Metabolic syndrome and risk of fetal neural tube defects

Abstract

complicated versus 21.2% uncomplicated pregnancies (Pb0.001). Thirty-seven (10.5%) placentas showed more than 1 abnormality. Pathology was more likely to be documented in the presence of more than 1 obstetric complication. In such situations, the possibility of detecting more than 1 pathologic diagnosis increased (Table 1). Pathological chorioamnionitis was more common in cases of abruptio placentae compared to those with an uncomplicated clinical course (19.0% versus 3.0%, P=0.031), even when chorioamnionitis was not suspected clinically. Pathologies were noted in 62.2% IUFD, 61.9% abruption, 57.5% chorioamnionitis, 54.2% IUGR, 52.4% HT, and 51.7% MS cases. The highest pathology yield was from placentas submitted for abruption with IUFD (6/8, 75%) and chorioamnionitis with high grade fever (11/14, 78.6%). In IUFD, the result was similar in those less than 500 g (11/19, 57.9%) and those more than 500 g (22/34, 64.7%). Placentas were normal in 5/13 (38.5%) cases with the clinical diagnosis of abruptio placentae and chorioamnionitis. Factors for this suboptimal yield should be sought and amended. Residency training programs that stress the importance of placental pathology, recruitment of pathologists experienced in placental pathology with appropriate technical support, utilization of adequate staining techniques and sensitive markers, adherence to guidelines for placental pathologic examination, and adequate communication between obstetricians and pathologists are needed [2]. Such a plan might initially increase costs but improve the long-term outcome and hence compliance with recommendations.