Placental malperfusion as a possible mechanism of preterm birth in patients with Müllerian anomalies
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Jovana Lekovich
, Joshua Stewart
Abstract
Objective:
Müllerian anomalies are associated with increased risk of miscarriage, intrauterine growth restriction (IUGR) and preterm birth. While a commonly implicated cause is restricted expansion of endometrial cavity, alternatively it could be due to abnormal placentation. We sought to examine clinical and histopathologic factors associated with preterm delivery in women with Müllerian anomalies.
Study design:
One hundred and eleven singleton pregnancies in 85 women were analyzed retrospectively. There were 42 pregnancies with bicornaute, 24 with unicornuate, 24 with septate, 19 with didelphys and one each with arcuate and T-shaped uterus. Primary outcomes included gestational age at delivery, placental histopathology, placenta previa and accreta.
Results:
Twenty-eight (25.2%) of pregnancies were delivered prior to term. Of those, only 14 (50%) were due to preterm labor or preterm premature rupture of membranes (PPROM). Histological evidence of placental malperfusion was present in 22% of all pregnancies and those delivered at an earlier median gestational age [34 (IQR 31–37) vs. 37 weeks (IQR 34–39); P=0.001]. Malperfusion was more common in preterm than in full term births (46% vs. 14%; P=0.04). Conversely, inflammation was not more common in preterm compared to term deliveries (17.9% vs. 16.9%; P=0.89). Five pregnancies had placenta previa, three of which were complicated by accreta.
Conclusion:
Placental malperfusion, rather than inflammation, was more commonly associated with preterm births in women with uterine anomalies.
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2017 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- What’s new in preterm birth prediction and prevention?
- Academy’s Corner
- Antenatal corticosteroids: current controversies
- Review articles
- The safety of progestogen in the prevention of preterm birth: meta-analysis of neonatal mortality
- Cervical pessary for the prevention of preterm birth: is it of any use?
- Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability
- Highlight articles
- Placental malperfusion as a possible mechanism of preterm birth in patients with Müllerian anomalies
- Nifedipine increases fetoplacental perfusion
- Effect of sleep disorders on threatened premature delivery
- Risk of recurrent preterm birth among women according to change in partner
- Biomarkers of spontaneous preterm birth: a systematic review of studies using multiplex analysis
- Influence of transvaginal ultrasound examination on quantitative vaginal fibronectin measurements: a prospective evaluation study
- Evaluation of quantitative fFn test in predicting the risk of preterm birth
- The value of ultrasound measurement of cervical length and parity in prediction of cesarean section risk in term premature rupture of membranes and unfavorable cervix
- Comparison of the duo of insulin-like growth factor binding protein-1/alpha fetoprotein (Amnioquick duo+®) and traditional clinical assessment for diagnosing premature rupture of fetal membranes
- Efficacy of a prospective community-based intervention to prevent preterm birth
- Maternal complications in settings where two-thirds of extremely preterm births are delivered by cesarean section
- The risk of neonatal respiratory morbidity according to the etiology of late preterm delivery
- Thyroid dysfunction in preterm neonates exposed to iodine
- Congress Calendar
- Congress Calendar
Artikel in diesem Heft
- Frontmatter
- Editorial
- What’s new in preterm birth prediction and prevention?
- Academy’s Corner
- Antenatal corticosteroids: current controversies
- Review articles
- The safety of progestogen in the prevention of preterm birth: meta-analysis of neonatal mortality
- Cervical pessary for the prevention of preterm birth: is it of any use?
- Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability
- Highlight articles
- Placental malperfusion as a possible mechanism of preterm birth in patients with Müllerian anomalies
- Nifedipine increases fetoplacental perfusion
- Effect of sleep disorders on threatened premature delivery
- Risk of recurrent preterm birth among women according to change in partner
- Biomarkers of spontaneous preterm birth: a systematic review of studies using multiplex analysis
- Influence of transvaginal ultrasound examination on quantitative vaginal fibronectin measurements: a prospective evaluation study
- Evaluation of quantitative fFn test in predicting the risk of preterm birth
- The value of ultrasound measurement of cervical length and parity in prediction of cesarean section risk in term premature rupture of membranes and unfavorable cervix
- Comparison of the duo of insulin-like growth factor binding protein-1/alpha fetoprotein (Amnioquick duo+®) and traditional clinical assessment for diagnosing premature rupture of fetal membranes
- Efficacy of a prospective community-based intervention to prevent preterm birth
- Maternal complications in settings where two-thirds of extremely preterm births are delivered by cesarean section
- The risk of neonatal respiratory morbidity according to the etiology of late preterm delivery
- Thyroid dysfunction in preterm neonates exposed to iodine
- Congress Calendar
- Congress Calendar