Fetal thrombotic vasculopathy is associated with thromboembolic events and adverse perinatal outcome but not with neurologic complications: A retrospective cohort study of 54 cases with a 3-year follow-up of children

Lepais, Laureline; Gaillot-Durand, Lucie; Boutitie, Florent; Lebreton, F.; Buffin, Rachel; Huissoud, Cyril; Massardier, Jérôme; Guibaud, Laurent; Devouassoux‐Shisheboran, Mojgan; Allias, Fabienne

doi:10.1016/j.placenta.2014.04.012

Cited by 41 publications

(26 citation statements)

References 32 publications

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“…A previous study has demonstrated an association between inflammatory markers and thrombotic pathology . Elevated levels of C‐reactive protein have been associated with an increased risk of venous thromboembolism, and increased levels of certain pro‐inflammatory substances, such as IL‐6, have been linked with venous thrombosis .…”

Section: Discussionmentioning

confidence: 66%

“…39 We also observed that A previous study has demonstrated an association between inflammatory markers and thrombotic pathology. 40 Elevated levels of C-reactive protein have been associated with an increased risk of venous thromboembolism, 41 and increased levels of certain pro-inflammatory substances, such as IL-6, have been linked with venous thrombosis. 42 Also, maternal placental malperfusion is known to lead to fetal metabolic and cardiovascular sequelae, which have been linked to fetal brain injury.…”

Section: Discussionmentioning

confidence: 99%

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Melatonin for prevention of placental malperfusion and fetal compromise associated with intrauterine inflammation‐induced oxidative stress in a mouse model

Lee

Shin

et al. 2019

Journal of Pineal Research

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Melatonin has been shown to reduce oxidative stress and mitigate hypercoagulability. We hypothesized that maternally administered melatonin may reduce placental oxidative stress and hypercoagulability associated with exposure to intrauterine inflammation (IUI) and consequently improve fetoplacental blood flow and fetal sequelae. Mice were randomized to the following groups: control (C), melatonin (M), lipopolysaccharide (LPS; a model of IUI) (L), and LPS with melatonin (ML). The expression of antioxidant mediators in the placenta was significantly decreased, while that of pro‐inflammatory mediators was significantly increased in L compared to C and ML. The systolic/diastolic ratio, resistance index, and pulsatility index in uterine artery (UtA) and umbilical artery (UA) were significantly increased in L compared with other groups when analyzed by Doppler ultrasonography. The expression of antioxidant mediators in the placenta was significantly decreased, while that of pro‐inflammatory mediators was significantly increased in L compared to C and ML. Vascular endothelial damage and thrombi formation, as evidenced by fibrin deposits, were similarly increased in L compared to other groups. Maternal pretreatment with melatonin appears to modulate maternal placental malperfusion, fetal cardiovascular compromise, and fetal neuroinflammation induced by IUI through its antioxidant properties.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Melatonin for prevention of placental malperfusion and fetal compromise associated with intrauterine inflammation‐induced oxidative stress in a mouse model

Lee

Shin

et al. 2019

Journal of Pineal Research

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“…Saleemuddin and colleagues [23] found that IUFD was significantly more common in cases of FTV compared to their control population (12.4 vs 1.4 %, respectively). Lepais and colleagues [27] found that mortality in cases of FTV was three times that seen in their control population. Other complications that have shown significant association with FTV include liver injury [14,28], IUGR [13,21,29], intestinal atresia [30], cardiac abnormalities [23], oligohydramnios [23], and major thromboembolic events [1,4,25,27].…”

Section: Discussionmentioning

confidence: 91%

Fetal Thrombotic Vasculopathy

Marsden

Comstock

2015

Journal of Fetal Medicine

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Fetal thrombotic vasculopathy (FTV) is the term used to encompass the histologic findings identified in placentas with fetal thrombotic lesions: occlusive and nonocclusive chorionic vessel thrombi, avascular villi in the distribution of a single villous tree, intramural vascular fibrin, and hemorrhagic endovasculitis. The underlying etiology of FTV is largely unknown though hypercoagulability and circulatory stasis have been the main focuses in the literature to explain the hemostatic abnormalities. This article reviews the literature in both defining and discussing, potential etiologies of FTV, as well as neonatal outcomes.

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“…Mcdonald et al, 8 in a retrospective cohort of 93 cases, found a relationship between FTV and the occurrence of neonatal encephalopathy. In a more recent study, Lepais et al, 3 through a retrospective cohort analysis of 54 placentas and monitoring of newborns for 3 years, found an association between FTV and pregnancy-induced hypertension (PIH), FGR (5.4 times higher), perinatal death and early neonatal death, in addition to a greater need for caesarean sections and emergency deliveries. There was also a higher number of thromboembolic events during the follow-up of these children, while other abnormalities such as brain or cardiac impairment, or the presence of malformations, were not related to this change.…”

Section: Discussionmentioning

confidence: 99%

“…It can, however, be suspected in cases of FGR, Doppler changes such as zero or reverse diastole, and a non-reassuring intrapartum cardiotocography. 3 The objective of this study is to report a case of FTV and present a literature review on the topic.…”

Section: Introductionmentioning

confidence: 99%