Torstein Vik1, Raymond Redline2, Karin B Nelson3, Solveig Bjellmo4, Christina Vogt5, Pamela Ng6, Kristin Melheim Strand7, Tuyet Nhung Ton Nu8, Maryam Oskoui9. 1. Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: torstein.vik@ntnu.no. 2. Department of Pathology and Reproductive Biology, Case Western Reserve University School of Medicine and University Hospitals, Cleveland Medical Center, Cleveland, OH. 3. National Institute of Neurologic Disorders and Stroke, National Institutes of Health, Bethesda, MD. 4. Department of Obstetrics and Gynecology, More and Romsdal Hospital Trust, Aalesund, Norway. 5. Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pathology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. 6. Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. 7. Department of Obstetrics and Gynecology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. 8. Department of Pathology, McGill University Health Center, McGill University, Montreal, Québec, Canada. 9. Department of Pediatrics and Neurology and Neurosurgery, McGill University, Montreal, Québec, Canada.
Abstract
OBJECTIVE: We assessed whether specific histologic placental lesions were associated with risk for neonatal encephalopathy, a strong predictor of death or cerebral palsy. STUDY DESIGN: Case-control study of singletons with gestational ages ≥35 weeks. Data were abstracted from a prospectively collected database of consecutive births at a hospital in which placental samples from specified sites are collected and stored for all inborn infants. Placentas of infants with neonatal encephalopathy were compared with randomly selected control infants (ratio of 1:3). Placental histologic slides were read by a single experienced perinatal pathologist unaware of case status, using internationally recommended definitions and terminology. Findings were grouped into inflammatory, maternal, or fetal vascular malperfusion (FVM) and other lesions. RESULTS: Placental samples were available for 73 of 87 (84%) cases and 253 of 261 (97%) controls. Delivery complications and gross placental abnormalities were more common in cases, of whom 4 died. Inflammation and maternal vascular malperfusion did not differ, and findings consistent with global FVM were more frequent in case (20%) than control (7%) placentas (P = .001). There was a trend toward more segmental FVM and high-grade FVM (fetal thrombotic vasculopathy) among cases. Some type of FVM was observed in 24% of placentas with neonatal encephalopathy. In infants with both neonatal encephalopathy and placental FVM, more often than in infants with neonatal encephalopathy without FVM, electronic fetal monitoring tracings were considered possibly or definitely abnormal (P = .028). CONCLUSIONS: Vascular malperfusion of subacute or chronic origin on the fetal side of the placenta was associated with increased risk of neonatal encephalopathy.
OBJECTIVE: We assessed whether specific histologic placental lesions were associated with risk for neonatal encephalopathy, a strong predictor of death or cerebral palsy. STUDY DESIGN: Case-control study of singletons with gestational ages ≥35 weeks. Data were abstracted from a prospectively collected database of consecutive births at a hospital in which placental samples from specified sites are collected and stored for all inborn infants. Placentas of infants with neonatal encephalopathy were compared with randomly selected control infants (ratio of 1:3). Placental histologic slides were read by a single experienced perinatal pathologist unaware of case status, using internationally recommended definitions and terminology. Findings were grouped into inflammatory, maternal, or fetal vascular malperfusion (FVM) and other lesions. RESULTS: Placental samples were available for 73 of 87 (84%) cases and 253 of 261 (97%) controls. Delivery complications and gross placental abnormalities were more common in cases, of whom 4 died. Inflammation and maternal vascular malperfusion did not differ, and findings consistent with global FVM were more frequent in case (20%) than control (7%) placentas (P = .001). There was a trend toward more segmental FVM and high-grade FVM (fetal thrombotic vasculopathy) among cases. Some type of FVM was observed in 24% of placentas with neonatal encephalopathy. In infants with both neonatal encephalopathy and placental FVM, more often than in infants with neonatal encephalopathy without FVM, electronic fetal monitoring tracings were considered possibly or definitely abnormal (P = .028). CONCLUSIONS: Vascular malperfusion of subacute or chronic origin on the fetal side of the placenta was associated with increased risk of neonatal encephalopathy.
Authors: C Zenobi; J L Wisnowski; B Tamrazi; A M-C Wong; R Chapman; S Blüml; T-W Wu Journal: AJNR Am J Neuroradiol Date: 2022-02-03 Impact factor: 3.825
Authors: Laura Lambicchi; Sara Ornaghi; Giulia Dal Molin; Giuseppe Paterlini; Davide P Bernasconi; Francesca Moltrasio; Patrizia Vergani Journal: Int J Gynaecol Obstet Date: 2021-06-22 Impact factor: 4.447
Authors: Jessica L Wisnowski; Stefan Bluml; Ashok Panigrahy; Amit M Mathur; Jeffrey Berman; Ping-Sun Keven Chen; James Dix; Trevor Flynn; Stanley Fricke; Seth D Friedman; Hayden W Head; Chang Y Ho; Beth Kline-Fath; Michael Oveson; Richard Patterson; Sumit Pruthi; Nancy Rollins; Yanerys M Ramos; John Rampton; Jerome Rusin; Dennis W Shaw; Mark Smith; Jean Tkach; Shreyas Vasanawala; Arastoo Vossough; Matthew T Whitehead; Duan Xu; Kristen Yeom; Bryan Comstock; Patrick J Heagerty; Sandra E Juul; Yvonne W Wu; Robert C McKinstry Journal: BMJ Open Date: 2021-04-22 Impact factor: 2.692
Authors: Jonathon L Hecht; Bradley Quade; Vikram Deshpande; Mari Mino-Kenudson; David T Ting; Niyati Desai; Beata Dygulska; Taryn Heyman; Carolyn Salafia; Dejun Shen; Sara V Bates; Drucilla J Roberts Journal: Mod Pathol Date: 2020-08-02 Impact factor: 8.209