Placental Streptococcus agalactiae DNA is associated with neonatal unit admission and foetal pro-inflammatory cytokines in term infants.

Streptococcus agalactiae (Group B Streptococcus; GBS) is a common cause of sepsis in neonates. Previous work detected GBS DNA in the placenta in ~5% of women before the onset of labour, but the clinical significance of this finding is unknown. Here we re-analysed this dataset as a case control study of neonatal unit (NNU) admission.

Abnormal placental CD8 T-cell infiltration is a feature of fetal growth restriction and pre-eclampsia.

Key Points: Placental pathological abnormalities are more frequently observed in complicated pregnancies than in healthy pregnancies. Infiltration of CD8 T-cells into the placental villous tissue occurred in both fetal growth restriction and pre-eclampsia, whereas CD79α B-cell infiltration was only apparent with reduced fetal growth. Vascularization, fibrin depositions, macrophage and neutrophil infiltration in the placenta did not differ between healthy and complicated pregnancies.

Coeliac disease in children with type 1 diabetes: are current guidelines proving difficult to implement in practice?

Updated European guidelines for the diagnosis of coeliac disease (CD) in the paediatric population (the European Society for Gastroenterology, Hepatology, and Nutrition, January 2012) outlined distinct diagnostic algorithms for patients with type 1 diabetes mellitus (T1DM). In this short report we demonstrate a period prevalence of CD in the T1DM population of 5.8% at a large tertiary centre.

Perinatal postmortems: what is important to parents and how do they decide?

Background: Falling consent rates for postmortems, regardless of age of death, have been widely reported in recent years. The aim of this study was to explore parental attitudes to, and decision-making about, a perinatal postmortem after termination for fetal abnormality, late miscarriage, or stillbirth.

Methods: A prospective self-completion questionnaire was given to 35 women and their partners.

Frequency and clinical significance of placental histological lesions in an unselected population at or near term.

Associations between specific placental histological abnormalities and obstetric outcomes are reported. However, most data are based either on high-risk cases or relate to case-control studies selected from those with abnormal placental histology findings, with the unavoidable biases that these approaches entail. This study reports the frequency of the several common, objective and predefined histological abnormalities of the placenta as identified by pathologists blinded to all clinical information.

Relationship between placental morphology and histological findings in an unselected population near term.

Whilst individual histological features are well described, there are no universally agreed criteria as to what constitutes a clinically significant histological lesion of the placenta in an uncomplicated pregnancy, nor has the presence of such histological findings been systematically related to quantitative morphological characteristics of the placenta (such as placental shape, cord insertion and cord coiling). This study aims to explore this relationship and further to describe the incidence of predefined categories of histological lesions of the placenta in an unselected obstetric population recruited prior to delivery. The study is based upon the placental examination of 1,156 women with singleton pregnancies recruited prospectively in a single unit.

Attitudes to perinatal postmortem: parental views about research participation.

Objective: To study parental attitudes to participating in questionnaire research about perinatal postmortem immediately after late miscarriage, stillbirth and termination for fetal abnormality.

Design: Prospective self-completion questionnaire.

Setting: UK fetal medicine and delivery unit.

Placental weight, digitally derived placental dimensions at term and their relationship to birth weight.

Objective: A few recent studies have investigated the relationship between birth weight and digitally derived placental dimensions, and no standardised methodology has been used. The aims of this study are to compare manually derived placental measurements with those derived digitally and to establish the relationship of birth weight to the placental weight and circumference.

Methods: Three hundred fifty-one consecutive unselected women with singleton pregnancy delivering in a tertiary maternity unit at 37-42 weeks were recruited.

Treatment of wild-type gastrointestinal stromal tumor (WT-GIST) with imatinib and sunitinib.

We report a rare case of advanced, metastatic gastrointestinal stromal tumor (GIST) in a young female. Molecular analysis of the tumor revealed wild-type (WT) KIT and platelet derived growth factor receptor alpha (PDGFRA) gene status with no mutations characteristic of adult GIST. Despite this she had clinical benefit and evidence of radiological response to sequential treatment with the tyrosine kinase inhibitors imatinib and sunitinib.