Introduction: Placental abruption is a serious condition that increases perinatal morbidity and mortality. Clinical prevention and treatment options are limited, especially in human preterm deliveries. Knowledge of the mechanisms that keep the placenta in place during pregnancy is critical for developing strategies for the prevention of abruption. Failure of physiological transformation of spiral arteries has been described as a major contributing factor of the placental abruption development. Baboons (Papio spp.) share striking similarities with humans in regard to placental structure, utero-placental blood flow, and fetal development; however, the mode of trophoblast invasion is shallow in baboons. This fact prompted the hypothesis that the incidence of placental abruption will be increased in baboons compared to humans.
Material And Methods: Baboon placentas were collected between 2002 and 2008. Two independent veterinary pathologists evaluated the slides. A certified physician pathologist performed additional histology.
Results: Placental abruption was diagnosed in 22 baboons among 2423 live births during the study period (0.9% prevalence). The most common clinical presentations were fetal demise and vaginal bleeding. The most common pathological findings were intraplacental hemorrhages with or without hematoma formation (86.4%). Other findings consisted of neutrophil infiltration (50%), decidual necrosis (22.7%), decidual vascular congestion and inflammation, villous congestion and retroplacental hemorrhage/hematoma (each 18.2%). These pathologic findings were the same for term and preterm deliveries.
Conclusion: This is the first systematic study of placental abruption in non-human primates, analyzing a large colony of baboons. Despite differences in trophoblast invasion, the clinical features observed in placental abruption affecting baboons resembled those reported in humans. The cluster of placental pathological findings in baboons also agreed with clinical reports, but the prevalence of these findings differed between baboons and humans. We discuss a mechanism of anti-abruption forces that offset shallow trophoblast invasion observed in baboons.
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http://dx.doi.org/10.1016/j.placenta.2011.12.019 | DOI Listing |
Cureus
December 2024
Department of Obstetrics and Gynecology Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
An adherent placenta is a life-threatening condition that impairs the mother's life owing to hemorrhagic shock and disseminated intravascular coagulation. Profound hemorrhage resulting from placental abruption is often managed using hysterectomy to preserve the mother's life, although the consequent loss of fertility can be devastating, particularly in younger women. Thus, strategies that facilitate fertility preservation while effectively controlling hemorrhage should be considered viable alternatives.
View Article and Find Full Text PDFInt J Gynaecol Obstet
January 2025
Department of Obstetrics and Gynecology, The First Affiliate Hospital of Jinan University, Jinan University, Guangzhou, China.
Objectives: To develop and validate a nomogram to predict severe postpartum hemorrhage following cesarean delivery.
Methods: This is a two-center retrospective cohort study. Cesarean delivery patients from the First Affiliate Hospital of Jinan University were divided into a development cohort (n = 11 137) and an internal validation cohort (n = 4739).
J Med Ultrasound
November 2024
Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
Amniotic fluid assessment is crucial in prenatal ultrasound to monitor fetal conditions, with polyhydramnios, characterized by excessive amniotic fluid, affecting 1%-2% of pregnancies. Polyhydramnios is linked to complications such as placental abruption, preterm labor, congenital anomalies, and postpartum hemorrhage, emphasizing the need for early detection and management. While idiopathic causes account for 60%-70% of cases, other causes include impaired fetal swallowing and increased urine production due to maternal, fetal, and placental conditions.
View Article and Find Full Text PDFPrenat Diagn
January 2025
Department of Preventive Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Introduction: Fetoscopic laser surgery (FLS) is the gold standard treatment for monochorionic (MC) twin pregnancies complicated by twin-twin transfusion syndrome (TTTS). The aim of our study was to evaluate the rate and risk factors for cord entanglement in the presence of iatrogenic monoamnioticity (iMA), a consequence of inadvertent septostomy during FLS.
Methods: This is a retrospective analysis of two consecutive cohorts of FLS performed either using the selective technique from January 2004 to January 2012, or with the Solomon technique, from that date onwards.
Am J Reprod Immunol
January 2025
Placental Analytics, LLC, New Rochelle, New York, USA.
Problem: Hashimoto's disease is the commonest autoimmune disease of pregnancy. The presence of Anti-Thyroid antibodies (ATAs) alone [subclinical hypothyroidism] has also been shown to have adverse pregnancy effects. These can result in failure to conceive, recurrent miscarriages, anemia, preeclampsia, and abruption.
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