L Lepais1, L Gaillot-Durand1, F Boutitie2, F Lebreton1, R Buffin3, C Huissoud4, J Massardier5, L Guibaud6, M Devouassoux-Shisheboran1, F Allias7. 1. Centre de Pathologique Nord, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, 69317 Lyon Cedex 04, France. 2. Service de Biostatistique, Hospices Civils de Lyon, F-69003 Lyon, France; CNRS, UMR5558, F-69100 Villeurbanne, France. 3. Service de Réanimation Néonatale, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, 69317 Lyon Cedex 04, France. 4. Service d'Obstétrique, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, 69317 Lyon Cedex 04, France. 5. Service d'Obstétrique, Hôpital Femme-Mère-Enfant, 59 Boulevard Pinel, 69677 Bron Cedex, France. 6. Service d'Imagerie Pédiatrique et Fœtale, Hôpital Femme-Mère-Enfant, 59 Boulevard Pinel, 69677 Bron Cedex, France. 7. Centre de Pathologique Nord, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, 69317 Lyon Cedex 04, France. Electronic address: fabienne.allias@chu-lyon.fr.
Abstract
OBJECTIVE: to test the hypothesis that placental fetal thrombotic vasculopathy (FTV) is associated with obstetric complications and predisposes the child to unfavorable outcomes. METHODS: 54 placentas with FTV lesions and 100 placentas without FTV lesions were collected over a 5-year period at the Croix-Rousse Pathology Department. Clinical findings including maternal, fetal, neonatal condition and pediatric outcome up to three years were collected for each case and control observation. The statistical analyses were assessed with Wald's chi-square derived from conditional logistic regression modeling. RESULTS: FTV was associated with a significantly higher frequency of obstetric complications: (pregnancy-induced hypertension (OR 3.620, CI 1.563-8.385), preeclampsia (OR 3.674, CI 1.500-8.998), emergency delivery procedures (OR 3.727, CI 1.477-9.403), cesarean sections (OR 2.684, CI 1.016-7.088)), poor fetal condition (intrauterine growth restriction (IUGR) (OR 5.440, CI 2.007-14.748), nonreassuring fetal heart tracing (OR 6.062, CI 2.280-16.115), difficulties in immediate ex utero adaptation (OR 3.416, CI 1.087-10.732)) and perinatal or early childhood demise (OR 3.043, CI 1.327-6.978). On pathological examination, FTV was associated with marginal cord insertion (OR 3.492, CI 1.350-9.035), cord stricture and hypercoiled cord (OR 3.936, CI 1.209-12.813). Thromboembolic events were significantly more frequent in cases with FTV (OR 2.154, CI 1.032-5.622). Neurological complications within the first 3 years of life were also more frequent in the FTV group compared to the control group, but this association was not statistically significant. CONCLUSIONS: FTV is associated with maternal complications, pathological findings in the placenta, especially gross cord abnormalities, IUGR, and poor perinatal or early childhood outcome. It may also predispose children to somatic thromboembolic events.
OBJECTIVE: to test the hypothesis that placental fetal thrombotic vasculopathy (FTV) is associated with obstetric complications and predisposes the child to unfavorable outcomes. METHODS: 54 placentas with FTV lesions and 100 placentas without FTV lesions were collected over a 5-year period at the Croix-Rousse Pathology Department. Clinical findings including maternal, fetal, neonatal condition and pediatric outcome up to three years were collected for each case and control observation. The statistical analyses were assessed with Wald's chi-square derived from conditional logistic regression modeling. RESULTS:FTV was associated with a significantly higher frequency of obstetric complications: (pregnancy-induced hypertension (OR 3.620, CI 1.563-8.385), preeclampsia (OR 3.674, CI 1.500-8.998), emergency delivery procedures (OR 3.727, CI 1.477-9.403), cesarean sections (OR 2.684, CI 1.016-7.088)), poor fetal condition (intrauterine growth restriction (IUGR) (OR 5.440, CI 2.007-14.748), nonreassuring fetal heart tracing (OR 6.062, CI 2.280-16.115), difficulties in immediate ex utero adaptation (OR 3.416, CI 1.087-10.732)) and perinatal or early childhood demise (OR 3.043, CI 1.327-6.978). On pathological examination, FTV was associated with marginal cord insertion (OR 3.492, CI 1.350-9.035), cord stricture and hypercoiled cord (OR 3.936, CI 1.209-12.813). Thromboembolic events were significantly more frequent in cases with FTV (OR 2.154, CI 1.032-5.622). Neurological complications within the first 3 years of life were also more frequent in the FTV group compared to the control group, but this association was not statistically significant. CONCLUSIONS:FTV is associated with maternal complications, pathological findings in the placenta, especially gross cord abnormalities, IUGR, and poor perinatal or early childhood outcome. It may also predispose children to somatic thromboembolic events.
Authors: Lorenzo Giacchetti; Martina De Gaudenzi; Andrea Leoncini; Elisabetta Ferrucci; Valdo Pezzoli; Manuela Albisetti Journal: J Med Case Rep Date: 2017-08-28
Authors: Solange N Eloundou; JiYeon Lee; Dan Wu; Jun Lei; Mia C Feller; Maide Ozen; Yan Zhu; Misun Hwang; Bei Jia; Han Xie; Julia L Clemens; Michael W McLane; Samar AlSaggaf; Nita Nair; Marsha Wills-Karp; Xiaobin Wang; Ernest M Graham; Ahmet Baschat; Irina Burd Journal: PLoS One Date: 2019-04-03 Impact factor: 3.240
Authors: Fatih Anfasa; Marco Goeijenbier; Widagdo Widagdo; Jurre Y Siegers; Noreen Mumtaz; Nisreen Okba; Debby van Riel; Barry Rockx; Marion P G Koopmans; Joost C M Meijers; Byron E E Martina Journal: Front Microbiol Date: 2019-04-24 Impact factor: 5.640