Patterns of placental injury in various types of fetal congenital heart disease
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Jerzy Stanek
Abstract
Objectives
Fetal blood circulation may be modified in congenital heart disease (CHD). This retrospective analysis was performed to study whether the type of CHD is associated with specific placental pathology.
Methods
Three types of CHD based on presumed proportion of placental and systemic blood distribution in fetal circulation were analyzed: Group 1: 89 cases with low placental blood content (hypoplastic left heart syndrome, transposition of great arteries, coarctation of aorta), Group 2: 71 placentas with intermediate placental and systemic blood content due to increased intracardiac blood mixing (tetralogy of Fallot, truncus arteriosus, double inlet/outlet ventricle), and Group 3: 24 placentas with high placental blood content (tricuspid or pulmonary atresia, Ebstein anomaly). Frequencies of 27 independent clinical and 47 placental phenotypes of 184 placentas in those three groups were statistically compared.
Results
The most advanced gestational age at delivery, and large vessel (global) fetal vascular malperfusion (FVM) were most common in Group 1, while macerated stillbirths, neonatal mortality, abnormal amniotic fluid volume (oligohydramnios or polyhydramnios), other congenital anomalies, distal villous lesions of FVM, placental edema and amnion nodosum were most common in Groups 2 and 3, although the frequencies of placental lesions were statistically not significant.
Conclusions
Left heart obstructive lesions potentially associated with brain maldevelopment show increase in lesions of global FVM (in aggregate and individually fetal vascular ectasia, stem vessel obliteration and intramural fibrin deposition) as may be seen in umbilical cord compromise. CHD with increased intracardiac blood mixing or with right heart defects is associated with average preterm gestational age at delivery and placental lesions of distal villous FVM, villous edema and amnion nodosum.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
References
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Reviews
- Disquiet concerning cesarean birth
- Prenatal care and pregnancy outcome among incarcerated pregnant individuals in the United States: a systematic review and meta-analysis
- Corner of Academy
- Does COVID-19 infection acquired in different pregnancy trimester influence placental pathology?
- Original Articles – Obstetrics
- Did the first wave of the COVID-19 pandemic impact the cesarean delivery rate? A retrospective cohort study at a primary care center in Switzerland
- Hypertensive disorders of pregnancy and severe acute respiratory syndrome coronavirus-2 infection
- Hidden in plain sight in the delivery room – the Apgar score is biased
- Comparison of phase rectified signal averaging and short term variation in predicting perinatal outcome in early onset fetal growth restriction
- Serum levels of kynurenine in pregnancies with fetal growth restriction and oligohydramnios
- Effect of third trimester maternal vitamin D levels on placental weight to birth weight ratio in uncomplicated pregnancies
- One-third of patients with eclampsia at term do not have an abnormal angiogenic profile
- Chorioangioma: a single tertiary care center retrospective study
- A prospective cohort study: can advanced ultrasonography replace magnetic resonance imaging in the diagnosis of placental adhesion disorders?
- Original Articles – Fetus
- Fetal left brachiocephalic vein diameters in normal and growth restricted fetuses
- Functional assessment of atrial wall excursion and foramen ovale flap tracings in 3rd trimester as predictor of short-term hemodynamic stability in congenital heart defects fetuses
- Original Articles – Neonates
- Developing a new pediatric extracorporeal membrane oxygenation (ECMO) program
- Patterns of placental injury in various types of fetal congenital heart disease
- Short Communication
- Prenatal care in the era of economic collapse
- Letters to the Editor
- Does fetus feel stress or pain on uterine contraction?
- Pregnancy associated plasma protein-A for the prediction of small for gestational age
- Reply to: Pregnancy associated plasma protein-A for the prediction of small for gestational age
Articles in the same Issue
- Frontmatter
- Reviews
- Disquiet concerning cesarean birth
- Prenatal care and pregnancy outcome among incarcerated pregnant individuals in the United States: a systematic review and meta-analysis
- Corner of Academy
- Does COVID-19 infection acquired in different pregnancy trimester influence placental pathology?
- Original Articles – Obstetrics
- Did the first wave of the COVID-19 pandemic impact the cesarean delivery rate? A retrospective cohort study at a primary care center in Switzerland
- Hypertensive disorders of pregnancy and severe acute respiratory syndrome coronavirus-2 infection
- Hidden in plain sight in the delivery room – the Apgar score is biased
- Comparison of phase rectified signal averaging and short term variation in predicting perinatal outcome in early onset fetal growth restriction
- Serum levels of kynurenine in pregnancies with fetal growth restriction and oligohydramnios
- Effect of third trimester maternal vitamin D levels on placental weight to birth weight ratio in uncomplicated pregnancies
- One-third of patients with eclampsia at term do not have an abnormal angiogenic profile
- Chorioangioma: a single tertiary care center retrospective study
- A prospective cohort study: can advanced ultrasonography replace magnetic resonance imaging in the diagnosis of placental adhesion disorders?
- Original Articles – Fetus
- Fetal left brachiocephalic vein diameters in normal and growth restricted fetuses
- Functional assessment of atrial wall excursion and foramen ovale flap tracings in 3rd trimester as predictor of short-term hemodynamic stability in congenital heart defects fetuses
- Original Articles – Neonates
- Developing a new pediatric extracorporeal membrane oxygenation (ECMO) program
- Patterns of placental injury in various types of fetal congenital heart disease
- Short Communication
- Prenatal care in the era of economic collapse
- Letters to the Editor
- Does fetus feel stress or pain on uterine contraction?
- Pregnancy associated plasma protein-A for the prediction of small for gestational age
- Reply to: Pregnancy associated plasma protein-A for the prediction of small for gestational age
