Placental histology of acute versus continuous meconium exposure - Association with obstetric and neonatal outcomes

Tamayev, Liliya; Mor, Liat; Herman, Hadas Ganer; Schreiber, Letizia; Kovo, Michal; Bar, Jacob; Weiner, Eran

doi:10.1016/j.placenta.2020.10.002

Cited by 7 publications

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Whether meconium contributes to fetal distress or is a manifestation of an underlying pathologic process remains controversial. A recent retrospective cohort study ( 32 ) compared singleton deliveries complicated by meconium stained amniotic fluid with acute vs. continuous meconium exposure-associated placental changes. The acute exposure group had a shorter interval between the rupture of membranes and delivery, and higher rates of non-reassuring FHR in labor and adverse neonatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Placental pathology in perinatal asphyxia: a case–control study

Alongi,

Lambicchi,

Moltrasio

et al. 2023

Front. Clin. Diabetes Healthc.

View full text Add to dashboard Cite

IntroductionPlacentas of term infants with birth asphyxia are reported to have more lesion such as maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM) and chorioamnionitis with fetal response (FIR) than those of term infants without birth asphyxia. We compared the placental pathology of asphyxiated newborns, including those who developed hypoxic-ischemic encephalopathy (HIE), with non-asphyxiated controls.MethodsWe conducted a retrospective case–control study of placentas from neonates with a gestational age ≥ 35 weeks, a birthweight ≥ 1,800 g, and no malformations. Cases were asphyxiated newborns (defined as those with an umbilical artery pH ≤ 7.0 or base excess ≤ −12 mMol, 10-minute Apgar score ≤ 5, or the need for resuscitation lasting >10 min) from a previous cohort, with (n=32) and without (n=173) diagnosis of HIE. Controls were non-asphyxiated newborns from low-risk l (n= 50) or high-risk (n= 68) pregnancies. Placentas were analyzed according to the Amsterdam Placental Workshop Group Consensus Statement 2014.ResultsCases had a higher prevalence of nulliparity, BMI>25, thick meconium, abnormal fetal heart monitoring, and acute intrapartum events than controls (p<0.001). MVM and FVM were more frequent among non-asphyxiated than asphyxiated newborns (p<0.001). There was no significant difference in inflammatory lesions or abnormal umbilical insertion site. Histologic meconium-associated changes (MAC) were observed in asphyxiated newborns only (p= 0.039).DiscussionOur results confirm the role of antepartum and intrapartum risk factors in neonatal asphyxia and HIE. No association between neonatal asphyxia and placental lesions was found, except for in the case of MAC. The association between clinical and placental data is crucial to understanding and possibly preventing perinatal asphyxia in subsequent pregnancies.

show abstract

Section: Discussionmentioning

confidence: 99%

Placental pathology in perinatal asphyxia: a case–control study

Alongi,

Lambicchi,

Moltrasio

et al. 2023

Front. Clin. Diabetes Healthc.

View full text Add to dashboard Cite

show abstract

“…Meconium aspiration syndromeColumnar epithelial changes vs. meconium-laden macrophages differentially associated with adverse neonatal outcome; funisitis(20,21) Placental changes could inform the extent and timing of causes, and thus guide work-up and management approaches (e.g., treat for infection, work-up for perinatal depression, supportive respiratory care). BPD HCA and FIR (inconclusive in meta-analyses) (22) and decreased risk of BPD and death (23) MVM increased with BPD-associated pulmonary hypertension (10, 24) Chorionic plate vascularization (25) Chronic inflammatory lesions (26) Could help differentiate certain endotypes of BPD, such as inflammatory versus vascular, which could inform response to specific treatments of which there are currently multiple approaches with untoward side effects (e.g., steroids, pulmonary vasodilators, diuretics, chronic mechanical ventilation).…”

mentioning

confidence: 99%

Leveraging the placenta to advance neonatal care

Mestan,

Leibel,

Sajti

et al. 2023

Front. Pediatr.

View full text Add to dashboard Cite

The impact of placental dysfunction and placental injury on the fetus and newborn infant has become a topic of growing interest in neonatal disease research. However, the use of placental pathology in directing or influencing neonatal clinical management continues to be limited for a wide range of reasons, some of which are historical and thus easily overcome today. In this review, we summarize the most recent literature linking placental function to neonatal outcomes, focusing on clinical placental pathology findings and the most common neonatal diagnoses that have been associated with placental dysfunction. We discuss how recent technological advances in neonatal and perinatal medicine may allow us to make a paradigm shift, in which valuable information provided by the placenta could be used to guide neonatal management more effectively, and to ultimately enhance neonatal care in order to improve our patient outcomes. We propose new avenues of clinical management in which the placenta could serve as a diagnostic tool toward more personalized neonatal intensive care unit management.

show abstract