Investigation of Neonatal Encephalopathy: The Oft-Lost Placental “Black Box”

Clarke, Paul; Muniraman, Hemananda; Gardner, Danielle; Venkatesh, Vidheya; Curley, Anna; Victor, Suresh; Turner, Mark A.

doi:10.2350/15-02-1611-let.1

Cited by 6 publications

(6 citation statements)

References 3 publications

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“…Placental pathology has been described as the “blackbox” of pregnancy. Standardized classification of placental pathology findings are essential to further delineate etiology in NE (39).…”

Section: Placental Abnormalitiesmentioning

confidence: 99%

Neonatal Encephalopathy: Need for Recognition of Multiple Etiologies for Optimal Management

2019

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Neonatal encephalopathy (NE) is associated with high mortality and morbidity. Factors predisposing to NE can be antenatal, perinatal, or a combination of both. Antenatal maternal factors, familial factors, genetic predisposition, hypoxic ischemic encephalopathy, infections, placental abnormalities, thrombophilia, coagulation defects, and metabolic disorders all have been implicated in the pathogenesis of NE. At present, therapeutic hypothermia is the only treatment available, regardless of etiology. Recognizing the etiology of NE involved can also guide investigations such as metabolic and sepsis workups to ensure optimal management. Understanding the etiology of NE may allow the development of targeted adjunctive therapies related to the underlying mechanism and develop preventative strategies.

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Section: Placental Abnormalitiesmentioning

confidence: 99%

Neonatal Encephalopathy: Need for Recognition of Multiple Etiologies for Optimal Management

2019

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“…It is common practice to examine the placenta of babies born with NE or who are stillborn 9 . This practice has been recommended by many professional bodies including the Royal College of Obstetricians and Gynecologists and the Royal College of Pathologists in the United Kingdom since 2001 11 . This practice is to investigate the cause of NE for each case.…”

Section: Introductionmentioning

confidence: 99%

Placental pathology and neonatal encephalopathy

Fox

Doyle

Geary

et al. 2022

Intl J Gynecology & Obste

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“…To the Editor, I read with great interest the article by Clarke and colleagues regarding the low rate of placentas submitted from babies with neonatal encephalopathy (NE) in several centers in the United Kingdom [1].…”

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confidence: 99%

“…In addition to acute chorioamnionitis and/or funisitis referred to in the article [1], there are many other placental lesions associated with adverse neurological outcome in the baby, including fetal thrombotic vasculopathy, chronic villitis of unknown etiology, massive perivillous fibrin deposition, and delayed chorionic villous maturation [2,3]. Many of these lesions will not be suspected clinically, and will be missed without placental examination by perinatal pathologists.…”

mentioning

confidence: 99%

“…The multicenter study by Clarke and colleagues [1] provides evidence by “nonperinatal pathologists” that the available current guidelines for placental examination are not being followed. Different hospitals have different indications for placental examination, depending on the value placed on placental pathology by the local obstetricians and on local resources.…”

mentioning

confidence: 99%

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