Sampling and Definitions of Placental Lesions: Amsterdam Placental Workshop Group Consensus Statement

Khong, T. Yee; Mooney, Eoghan E.; Ariel, Ilana; Balmus, Nathalie C.M.; Boyd, Theonia K.; Bründler, Marie Anne; Derricott, Hayley; Evans, Margaret J.; Faye-Petersen, Ona; Gillan, John; Heazell, Aep; Heller, Debra S.; Jacques, Suzanne M.; Keating, Sarah; Kelehan, P.; Maes, Ann; McKay, E.; Morgan, Terry K.; Nikkels, Peter G. J.; Parks, W. Tony; Redline, Raymond W.; Scheimberg, Irene; Schoots, Mirthe H.; Sebire, Neil J.; Timmer, Albert; Turowski, G; Voorn, J. Patrick van der; Lijnschoten, Ineke van; Gordijn, Sanne J.

doi:10.5858/arpa.2015-0225-cc

Cited by 1,296 publications

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“…Collective agreement of definitions of placental lesions and their importance is also needed. 41 Although the same lesions might be seen in stillbirths and in livebirths, placental lesions are more frequently noted in cases of stillbirth. 42 …”

Section: Addressing Data Quality In Causes Of Stillbirthmentioning

confidence: 97%

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Stillbirths: recall to action in high-income countries

et al. 2016

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Variation in stillbirth rates across high-income countries and large equity gaps within high-income countries persist. If all high-income countries achieved stillbirth rates equal to the best performing countries, 19 439 late gestation (28 weeks or more) stillbirths could have been avoided in 2015. The proportion of unexplained stillbirths is high and can be addressed through improvements in data collection, investigation, and classification, and with a better understanding of causal pathways. Substandard care contributes to 20-30% of all stillbirths and the contribution is even higher for late gestation intrapartum stillbirths. National perinatal mortality audit programmes need to be implemented in all high-income countries. The need to reduce stigma and fatalism related to stillbirth and to improve bereavement care are also clear, persisting priorities for action. In high-income countries, a woman living under adverse socioeconomic circumstances has twice the risk of having a stillborn child when compared to her more advantaged counterparts. Programmes at community and country level need to improve health in disadvantaged families to address these inequities.

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Section: Addressing Data Quality In Causes Of Stillbirthmentioning

confidence: 97%

“…Through the ISA survey of care providers we assessed uptake and perceived barriers to implementation of the Lancet Stillbirths Series recommended interventions in stillbirth prevention (appendix pp 40,41). Only 60% of respondents said their facility always provided smoking cessation advice.…”

Section: Quality Of Care Uptake Of Interventions In Stillbirth Prevenmentioning

confidence: 99%

Stillbirths: recall to action in high-income countries

et al. 2016

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“…In selected cases E-cadherin/CD34 immunohistochemistry was performed to detect the incipient fetal malperfusion of fetal thrombotic vasculopathy, and highlighting the histological features of chronic hypoxic placental injury [32,33] and immunofluorescence for X and Y chromosomes was performed in selected cases to confirm the origin of inflammatory cells (maternal versus fetal) [29]. The diagnosis of VUE was made based on the presence of lymphohistiocytic villitis involving groups of at least 3 chorionic villi with a tendency to agglutinate together, with blurring of contours thereof, hypovascularity/avascularity, and spilling of inflammatory infiltrate into the intervillous space [3,4,5,6] (Figs. 1 and 2), and no clinical or pathological evidence of infectious etiology.…”

Section: Methodsmentioning

confidence: 99%

“…It may be of infectious origin (viral, bacterial), or, most commonly, of yet unknown etiology (VUE). If high grade, VUE may be recurrent and associated with perinatal pathology such as recurrent reproductive loss, fetal growth restriction (FGR), preterm birth, long-term neurological impairment, and cerebral palsy [3,4,5,6,7,8,9,10]. The mechanism of villous damage in VUE is the maternal anti-fetal immune reaction resembling allograft rejection, as it histologically features the inflammatory infiltrate containing predominantly maternal T-lymphocytes [11].…”

Section: Introductionmentioning

confidence: 99%

Placental infectious villitis versus villitis of unknown etiology

Stanek¹

2017

pjp

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To assess the incidence, diagnosis, pathogenesis, and clinical and placental associations of congenital cytomegalovirus infection, 34 cases thereof diagnosed by placental/fetal or neonatal workup (group 1), and 494 placentas with villitis of unknown etiology (group 2) were extracted from a 6083-case placental database. 28 clinical and 47 placental phenotypes were compared between the two groups by Yates c 2 or ANOVA using the Bonferroni correction. 26 group 1 cases did and 8 did not feature placental villitis, but all cases were positive as shown by immunohistochemistry and/or in situ hybridization. Only 5 differences were statistically significant (p Bonferroni < 0.0056): gestational age 29.8 ±6.5 vs. 35.5 ±4.9 weeks, perinatal mortality 67.6 vs. 16.2%, nonmacerated stillbirth 20.6 vs. 3.0%, macerated stillbirth 38.2 vs. 9.3%, and diffuse villous fibrosis 44.1 vs. 12.5%, between group 1 and group 2, respectively. The absence of significant differences in placental phenotypes between group 1 and group 2 other than the histological pattern of villitis indicates that not the cytomegalovirus villitis but the direct viral cytopathogenic effect on fetal organs makes the difference in the dire clinical outcome in the former. As about a third of cytomegalovirus infections show no villitis, the combination of the clinical picture and placental patterns creates the best chance to detect congenital cytomegalovirus infection.

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“…Otherwise, according to the 2005 grading rules, a tumor with 80% pattern 3 and 20% pattern 5 would be a Gleason score 3 þ 5 ¼ 8, and another tumor with 50% pattern 3, 30% pattern 4, and 20% pattern 5 would be graded 3 þ 4 ¼ 7, which makes no sense, given that both have the same large amount of Gleason pattern 5 cancer. As noted in the previous AJSP response, 1 ''Several members of the 2014 organizing committee, instead of incorporating the issue of tertiary patterns and the recommendation to report the percentage of pattern 4 in the 2014 consensus conference published in AJSP in 2016, as I recommended, argued to split these topics into an additional manuscript. There is not even a circulated draft of this additional manuscript over 2 years after the consensus conference.…”

mentioning

confidence: 99%