Infant

Benders

Groenendaal

Uiterwaal

et al. 2007

Stroke

113

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Background and Purpose-Most perinatal arterial stroke (PAS) studies that investigated infant characteristics have excluded preterm infants from the study population. We sought to analyze the imaging findings and antenatal and perinatal risk factors in preterm infants with PAS. Methods-This was a hospital-based, case-control study of preterm infants. Case infants were confirmed by reviewing brain imaging scans and medical records (nϭ31). Three controls per case were individually matched with case infants from the study population. Results-Gestational age ranged between 27 and 36 weeks, and birth weight ranged between 580 and 3180 g. PAS was more common on the left side (61%), and 7% had bilateral PAS. The majority of strokes involved the middle cerebral artery distribution. Involvement of 1 or more lenticulostriate branches was most common among infants with a gestational age of 28 to 32 weeks, but main branch involvement was seen only in those with a gestational age of Ͼ32 weeks. Twin-to-twin-transfusion syndrome, fetal heart rate abnormality, and hypoglycemia were identified as independent risk factors for PAS. Conclusions-Preterm PAS is associated with prenatal, perinatal, and postpartum risk factors. We were unable to identify any maternal risk factors. Involvement of the different branches of the middle cerebral artery changed with an increase in gestational age.

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Section: Benders Et Al Perinatal Arterial Stroke In Preterm Infantsmentioning

confidence: 92%

Maternal and Infant Characteristics Associated With Perinatal Arterial Stroke in the Preterm Infant

Benders

Groenendaal

Uiterwaal

et al. 2007

Stroke

113

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“…[1][2][3][4][5] The clinical and pathologic features of fetal vessel thrombosis in twins, however, are not clear.…”

mentioning

confidence: 99%

Increased Prevalence of Fetal Thrombi in Monochorionic-Twin Placentas

Sato

Benirschke

2006

Pediatrics

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OBJECTIVE. Fetal vessel thrombosis has been related to pregnancy complications and adverse neonatal outcomes in singleton pregnancies, but the clinical and pathologic characteristics of fetal thrombosis in twin pregnancy are still ill defined. METHODS. To clarify the characteristics of fetal thrombosis in twins, we reviewed the histology slides and medical records of live-born infants of twin pregnancies involving the live birth of at least 1 fetus (monochorionic: 389 cases; dichorionic: 780 cases) and singleton pregnancies (1162 cases). RESULTS. The incidence of fetal thrombosis in monochorionic-twin pregnancies was significantly higher than that of dichorionic-twin and singleton pregnancies (5.1% vs 3.0% and 2.8%, respectively). The incidence of velamentous umbilical cord insertion in monochorionic- and dichorionic-twin placentas was also higher than in singleton placentas (12% and 7% vs 2%, respectively). Fetal thrombosis in twin placentas was associated with intrauterine growth restriction. In monochorionic twins, fetal thrombosis was associated with co-twin fetal death, but in dichorionic twins no correlation was identified. Microscopically, fetal vessel thrombosis in twin placentas was associated with vascular cushions (fibrous hyperplasia of fetal vessel), as is the case occasionally in singletons. CONCLUSIONS. The incidence of fetal vessel thrombosis in monochorionic placentas was higher than that seen in dichorionic-twin placentas and singleton gestations. Fetal vessel thrombosis in twin pregnancies showed a correlation with intrauterine growth restriction, peripheral cord insertions, and major vascular cushions.

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“…Leistra-Leistra et al, 2 in turn, found no correlation between the occurrence of fetal thromboembolism and FTV or thrombophilia and FTV. conclusion FTV may be related to the occurrence of adverse perinatal outcomes, including FGR and fetal death, as described in the present case.…”

Section: Discussionmentioning

confidence: 93%

“…2 Such classification was studied by Chisholm et al 6 in a retrospective cohort of 139 cases, in which 67 cases with severe FTV large vessels were associated with preeclampsia, birth by fetal indication, lower placental weight, umbilical cord abnormalities, and small for gestational age fetus. In the cases that were not classified as severe, the results were similar to those without FTV.…”

Section: Discussionmentioning

confidence: 99%

“…1 These lesions limit perfusion of villi distal to the occlusion resulting in stromal-vascular karyorrhexis and avascular villi. 2,12 Even with a variety of possible clinical manifestations, FTV can remain asymptomatic until birth, induce fetal growth restriction (FGR) or cause fetal death when there is massive placental involvement or damage to the cord. To date, no specific sonographic criteria are reliable enough for the diagnosis of prenatal FTV.…”

Section: Introductionmentioning

confidence: 99%

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