Decreased Total Placental Mass Found in Twin-Twin Transfusion Syndrome Gestations with Selective Growth Restriction

2016 ◽  
Vol 40 (2) ◽  
pp. 116-122 ◽  
Author(s):  
Kristi R. Van Winden ◽  
Rubén A. Quintero ◽  
Eftichia V. Kontopoulos ◽  
Lisa M. Korst ◽  
Arlyn Llanes ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Laser Surgery ◽  
Growth Restriction ◽  
Placental Weight ◽  
Apparent Difference ◽  
Inclusion Criteria ◽  
Fetal Demise ◽  
Intrauterine Growth ◽  
Share Data ◽  
The Individual

Introduction: We examined placental weight characteristics associated with donor selective intrauterine growth restriction (SIUGR) among patients with twin-twin transfusion syndrome (TTTS) who underwent laser surgery. Materials and Methods: Fresh placental specimens were studied. Pregnancies with higher-order multiples, fetal demise, or disrupted or nonsubmitted placental specimens were excluded. Placental characteristics prospectively collected included total placental weight, individual placental weight, and placental share. Data were compared between pregnancies with SIUGR (TTTS + SIUGR group) and those without SIUGR (TTTS-only group). Results: Of 369 consecutive patients who underwent laser surgery for TTTS, 155 (42%) met inclusion criteria: 91 with TTTS + SIUGR and 64 with TTTS-only. Compared to the TTTS-only group, patients in the TTTS + SIUGR group had a lower total placental weight (608 ± 163 vs. 687 ± 224 g, p = 0.012), with a lower donor individual placental weight (237 ± 91 vs. 291 ± 124 g, p = 0.002), but no apparent difference in the individual placental weight of recipient twins (371 ± 109 vs. 396 ± 133 g, p = 0.211). Donor placental share was smaller in those pregnancies affected by SIUGR (38.7 ± 9.6 vs. 42.3 ± 9.8%, p = 0.029). Discussion: TTTS patients with SIUGR had a lower total placental weight and a lower donor individual placental weight compared to those without SIUGR. These findings suggest that differences in donor individual placental weights for SIUGR gestations may not solely be related to differences in placental share.

Weights of Fetal Membranes and Umbilical Cords: Correlation With Placental Pathology

2019 ◽  
Vol 23 (4) ◽  
pp. 249-252 ◽  
Author(s):  
Lucy X Ma ◽  
Daniel Levitan ◽  
Rebecca N Baergen
Keyword(s):  
Umbilical Cord ◽  
Intrauterine Growth Restriction ◽  
Maternal Diabetes ◽  
Growth Restriction ◽  
Placental Weight ◽  
Fetal Membranes ◽  
Fetal Demise ◽  
Intrauterine Growth ◽  
The Mean ◽  
Umbilical Cords

Introduction Proper placental gross examination requires weighing the placental disc trimmed of fetal membranes and the umbilical cord. However, untrimmed placental weights are often reported, both in cases submitted for consultation and in publications. Thus, determining the contribution of membranes and cords to untrimmed placental weights would be helpful in estimating the true trimmed weight of placentas. We sought to report the average weights of membranes and cord in term placentas and to correlate these weights with common placental pathologies. Methods A total of 500 consecutive placentas delivered between 36 and 42 weeks gestational age were subjected to a modified grossing protocol, in which the weight of the trimmed and untrimmed placentas, fetal membranes, and umbilical cords were recorded. Acute chorioamnionitis, meconium, maternal vascular malperfusion, and fetal vascular malperfusion were included as pathologic correlates. Clinical data such as the presence of fetal hydrops, intrauterine growth restriction, intrauterine fetal demise, and maternal diabetes were also recorded. Results The mean weights of the trimmed placenta, fetal membranes, and umbilical cords were 442 g (180–805 g), 47.2 g (16–108 g), and 37.9 g (9–126 g), respectively. The fetal membranes and umbilical cord weights contributed a mean of 16% to the total untrimmed placental weight. Meconium was associated with heavier fetal membranes. Fetal vascular malperfusion was associated with longer umbilical cord and thus also with heavier umbilical cords. Maternal vascular malperfusion and intrauterine growth restriction were associated with lighter placentas. Discussion The trimmed placental disc weight may be estimated by subtracting 16% (ie, weight of the fetal membranes and umbilical cord) from the untrimmed placental weight, or alternatively by subtracting the mean weight of the membranes and umbilical cord. It is important to consider the effects of meconium, fetal and maternal vascular malperfusion, and intrauterine growth restriction on membrane and cord weights when estimating the trimmed placental disc weight.

The individual fetal weight/estimated placental weight ratios in monochorionic twins with selective intrauterine growth restriction

2008 ◽  
Vol 28 (3) ◽  
pp. 217-221 ◽  
Author(s):  
Yao-Lung Chang ◽  
Shuenn-Dyh Chang ◽  
An-Shine Chao ◽  
Peter C. C. Hsieh ◽  
Chao-Nin Wang ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Placental Weight ◽  
Fetal Weight ◽  
Monochorionic Twins ◽  
Intrauterine Growth ◽  
The Individual

Searching the web: a survey on the quality of advice on postnatal sequelae of intrauterine growth restriction and the implication of developmental origins of health and disease

2017 ◽  
Vol 8 (5) ◽  
pp. 604-612 ◽  
Author(s):  
S. Perzel ◽  
H. Huebner ◽  
W. Rascher ◽  
C. Menendez-Castro ◽  
A. Hartner ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Later Life ◽  
Growth Restriction ◽  
Developmental Origins ◽  
Intrauterine Growth ◽  
Growing Body ◽  
Health Related ◽  
Health And Disease ◽  
The Individual

Intrauterine growth restriction (IUGR) and fetal growth restriction (FGR) are pregnancy complications associated with morbidity in later life. Despite a growing body of evidence from current research on developmental origins of health and disease (DOHaD), little information is currently provided to parents on long-term metabolic, cardiovascular and neurologic consequences. As parents strongly rely on internet-based health-related information, we examined the quality of information on IUGR/FGR sequelae and DOHaD in webpages used by laypersons. Simulating non-clinicians experience, we entered the terms ‘IUGR consequences’ and ‘FGR consequences’ into Google and Yahoo search engines. The quality of the top search-hits was analyzed with regard to the certification through the Health On the Net Foundation (HON), currentness of cited references, while reliability of information and DOHaD-related consequences were assessed via the DISCERN Plus score (DPS). Overall the citation status was not up-to-date and only a few websites were HON-certified. The results of our analysis showed a dichotomy between the growing body of evidence regarding IUGR/FGR-related sequelae and lack of current guidelines, leaving parents without clear directions. Furthermore, detailed information on the concept of DOHaD is not provided. These findings emphasize the responsibility of the individual physician for providing advice on IUGR/FGR-related sequelae, monitoring and follow-up.

73 INTRAUTERINE GROWTH RESTRICTION AFTER BETWEEN-BREED EMBRYO TRANSFER IS ASSOCIATED WITH STRONG ALTERATIONS IN PLACENTAL STRUCTURE AND FUNCTION IN HORSES

2014 ◽  
Vol 26 (1) ◽  
pp. 150
Author(s):  
P. Peugnet ◽  
S. Valentino ◽  
A. Tarrade ◽  
L. Wimel ◽  
F. Reigner ◽  
...  
Keyword(s):  
Gene Expression ◽  
Embryo Transfer ◽  
Intrauterine Growth Restriction ◽  
Surface Density ◽  
Structure And Function ◽  
Growth Restriction ◽  
Placental Weight ◽  
Compensatory Mechanism ◽  
Intrauterine Growth ◽  
And Function

In equids, placentation is diffuse and the nutrient supply to the fetus is determined by uterine size, which is correlated with maternal size. The size of the mare affects fetal development as shown by embryo transfer (ET) between Ponies and Thoroughbreds. In turn, insulin sensitivity in the newborn foal and subsequent postnatal growth rate are affected. We enhanced or restricted fetal growth through ET using Pony (P), Saddlebred (S), and Draft (D) horses and investigated placental morphology, structure, and function at term. Control pregnancies of P-P (n = 21), S-S (n = 28), and D-D (n = 8) were obtained by AI. Enhanced and restricted pregnancies were obtained by transferring P (P-D, n = 6) and S embryos (S-D, n = 8) into D mares or S embryos into P mares (S-P, n = 6), respectively. Placental weight and surface were recorded at delivery. Samples were collected for stereology and RT-qPCR analysis of expression of genes involved in placental growth, vascularization, and nutrient transport. Housekeeping genes were RPL32, SCAMP3, and B2M. Data were analysed by Kruskal-Wallis followed by Dunn's post hoc test. Placental weight and surface were increased in S-S and in D-D compared with P-P, whereas S-S and D-D were not different. No histological changes were observed among controls, but most genes had their expression decreased in P-P compared with S-S and D-D. The P-D foals had a 57% increased birthweight with heavier and larger placentas than P-P foals. The S-D foals were similar to both S-S and D-D in terms of birthweight and placental weight and surface. No major modifications in placental histology or transcript levels were observed in both enhanced groups. In contrast, S-P foals had a 37% decreased birthweight with lighter and smaller placentas compared with S-S and S-D foals. There was no gross histological difference between S-P and S-S but the microcotyledonary surface density was higher in S-P compared with S-D. Moreover, the expression of IGF2, IGF2R, SLC2A1, and eNOS was decreased in S-P compared with S-S. There was no difference in gene expression between S-P and P-P. In conclusion, intrauterine growth restriction led to marked changes in placental morphology, histology, and gene expression. The increased microcotyledonary surface density suggests a lengthening of villi, which could increase feto-maternal contact surface as a compensatory mechanism for the restricted uterine capacity. Surprisingly, placental adaptation to the restricted intrauterine environment in S-P induced gene profiles resembling that of control P, whereas no difference was observed in enhanced pregnancies.

393: Intrauterine growth restriction in twin-twin transfusion syndrome treated with laser surgery

2011 ◽  
Vol 204 (1) ◽  
pp. S160
Author(s):  
Brendan Grubbs ◽  
Kurt Benirschke ◽  
Lisa M. Korst ◽  
Arlyn Llanes ◽  
Larisa Yedigarova ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Laser Surgery ◽  
Growth Restriction ◽  
Intrauterine Growth

scholarly journals MORPHOLOGICAL FINDINGS IN INTRAUTERINE GROWTH RESTRICTION (IUGR) PLACENTAS VERSUS NORMAL PLACENTAS IN PREGNANT WOMEN OF DISTRICT RAWALPINDI, PAKISTAN

2020 ◽  
Vol 17 (3) ◽  
pp. 65-69
Author(s):  
Nazma Kiran ◽  
Nadia Aslam ◽  
Tahira Tabassum ◽  
Saadia Kanwal ◽  
Tanveer Zia
Keyword(s):  
Blood Vessels ◽  
Intrauterine Growth Restriction ◽  
Neonatal Morbidity ◽  
Cross Sectional Study ◽  
Growth Restriction ◽  
Placental Weight ◽  
Major Influence ◽  
Control Group ◽  
Cross Sectional ◽  
Intrauterine Growth

Background: Intrauterine growth restriction (IUGR) is a principal cause of fetal and neonatal morbidity and mortality. The placenta, as a vector for maternal-fetal nutrient and oxygen exchange has major influence on birthweight. The objectives of this study were to compare the placental weight (grams), number of syncytial knots and number of blood vessels in villi of IUGR placentas versus normal placentas. Materials & Methods: This cross-sectional study was carried out at Rai Medical College, Sargodha, Pakistan in collaboration with Zainab Memorial Hospital, Rawalpindi, Pakistan from December 2016 to November 2018. Study group included 45 IUGR placentas and control group included 25 normal placentas. Placental weight in grams, number of syncytial knots and number of blood vessels in villi of placentas were three research variables. These were described by mean, minimum, maximum, range and standard deviation for each group separately and were compared between the two groups through independent-samples t-test. Results: Descriptively the mean placental weight in grams in IUGR group (423.35±64.13g) was lower than control group placentas (535.92±44.57g). The number of syncytial knots in IUGR group placentas (22.04±5.21) was more than control group placentas (13.84±4.41). The number of blood vessels in IUGR placentas was lower than control group placentas. All three null hypothesis for research variables between the two groups were rejected (p=

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