Placental findings in feto-maternal hemorrhage in livebirth and stillbirth

Ravishankar, Sanjita; Migliori, Alison; Struminsky, Judy; Has, Phinnara; Sung, Chih‐Chien; He, Mai

doi:10.1016/j.prp.2017.02.005

Cited by 11 publications

(6 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…High rate of placentomegaly (41%) was also reported [43]. Ravishankar et al [45] demonstrated that some macro- and microscopic placental pathology parameters, such as parenchymal pallor, intervillous thrombi, and increased nucleated red blood cells, are significantly higher in placentas with FMH, which was confirmed by the Kleihauer-Betke test, both in liveborns and stillborns. Although our limited data reveal a reduced incidence of these features, it is difficult to establish if the treatment of FMH with IUTs is able to reduce these placental features.…”

Section: Discussionmentioning

confidence: 75%

The Recurrence Risk of Fetomaternal Hemorrhage

et al. 2018

View full text Add to dashboard Cite

Massive fetomaternal hemorrhage (FMH) can cause devastating pregnancy outcomes. Perinatal prognosis may be improved by intrauterine transfusion, but the appropriate management for these pregnancies remains unclear. To determine the recurrence risk of FMH after intrauterine transfusion, we performed a systematic review of all case reports/series of patients with proven FMH treated with intrauterine transfusion and who had subsequent follow-up of at least 72 h until delivery. This revealed 13 cases, with 1 additional case from our institution. Ten patients (71.4%) had a second episode of FMH requiring a second intrauterine transfusion. Five patients (35.7%) required at least 3 intrauterine transfusions. The time interval between intrauterine transfusions was progressively reduced. The gestational age at the onset of signs/symptoms was 26.6 ± 2.1 weeks, and gestational age at delivery was 34.2 ± 4.2 weeks. Two cases of fetal demise (14.3%) and no neonatal deaths were recorded. Limited postnatal follow-up on 8 neonates was normal. The mean neonatal hemoglobin and transfusion rates were 13.2 ± 5.7 g/dL and 33.3%, respectively. Close fetal monitoring, likely daily, is necessary to recognize FMH recurrence. Several transfusions may be necessary once FMH is diagnosed if pregnancy is allowed to continue > 72 h.

show abstract

Section: Discussionmentioning

confidence: 75%

The Recurrence Risk of Fetomaternal Hemorrhage

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Studies have proved that the incidence of FMH is signi cantly underestimated due to the inadequate application of con rmatory tests for FMH [12] . Decreased or absent fetal movement, hydrops fetalis, and non-reassuring fetal tracking are common clinical signs or symptoms of signi cant FMH [13] .…”

Section: Discussionmentioning

confidence: 99%

Is chorioamnionitis the cause of the spontaneous fetomaternal hemorrhage?

Feng,

Li,

2023

Preprint

View full text Add to dashboard Cite

Background Fetomaternal hemorrhage (FMH) is a rare and serious pregnancy event, but the risk factors and pathogenesis of FMH are still unclear. Case presentation This paper reports three cases of fetomaternal hemorrhage with unexplained reasons. The three cases required emergency caesarean sections for non-reassuring fetal status and were treated with neonatal blood transfusion. Fetomaternal hemorrhage was confirmed via maternal Kleihauer-Betke test. Conclusion We found that reduced fetal movements, the sinusoidal model and increased MCA-PSV may be important indicators for early diagnosis of fetomaternal hemorrhage, and chorioamnionitismay be one of the causes of spontaneous fetomaternal hemorrhage.

show abstract

“…Fetal maternal hemorrhage was identified when intervillous fibrin forming layered lines of Zahn (indicative of blood clot formation in flowing blood [ 69 ]) was admixed with blood containing nucleated red blood cells (indicative of a fetal bleeding source) (Fig. 3 E) [ 70 , 71 ]. In contrast, massive perivillous fibrin (a manifestation of maternal intervillous blood thrombosis [ 72 – 74 ]) was identified when the intervillous space was largely filled with fibrin (Fig.…”

Section: Methodsmentioning

confidence: 99%

Placental Pathology Findings in Unexplained Pregnancy Losses

Thompson,

Holzer,

Kliman

2023

Reprod. Sci.

View full text Add to dashboard Cite

There are approximately 5 million pregnancies per year in the USA, with 1 million ending in miscarriage (a loss occurring prior to 20 weeks of gestation) and over 20,000 ending in stillbirth at or beyond 20 weeks of gestation. As many as 50% of these losses are unexplained. Our objective was to evaluate the effect of expanding the placental pathology diagnostic categories to include the explicit categories of (1) dysmorphic chorionic villi and (2) small placenta in examining previously unexplained losses. Using a clinical database of 1256 previously unexplained losses at 6–43 weeks of gestation, the most prevalent abnormality associated with each loss was determined through examination of its placental pathology slides. Of 1256 cases analyzed from 922 patients, there were 878 (69.9%) miscarriages and 378 (30.1%) antepartum stillbirths. We determined the pathologic diagnoses for 1150/1256 (91.6%) of the entire series, 777/878 (88.5%) of the miscarriages (< 20 weeks’ gestation), and 373/378 (98.7%) of the stillbirths (≥ 20 weeks’ gestation). The most common pathologic feature observed in unexplained miscarriages was dysmorphic chorionic villi (757 cases; 86.2%), a marker associated with genetic abnormalities. The most common pathologic feature observed in unexplained stillbirths was a small placenta (128 cases; 33.9%). Our classification system reinforced the utility of placental examination for elucidating potential mechanisms behind pregnancy loss. The improved rate of diagnosis appeared to be the result of filling a gap in previous pregnancy loss classification systems via inclusion of the categories of dysmorphic chorionic villi and small placenta. Graphical Abstract

show abstract

Placental findings in feto-maternal hemorrhage in livebirth and stillbirth

Cited by 11 publications

References 19 publications

The Recurrence Risk of Fetomaternal Hemorrhage

The Recurrence Risk of Fetomaternal Hemorrhage

Is chorioamnionitis the cause of the spontaneous fetomaternal hemorrhage?

Placental Pathology Findings in Unexplained Pregnancy Losses

Contact Info

Product

Resources

About