Placental pathology at term associated with elevated midtrimester maternal serum α-fetoprotein concentration

Salafia, Carolyn M.; Silberman, Lester; Herrera, Nilo E.; Mahoney, Maurice J.

doi:10.1016/0002-9378(88)90220-7

Cited by 109 publications

(40 citation statements)

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“…Recent reports suggest that placental abnormalities [2][3][4][5][6] and oligohydramnios [7][8][9] may be associated with elevated MS-AFP levels. However, the frequency of such observations is uncertain because of the small number of published series.…”

mentioning

confidence: 99%

Sonography of placental abnormalities and oligohydramnios in women with elevated alpha-fetoprotein levels: comparison with control subjects

Kelly

Nyberg

Mack

et al. 1989

American Journal of Roentgenology

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twins, or lack of follow-up were excluded.Overall, 27 (36%) of 76 patients with elevated MS-AFP levels had placental or amniotic fluid abnormalities compared with only three (3%) of 87 control subjects. Significant differences (p < .01) were noted in the frequency of penplacental hemorrhage (9% vs 0%), intraplacental sonolucencies greater than or equal to 1.5 cm in diameter (18% vs 3%) and moderate or severe oligohydramnios (17% vs 0%). More patients with elevated MS-AFP levels had placenta previa (4%) or placental thickness greater than or equal to 3.5 cm (12%) than did those In the control group (1% and 5%, respectively), although these differences did not reach statistical significance. Seven (26%) of the 27 patients had more than one abnormality.We conclude that placental and/or amniotic fluid abnormalities are frequently shown on sonograms in women who are examined because of elevated MS-AFP levels.

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mentioning

confidence: 99%

Sonography of placental abnormalities and oligohydramnios in women with elevated alpha-fetoprotein levels: comparison with control subjects

Kelly

Nyberg

Mack

et al. 1989

American Journal of Roentgenology

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“…In this instance, it was proposed that the elevated MSAFP was caused by a fetomaternal bleed from a chorionic decidual-placental separation (an inflammatory lesion) resulting in placental insufficiency and poor weight gain in third trimester pregnancy [35,36]. Investigators have since found that some AFP elevations result from inflammatory placental pathologies at term, namely, 1) chronic villitis, 2) placental vascular lesions of infarction and 3) intervillous thrombosis [36] ( Table 2). Women with chronic villitis also displayed elevated AFP levels together with low birth weight offspring, both conditions of which have a recognized association with IUGR.…”

Section: Afp and Inflammation During Pregnancymentioning

confidence: 99%

“…Another group of clinical investigators reported that elevated second trimester AFP conveyed a significant risk of low birth weight and neonatal death; both exemplify features of AFP as a positive APP [37]. Furthermore, elevated AFP has been associated with the presence of maternal vascular uterine lesions that compromised the blood supply to the vascular bed of the placenta, leading to placental ischemia and chronic villous damage; these lesions resulted in an increased flow of AFP to leak into the maternal circulation [36,38,39]. Finally, premature rupture of membranes is an inflammatory event following intrauterine fluid leakage which can occur as early as 22 to 26 and as late as 36 weeks gestation [38].…”

Section: Afp and Inflammation During Pregnancymentioning

confidence: 99%

Alpha-Fetoprotein (AFP) and Inflammation: Is AFP an Acute and/or Chronic Phase Reactant?

2015

J Hematol Thrombo Dis

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Even though alpha-fetoprotein has long been implicated with inflammation during pregnancy and adult liver dysfunction, the literature lacks a review of such a relationship. Clarification of the role of alpha-fetoprotein in the inflammatory response is explored in the present report regarding AFP's participation as a positive and/or negative phase inflammatory reactant. Inflammation follows a complex succession of vascular changes involving alternations in blood and lymphatic vessels both at local intracellular sites and at the organ (liver) level. The inflammatory response may result in either an acute phase or develop into a chronic phase following injury or insult from foreign bodies, microbes, toxins, carcinogens, or autoimmune self-antigens. The site of inflammation attracts pleiomorphic cell infiltrates which secrete various chemical mediators such as cytokines, chemokines, interferons, histamines, and a host of others. It is herein demonstrated that alpha-fetoprotein can serve both as an acute and a chronic phase reactant depending on its stage of ontogeny. It was found that alpha-fetoprotein functions as a positive acute phase reactant in the embryo, fetus, and placenta during pregnancy. In contrast, alpha-fetoprotein proceeds to function as a negative acute phase protein in the postnatal and adult periods of life, especially following liver dysfunction and toxic insult. In chronic viral-induced inflammation of the liver, especially viral hepatitis, alpha-fetoprotein appears to serve as a positive phase inflammatory reactant.

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“…Maturation of placenta causes an increase in the placental nutrient transfer capacity and thus improves placental efficiency, permitting an increase in the number of grams of fetal weight supported by every gram of placental mass. Not surprisingly "Placental insufficiency" is invoked commonly in case of impaired fetal growth [2] .…”

Section: Introductionmentioning

confidence: 99%

Morphological Changes of Placenta Associated with Maternal Anaemia

Mondal¹,

Baske²,

Biswas³

2017

IJLSSR

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ABSTRACT-Placenta is the mirror of fetomaternal status. The effect of anemia in pregnancy can be diverse and detrimental to the mother and the fetus. This prompted us to carry out the present study, which aimed to observe and compare the morphological features of placenta at term in anemic and non-anemic mothers of North Bengal and to find out the clinical relevance of such structural changes. Total 30 placentas were collected from each group of selected patients after delivery at labor room. Examination of placenta was conducted according to proforma. A general survey of umbilical cord, membranes, fetal surface, and maternal surface was carried out. The diameters were measured, area was estimated, and shape was noted. Placenta and fetus was weighed in the same scale. The volume was estimated by water displacement method. In anemic mothers, mean baby birth weight was found to be significantly less than that of control group. The mean placental weight in test group was significantly increased in comparison to controls. The mean placental volume and mean placental area in case of test group were significantly increased. Occurrence of morphological features, like subchorionic fibrosis; retroplacental clot, gross calcification, or placental infarction etc were found to be significantly higher in anemic mothers in comparison to non-anemic group. In the present study, it was proved that placenta has considerable functional reserve capacity. It tends to limit the ill-effects of tissue injury and of unfavorable maternal milieu like anemia. Our findings were in accordance with the previous studies in this field.

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Placental pathology at term associated with elevated midtrimester maternal serum α-fetoprotein concentration

Cited by 109 publications

References 1 publication

Sonography of placental abnormalities and oligohydramnios in women with elevated alpha-fetoprotein levels: comparison with control subjects

Sonography of placental abnormalities and oligohydramnios in women with elevated alpha-fetoprotein levels: comparison with control subjects

Alpha-Fetoprotein (AFP) and Inflammation: Is AFP an Acute and/or Chronic Phase Reactant?

Morphological Changes of Placenta Associated with Maternal Anaemia

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