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Kubler JM, Edwards C, Cavanagh E, Mielke GI, Gardiner PA, Trost SG, Fontanarosa D, Borg DJ, Kumar S, Clifton VL, Beetham KS. Maternal physical activity and sitting time and its association with placental morphology and blood flow during gestation: Findings from the Queensland Family Cohort study. J Sci Med Sport 2024; 27:480-485. [PMID: 38508889 DOI: 10.1016/j.jsams.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 02/17/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES Antenatal exercise is associated with placental morphological alterations, however research in this area is limited. Given the emphasis on the beneficial effects of antenatal exercise, it is important to understand its effect on placental function and the relationship to foetal development. The aim of this study was to investigate the association between physical activity, sitting time, and placental outcomes measured during gestation. DESIGN Prospective cohort study. METHODS Pregnant women in the Queensland Family Cohort study self-reported physical activity at 24 and 36 weeks of gestation (n = 203) and were categorised into physical activity volume groups of nil-low (0-<500 metabolic equivalent of task·minutes/week), moderate (500-<1000 metabolic equivalent of task·minutes/week), or high-volume activity (≥1000 metabolic equivalent of task·minutes/week). Participants reported average daily sitting time, whereby excessive sitting time was considered as ≥8h/day. Placental stiffness, thickness, and uteroplacental blood flow resistance were measured by ultrasound imaging at each timepoint. RESULTS Physical activity volume was not associated with changes to placental morphometrics or uteroplacental blood flow resistance at 24 or 36 weeks of gestation. Excessive sitting time at 36 weeks was associated with greater placental stiffness (p = 0.046), and a lower umbilical artery pulsatility index (p = 0.001). CONCLUSIONS Placental tissue stiffness and umbilical artery resistance were altered in late gestation with higher maternal sitting time but not with physical activity volume. Overall, excessive sitting time may be a risk for suboptimal placental function and could be an important focus for antenatal care.
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Affiliation(s)
- Jade M Kubler
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/jadekubler
| | - Christopher Edwards
- School of Clinical Sciences, Queensland University of Technology, Australia. https://twitter.com/edchris_
| | - Erika Cavanagh
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/ejcav
| | - Gregore I Mielke
- School of Public Health, University of Queensland, Australia. https://twitter.com/GregoreMielke
| | - Paul A Gardiner
- School of Public Health, University of Queensland, Australia. https://twitter.com/drpaulgardiner
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia. https://twitter.com/StewartTrost
| | - Davide Fontanarosa
- School of Clinical Sciences, Queensland University of Technology, Australia
| | - Danielle J Borg
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/DrDanBorg
| | - Sailesh Kumar
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/MFMresearch
| | - Vicki L Clifton
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/VickiClifton842
| | - Kassia S Beetham
- School of Behavioural and Health Sciences, Australian Catholic University, Australia.
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2
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Mahalinga G, Rajasekhar KV, Venkateshwar Reddy M, Kumar SS, Waheeduddin SK. Morphometric Analysis of Placenta and Fetal Doppler Indices in Normal and High-Risk Pregnancies. Cureus 2024; 16:e61663. [PMID: 38966466 PMCID: PMC11223667 DOI: 10.7759/cureus.61663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 07/06/2024] Open
Abstract
Background High-risk pregnancies, encompassing pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), preeclampsia toxemia (PET), and intrauterine growth restriction (IUGR), represent intricate medical challenges with potential repercussions for maternal and fetal health. This research undertakes a comprehensive comparative investigation into the variations of Doppler indices and placental parameters within the context of these high-risk conditions when juxtaposed against pregnancies characterized as normal. Methodology Employing a rigorous cross-sectional study design, a diverse cohort of pregnant individuals with gestational diabetes, IUGR, PIH, and preeclampsia was meticulously assembled. Additionally, a group of normal pregnant women served as the comparative reference. Doppler ultrasound assessments, viz, pulsatility index (PI), were carefully performed to estimate blood flow velocities within critical maternal and fetal vessels, while placental parameters were meticulously quantified, encompassing dimensions, vascular architecture, and morphological features. Results Except in the GDM group, all high-risk groups had reduced estimated placental weight and actual birth weight than normal pregnant women. All high-risk groups showed a highly significant elevation of the PI of the umbilical artery and PI of the middle cerebral artery (MCA) than normal but the PI of MCA was significantly reduced in the PET group than in normal individuals. The cerebro-placental ratio in the GDM and IUGR groups revealed markedly greater values, whereas PET showed lower values. IUGR and PIH groups showed a substantial reduction in the fetal birth weight. All high-risk groups (GDM, IUGR, PIH, and PET) showed a highly significant reduction in luminal area umbilical artery 1 than the normal pregnant women. In IUGR, marginal placental insertion was very high, followed by GDM and PET groups. Conclusions This study reveals that Doppler indices, placental parameters, newborn weight, and their related ratios may be utilized to anticipate gestation difficulties and gain insight into the pathophysiology of problematic conceptions.
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Affiliation(s)
- G Mahalinga
- Department of Anatomy, Meenakshi Academy of Higher Education and Research, Chennai, IND
| | - K V Rajasekhar
- Department of Radiology, Meenakshi Medical College Hospital and Research Institute, Chennai, IND
| | - M Venkateshwar Reddy
- Department of Anatomy, Sri Venkata Sai (SVS) Medical College and Hospital, Mahabubnagar, IND
| | - S Saravana Kumar
- Department of Anatomy, Meenakshi Medical College Hospital and Research Institute, Chennai, IND
| | - Syed Khaja Waheeduddin
- Department of Anatomy, Sri Venkata Sai (SVS) Medical College and Hospital, Mahabubnagar, IND
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3
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Carlson K, Hergenrader A. Fetal survival in pregnancy complicated by massive subchorionic thrombohaematoma. BMJ Case Rep 2023; 16:e258402. [PMID: 38160039 PMCID: PMC10759021 DOI: 10.1136/bcr-2023-258402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
This case involves a pregnant patient in her late 20s whose pregnancy was complicated by placentamegaly and early-onset, severe fetal growth restriction (FGR). Investigations ruled out genetic and infectious aetiologies. The pregnancy eventually was further complicated by abnormal umbilical artery blood flow. Shared decision-making with the patient and obstetrical team led to delivery by caesarean section at 28 weeks and 4 days. The baby was admitted to the neonatal intensive care unit but, overall, did well. Placental pathology revealed a massive subchorionic thrombohaematoma (MST). This case highlights the importance of early detection, evaluation and management of pregnancies complicated by severe FGR as well as the significance of shared decision-making with patients. We aim to increase the awareness of MST in the differential diagnosis of placentamegaly, as this finding in combination with early and severe FGR has been shown to be a poor prognostic factor for the fetus.
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Affiliation(s)
- Karen Carlson
- Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Alexandra Hergenrader
- Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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4
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Gomez Ribot D, Diaz E, Fazio MV, Gómez HL, Careaga V, Maier M, Macchi SB, Gresta CA, Capobianco E, Jawerbaum A. Metabolic and molecular effects of dietary extra virgin olive oil in blood and placenta of women with GDM. Front Endocrinol (Lausanne) 2023; 14:1219276. [PMID: 37654560 PMCID: PMC10465367 DOI: 10.3389/fendo.2023.1219276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/10/2023] [Indexed: 09/02/2023] Open
Abstract
Gestational diabetes mellitus (GDM) increases the risks of maternal, placental, and neonatal complications. Previously, we found that a diet enriched in extra virgin olive oil (EVOO) prevents increased maternal triglyceridemia and placental proinflammatory markers in a cohort of GDM patients. The aim of this work was to evaluate maternal circulating markers of insulin resistance, placental collagen, glycogen and lipid levels, and placental levels of proteins, mRNAs, and a microRNA involved in the endocytic pathway in the same cohort of control women and women with GDM who received or did not receive a diet enriched in EVOO (36 g/day) from weeks 24 to 28 of pregnancy until term. Results At term, the TG/HDL cholesterol ratio, fatty acid binding protein 4 circulating levels, and maternal BMI were increased in the GDM patients, alterations prevented by the maternal diet enriched in EVOO. Although there were no changes in placental lipid levels and lipid profile, GDM placentas were thicker than controls and showed increased glycogen and collagen content, alterations prevented by the EVOO enriched diet. GDM placentas showed increases in megalin levels, in the expression of several genes involved in the endocytic pathway, and in miR-199, which targets these genes, alterations prevented by the maternal diet enriched in EVOO. Conclusions We identified novel beneficial effects of an EVOO-enriched diet in GDM women, a diet capable of regulating maternal insulin resistance, the structure and metabolism of the placenta, and the placental endocytic pathway, suggesting effects that may be beneficial for fetal development.
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Affiliation(s)
- Dalmiro Gomez Ribot
- Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) – Universidad de Buenos Aires (UBA), Laboratory of Reproduction and Metabolism, Centro de Estudios Farmacológicos y Botánicos (CEFYBO), Buenos Aires, Argentina
- Department of Obstetrics, Hospital General de Agudos Dr. Ignacio Pirovano, Buenos Aires, Argentina
| | - Esteban Diaz
- Department of Obstetrics, Hospital General de Agudos Dr. Ignacio Pirovano, Buenos Aires, Argentina
| | - María Victoria Fazio
- Department of Obstetrics, Hospital General de Agudos Dr. Ignacio Pirovano, Buenos Aires, Argentina
| | - Hebe Lorena Gómez
- Department of Obstetrics, Hospital General de Agudos Dr. Ignacio Pirovano, Buenos Aires, Argentina
| | - Valeria Careaga
- Unidad de Microanálisis y Métodos Físicos Aplicados a Química Orgánica (UMYMFOR) [Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-Universidad de Buenos Aires (UBA)], Department of Organic Chemistry, School of Exact and Natural Sciences, University of Buenos Aires, Buenos Aires, Argentina
| | - Marta Maier
- Unidad de Microanálisis y Métodos Físicos Aplicados a Química Orgánica (UMYMFOR) [Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-Universidad de Buenos Aires (UBA)], Department of Organic Chemistry, School of Exact and Natural Sciences, University of Buenos Aires, Buenos Aires, Argentina
| | - Silvia Beatriz Macchi
- Department of Obstetrics, Hospital General de Agudos Dr. Ignacio Pirovano, Buenos Aires, Argentina
| | - Carlos Alberto Gresta
- Department of Obstetrics, Hospital General de Agudos Dr. Ignacio Pirovano, Buenos Aires, Argentina
| | - Evangelina Capobianco
- Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) – Universidad de Buenos Aires (UBA), Laboratory of Reproduction and Metabolism, Centro de Estudios Farmacológicos y Botánicos (CEFYBO), Buenos Aires, Argentina
| | - Alicia Jawerbaum
- Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) – Universidad de Buenos Aires (UBA), Laboratory of Reproduction and Metabolism, Centro de Estudios Farmacológicos y Botánicos (CEFYBO), Buenos Aires, Argentina
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5
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Nel S, Pattinson RC, Vannevel V, Feucht UD, Mulol H, Wenhold FAM. Integrated growth assessment in the first 1000 d of life: an interdisciplinary conceptual framework. Public Health Nutr 2023; 26:1523-1538. [PMID: 37170908 PMCID: PMC10410405 DOI: 10.1017/s1368980023000940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/03/2023] [Accepted: 04/26/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES Prenatal growth affects short- and long-term morbidity, mortality and growth, yet communication between prenatal and postnatal healthcare teams is often minimal. This paper aims to develop an integrated, interdisciplinary framework for foetal/infant growth assessment, contributing to the continuity of care across the first 1000 d of life. DESIGN A multidisciplinary think-tank met regularly over many months to share and debate their practice and research experience related to foetal/infant growth assessment. Participants’ personal practice and knowledge were verified against and supplemented by published research. SETTING Online and in-person brainstorming sessions of growth assessment practices that are feasible and valuable in resource-limited, low- and middle-income country (LMIC) settings. PARTICIPANTS A group of obstetricians, paediatricians, dietitians/nutritionists and a statistician. RESULTS Numerous measurements, indices and indicators were identified for growth assessment in the first 1000 d. Relationships between foetal, neonatal and infant measurements were elucidated and integrated into an interdisciplinary framework. Practices relevant to LMIC were then highlighted: antenatal Doppler screening, comprehensive and accurate birth anthropometry (including proportionality of weight, length and head circumference), placenta weighing and incorporation of length-for-age, weight-for-length and mid-upper arm circumference in routine growth monitoring. The need for appropriate, standardised clinical records and corresponding policies to guide clinical practice and facilitate interdisciplinary communication over time became apparent. CONCLUSIONS Clearer communication between prenatal, perinatal and postnatal health care providers, within the framework of a common understanding of growth assessment and a supportive policy environment, is a prerequisite to continuity of care and optimal health and development outcomes.
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Affiliation(s)
- Sanja Nel
- Department of Human Nutrition, University of Pretoria, Pretoria0002, South Africa
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa
- Maternal and Infant Health Care Strategies Unit, South African Medical Research Council (SAMRC), Pretoria, South Africa
| | - Robert C Pattinson
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa
- Maternal and Infant Health Care Strategies Unit, South African Medical Research Council (SAMRC), Pretoria, South Africa
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - Valerie Vannevel
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa
- Maternal and Infant Health Care Strategies Unit, South African Medical Research Council (SAMRC), Pretoria, South Africa
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - Ute D Feucht
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa
- Maternal and Infant Health Care Strategies Unit, South African Medical Research Council (SAMRC), Pretoria, South Africa
- Department of Paediatrics, University of Pretoria, Pretoria, South Africa
- Tshwane District Health Services, Gauteng Department of Health, Pretoria, South Africa
| | - Helen Mulol
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa
- Maternal and Infant Health Care Strategies Unit, South African Medical Research Council (SAMRC), Pretoria, South Africa
- Department of Paediatrics, University of Pretoria, Pretoria, South Africa
| | - Friede AM Wenhold
- Department of Human Nutrition, University of Pretoria, Pretoria0002, South Africa
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa
- Maternal and Infant Health Care Strategies Unit, South African Medical Research Council (SAMRC), Pretoria, South Africa
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6
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Di Filippo D, Henry A, Bell C, Haynes S, Chang MHY, Darling J, Welsh A. A new continuous glucose monitor for the diagnosis of gestational diabetes mellitus: a pilot study. BMC Pregnancy Childbirth 2023; 23:186. [PMID: 36932353 PMCID: PMC10023314 DOI: 10.1186/s12884-023-05496-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/03/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Gestational Diabetes Mellitus (GDM) incidence and adverse outcomes have increased globally. The validity of the oral glucose tolerance test (OGTT) for GDM diagnosis has long been questioned, with no suitable substitute reported yet. Continuous Glucose Monitoring (CGM) is potentially a more acceptable and comprehensive test. The aim of this study was to assess the Freestyle Libre Pro 2 acceptability as a diagnostic test for GDM, then triangulating its results with OGTT results as well as risk factors and sonographic features of GDM. METHODS Women wore the CGM device for 7 days at 24-28 weeks, undergoing the OGTT before CGM removal. CGM/OGTT acceptability as well as GDM risk factors evaluation occurred via three online surveys. CGM distribution/variability/time in range parameters, combined in a CGM Score of Variability (CGMSV), were triangulated with OGTT results and a risk-factor-based Total Risk Score (TRS). In a subgroup, GDM ultrasound features (as modified Ultrasound Gestational Diabetes Score - m-UGDS) were also incorporated. RESULTS Of 107 women recruited, 87 (81%) were included: 74 (85%) with negative OGTT (NGT) and 13 (15%) positive (GDM). No significant difference was found between NGT and GDM in terms of demographics (apart from family history of diabetes mellitus), CGM parameters and perinatal outcomes. Women considered CGM significantly more acceptable than OGTT (81% versus 27% rating 5/5, p < 0.001). Of the 55 NGT with triangulation data, 28 were considered 'true negative' (TRS concordant with OGTT and CGMSV): of these 4/5 evaluated at ultrasound had m-UGDS below the cut-off. Five women were considered 'false negative' (negative OGTT with both TRS and CGMSV above the respective cut-offs). Triangulation identified also six 'false positive' women (positive OGTT but TRS and CGM both below the cut-offs). Only one woman for each of the last two categories had m-UGDS evaluated, with discordant results. CONCLUSIONS CGM represents a more acceptable alternative for GDM diagnosis to the OGTT. CGM triangulation analysis suggests OGTT screening may result in both false positives and negatives. Further research including larger cohorts of patients, and additional triangulation elements (such as GDM biomarkers/outcomes and expanded m-UGDS) is needed to explore CGM potential for GDM diagnosis.
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Affiliation(s)
- Daria Di Filippo
- Discipline of Women's Health, School of Clinical Medicine, University of New South Wales Sydney, Locked Bag 2000, Barker Street, Randwick, NSW, 2031, Australia
| | - Amanda Henry
- Discipline of Women's Health, School of Clinical Medicine, University of New South Wales Sydney, Locked Bag 2000, Barker Street, Randwick, NSW, 2031, Australia
- Department of Women's and Children's Health, St George Hospital, Gray St, Kogarah, NSW, 2217, Australia
| | - Chloe Bell
- Discipline of Women's Health, School of Clinical Medicine, University of New South Wales Sydney, Locked Bag 2000, Barker Street, Randwick, NSW, 2031, Australia
| | - Sarah Haynes
- Discipline of Women's Health, School of Clinical Medicine, University of New South Wales Sydney, Locked Bag 2000, Barker Street, Randwick, NSW, 2031, Australia
| | - Melissa Han Yiin Chang
- Discipline of Women's Health, School of Clinical Medicine, University of New South Wales Sydney, Locked Bag 2000, Barker Street, Randwick, NSW, 2031, Australia
| | - Justine Darling
- Diabetes Clinic Royal Hospital for Women, Barker Street - Randwick, Randwick, NSW, 2031, Australia
| | - Alec Welsh
- Discipline of Women's Health, School of Clinical Medicine, University of New South Wales Sydney, Locked Bag 2000, Barker Street, Randwick, NSW, 2031, Australia.
- Department of Maternal-Fetal Medicine, Royal Hospital for Women, Barker Street - Randwick, Randwick, NSW, 2031, Australia.
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7
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Habek D, Prka M, Zovko T, Lerotić SB, Cerovac A. Focal increta placentomegaly of the posterior nonscarred uterine wall and posterior asynclitic presentation. Wien Med Wochenschr 2023; 173:78-80. [PMID: 34613519 DOI: 10.1007/s10354-021-00888-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Fetal malpresentations and malpositions are more common in placenta previa and uterine cavity abnormalities. AIM To show successful management of focal increta placentomegaly and uterine preservation in primiparous woman. CASE REPORT We describe posterior low-lying focal increta placentomegaly verified during cesarean section, which is a possible risk factor for persistent posterior asynclitism and consequent mechanical dystocia. In addition to antifibrinolytics and uterotonics, hemostatic compression sutures of the posterior uterine wall were performed with an applied intrauterine balloon, and thus the uterus was preserved in primiparous woman as a definitive therapy. CONCLUSION Timely identified malplacentation as well as adequate medical and surgical measures taken by an experienced team of obstetricians and anesthesiologists can contribute to preservation of the uterus and thus the life of mother and neonate.
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Affiliation(s)
- Dubravko Habek
- University Department of Gynecology and Obstetrics Clinical Hospital "Sveti Duh", Zagreb, School of Medicine, Catholic University of Croatia, Zagreb, Croatia
| | - Matija Prka
- University Department of Gynecology and Obstetrics Clinical Hospital "Sveti Duh", Zagreb, School of Medicine, Catholic University of Croatia, Zagreb, Croatia
| | - Tonćika Zovko
- University Department of Gynecology and Obstetrics Clinical Hospital "Sveti Duh", Zagreb, School of Medicine, Catholic University of Croatia, Zagreb, Croatia
| | - Sanja Berić Lerotić
- University Department of Gynecology and Obstetrics Clinical Hospital "Sveti Duh", Zagreb, School of Medicine, Catholic University of Croatia, Zagreb, Croatia
| | - Anis Cerovac
- Department of Gynecology and Obstetrics, General Hospital Tešanj, Braće Pobrić 17, 74260, Tešanj, Bosnia and Herzegovina. .,Department of Anatomy, School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.
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8
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Belak U, Pinter B, Ban Frangež H, Velikonja M, Korošec S. Pathology of the Placenta in Singletons after Assisted Reproductive Technology Compared to Singletons after Spontaneous Conception: A Systematic Review. Fetal Pediatr Pathol 2022; 42:438-449. [PMID: 36580043 DOI: 10.1080/15513815.2022.2157228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: We reviewed the literature comparing the pathological characteristics of singleton births conceived after assisted reproductive technology (ART) with those after spontaneous conception. Methods: We reviewed PubMed, EMBASE, Ovid MEDLINE, Google Scopus, Scholar, Cochrane Central Register of Controlled Trials and the Web of Science for the previous 10 years, up to November 2022. Results: Four eligible studies included 3445 placentas, 806 after ART (IVF/ICSI). Placentas after ART differed in frequency of retroplacental and marginal hematomas (p = 0.04), increased thickness (p = 0.02), higher overall occurrences of vascular and anatomical pathology (p < 0.001) and more frequent marginal (p = 0.001) and membranous (p = 0.02) umbilical cord insertion than placentas from non-ART pregnancies. Conclusion: Further research is needed to determine the extent to which these placental changes in ART pregnancies alter its function and pregnancy outcome.
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Affiliation(s)
- Urška Belak
- Department of Gyneacology and Obstetrics, General Hospital Celje, Celje, Slovenia.,Faculty of medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Bojana Pinter
- Faculty of medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Human Reproduction, Division of Obstetrics and Gyneacology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Helena Ban Frangež
- Faculty of medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Human Reproduction, Division of Obstetrics and Gyneacology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Mojca Velikonja
- Department of Pathology, Faculty of medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Sara Korošec
- Faculty of medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Human Reproduction, Division of Obstetrics and Gyneacology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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