Placental Mass Research Articles

Categories of variables in analysis of genetic diversity in S1 progenies of Psidium guajava

Crossing and developing inbred lines have been promising options for guava breeding programs. The purpose of this study was to evaluate the genetic divergence among genotypes of S1 inbred guava families by means of the Gower’s technique and the Ward-MLM methodology, to verify the correlation and relative contribution of traits, as well as to identify descriptors with minimum efficiency for this species. The experiment was implemented at the Estação Experimental da Ilha Barra do Pomba, in the municipality of Itaocara, RJ, Brazil. A randomized block design with 18 inbred families, three replicates, and ten plants per plot was used for the experimental design. After 19 months from the planting of the experiment, the 61 earliest and most productive genotypes (individual plants) were evaluated. For this purpose, 29 descriptors were evaluated, of which fifteen were qualitative and fourteen, quantitative. The characteristics required to obtain the distance matrix were analyzed based on the Gower algorithm, and a comparative cluster between the dendrograms of the morphoagronomic variables was achieved from this matrix. Lastly, the Ward-MLM procedure was applied to form the clusters of inbred families. By using all 29 descriptors, greater efficiency was achieved in cluster discrimination. Hence, according to the results identified, it is not possible to indicate minimum descriptors for the culture. Using the Ward-MLM method, the descriptors that most contributed to the divergence among the genotypes were fruit flesh mass, fruit weight, fruit diameter, fruit flesh thickness, fruit placental mass, and fruit length. The most divergent genotypes can be recommended for further crosses or self-pollinations to develop new lines in the guava breeding program of UENF.

Human Placental Lactogen in Relation to Maternal Metabolic Health and Fetal Outcomes: A Systematic Review and Meta-Analysis.

Human placental lactogen (hPL) is a placental hormone which appears to have key metabolic functions in pregnancy. Preclinical studies have putatively linked hPL to maternal and fetal outcomes, yet-despite human observational data spanning several decades-evidence on the role and importance of this hormone remains disparate and conflicting. We aimed to explore (via systematic review and meta-analysis) the relationship between hPL levels, maternal pre-existing and gestational metabolic conditions, and fetal growth. MEDLINE via OVID, CINAHL plus, and Embase were searched from inception through 9 May 2022. Eligible studies included women who were pregnant or up to 12 months post-partum, and reported at least one endogenous maternal serum hPL level during pregnancy in relation to pre-specified metabolic outcomes. Two independent reviewers extracted data. Meta-analysis was conducted where possible; for other outcomes narrative synthesis was performed. 35 studies met eligibility criteria. No relationship was noted between hPL and gestational diabetes status. In type 1 diabetes mellitus, hPL levels appeared lower in early pregnancy (possibly reflecting delayed placental development) and higher in late pregnancy (possibly reflecting increased placental mass). Limited data were found in other pre-existing metabolic conditions. Levels of hPL appear to be positively related to placental mass and infant birthweight in pregnancies affected by maternal diabetes. The relationship between hPL, a purported pregnancy metabolic hormone, and maternal metabolism in human pregnancy is complex and remains unclear. This antenatal biomarker may offer value, but future studies in well-defined contemporary populations are required.

Dam parity affects fetal growth, placental size, and neonatal metabolism in spring-born beef calves.

To determine effects of dam parity on perinatal nutrient availability in beef cattle, data and samples were collected from 18 primiparous and 35 multiparous spring-calving Sim-Angus dams and their calves. Time to stand was recorded and neonatal vigor assessed. Jugular blood was collected from a subset of calves at 0 (post-standing and pre-suckling) 6, 12, 24, 48, and 72 h of age, and blood chemistry panels were completed. Expelled placentas were dissected, dried, and weighed. Prepartum maternal circulating glucose, non-esterified fatty acids (NEFA), triglycerides, and urea N were analyzed. All statistical models included the fixed effect of dam parity, and calf sex (when P ≤ 0.25) was included for calf and placental variables. Effects of sampling hour, and parity × hour were included for calf metabolites over time using repeated measures. Multiparous dams had greater body weight prepartum (P < 0.001) but similar (P = 0.25) body condition score. Maternal circulating urea N and triglycerides were greater (P ≤ 0.05) in multiparous dams pre-calving. Calves born to primiparous dams weighed 10% less (P ≤ 0.04) at birth with smaller (P ≤ 0.01) heart and abdominal girths. Cotyledonary, intercotyledonary, and total placental masses were less (P ≤ 0.05) for primiparous dams. Dam parity did not affect (P ≥ 0.58) calf time to stand, vigor score at 10 min, or rectal temperature. Serum glucose was greater (P = 0.03) at 0 h but less (P ≤ 0.04) at all other hours in calves from primiparous dams. Calves from primiparous dams had greater (P ≤ 0.02) serum NEFA at 6, 12, and 24 h although plasma triglycerides were greater (P < 0.001) at 6 h. Calves from primiparous dams had greater (P ≤ 0.04) serum urea N at 12 h and creatinine at 12 and 24 h. Plasma insulin was greater (P ≤ 0.04) in calves from multiparous dams at 12, 48, and 72 h, but parity did not affect (P ≥ 0.18) serum total protein or plasma cortisol. Serum aspartate aminotransferase was greater (P ≤ 0.04) at 6 and 24 h, creatine kinase was greater at 24 h, and gamma-glutamyl transpeptidase was less (P ≤ 0.04) at 6, 12, and 24 h, for calves from primiparous dams. Calves born to primiparous dams had greater (P ≤ 0.02) total bilirubin and direct bilirubin at 12 and 24 h. Data indicate that calves born to first-parity heifers had decreased perinatal nutrient availability, resulting in reduced fetal and placental growth, as well as greater energy reserve mobilization and metabolic indicators of stress as neonates.

Two Giant Placental Chorangiomas Discovered at 34 week’s Gestation: A Case Report

Abstract Introduction/Objective Chorangioma is a benign vascular tumor of the placenta, likely hamartoma, occurring in 1% of all examined placentas and arising from the primitive chorionic mesenchyme. The clinical significance is related to the size of the tumor. Most chorangiomas are small and asymptomatic; however, those larger than 4 cm are associated with intrauterine growth restriction (IUGR), polyhydramnios, preterm delivery, arteriovenous shunting, hydrops, and fetal thrombocytopenia. Methods/Case Report Herein, we present a case report of a placenta with two chorangiomas that are prenatally detected in a 25-year-old G2P1 female patient by ultrasound which showed a placental mass and mild polyhydramnios. The patient also developed hypertension and preeclampsia so she was referred for early induction of labor. The patient was elected for caesarian section and the placenta was delivered at 35 weeks of gestation. Grossly, two tan soft well-circumscribed lobulated placental masses were identified and measured 9.5 x 9.1 x 3.3 cm and 5.5 x 4.5 x 1.9 cm, respectively. The two masses were joined together by a thick blood vessel. The larger 9.5 cm mass was connected to the placental disc at the umbilical cord insertion site and is associated with blood vessel thrombosis. Microscopically the mass showed proliferation of capillary-sized vessels with surrounding stroma consistent with chorangioma. Clinical, radiological, and microscopic profiles support the diagnosis of placental chorangioma. Results (if a Case Study enter NA) N/A Conclusion To our knowledge, this is the first case report of two giant placental chorangiomas connected together by a thick blood vessel. Although both are giant (more than 4 cm), early diagnosis and timely intervention led to good maternal and neonatal outcomes aided with neonatal intensive care unit management.

Stereological and histopathological assessment of intrauterine growth restriction placenta from Saudi women

BackgroundPlacental insufficiency causes fetal adaptation, leading to fetal programming of chronic diseases. Placentas with intrauterine growth restriction (IUGR) are smaller than average and may contribute to low birth weight of the newborn. The number of patients with IUGR in the Saudi population is increasing; however, little is known about their placentas. The aim of this study was to assess morphometric and histopathological placental changes in Saudi patients with IUGR. MethodsOverall, 20 healthy pregnant Saudi women (control group) and 20 pregnant Saudi women with IUGR were enrolled. Maternal and fetal morphometric measurements were recorded. The placentas from both groups were processed for histopathological examination using stereological techniques. ResultsThe IUGR group had lower placental weight, volume, length, breadth, and surface area than the control group. The total volume of villi and surface area of the terminal villi were significantly reduced in the IUGR placentas. IUGR group had a reduction in birth weight; length; and circumference of the head, chest, abdomen, and thigh compared to control group. ConclusionThe reduction in placental mass, specifically the reduction in the volume and surface area of villi, the functional units, may have reduced the capacity for nutrient transport. This led to a significant reduction in neonatal measurements. The fetus rearranged nutrient distribution in favor of the brain and other essential organs; however, at the expense of thigh development and growth. This fetal trade-off strategy increases the risk of developing chronic diseases in adulthood. Therefore, IUGR infants may require more clinical attention.

Role of Ultrasound in Early Detection of Molar Pregnancy

OBJECTIVES The objective of this study was to investigate the role of ultrasound in the detection of early pregnancies presenting with placental molar changes. METHODOLOGY This retrospective study was carried out at Radiology department of Hayatabad Medical Complex, Peshawar, between Aug 2020 and July 2021. All cases suspected of molar changes were evaluated from 10-14 weeks of gestation. The patient were referred to our department because of fetal abnormality, maternal disease or age and family or previous pregnancy history or were identified from an ongoing ultrasound screening study for aneuploidy by measurement of fetal nuchal translucency thickness. Transabdominal or transvaginal sonography was used to examine the fetus and placenta. RESULTS Total 85 patients of molar pregnancies were enrolled in the study. Age ranged between 20-45 years with a mean age of 32.5 years. There were 60(70.6%) complete moles (CM) and 25(27.4%) partial moles (PM) were suspected on ultrasound. In case of complete mole coexisting with a normal singleton or twin pregnancy, the molar placenta was clearly separated from the normal placenta, whereas with partial moles the molar structures were dispersed inside the placental mass. CONCLUSION Ultrasound detection of molar pregnancy remains a diagnostic challenge. Data suggest that there has been an increase in both the predictive value and the sensitivity of ultrasound over time; however, the diagnostic criteria remain ill defined. Prior to managing a miscarriage, being aware of the possibility of molar pregnancy will guide treatment and allow for adequate follow-up.

EP34.31: Wharton's jelly abundance and placental mass at umbilical cord insertion: a case report

EP34.31: Wharton's jelly abundance and placental mass at umbilical cord insertion: a case report

Predicting Placenta Accreta Spectrum Disorders in a Cohort of Pregnant Patients in the North-East Region of Romania-Diagnostic Accuracy of Ultrasound and Magnetic Resonance Imaging.

Background: Placenta accreta spectrum (PAS) disorders are associated with high mortality and morbidity due to postpartum hemorrhage, hysterectomy, and organ injury, and a multidisciplinary team is required for an individualized case management. In this study, we assessed the diagnostic and prognostic accuracy of the most important ultrasonographic (US) and magnetic resonance imagining (MRI) markers for PAS disorders. Material and Methods: The study included 39 adult pregnant patients with at least one previous cesarean delivery and both US and MRI investigations for placenta previa evaluated at the tertiary maternity hospital ‘Cuza Voda’, Iasi, between 2019 and 2021. The following US signs were evaluated: intra-placental lacunae, loss of the retroplacental hypoechoic zone, myometrial thinning < 1 mm, bladder wall interruption, placental bulging, bridging vessels, and the hypervascularity of the uterovesical or retroplacental space. The MRI signs that were evaluated were intra-placental dark T2 bands, placental bulging, loss of the retroplacental hypointense line on T2 images, myometrial thinning, bladder wall interruption, focal exophytic placental mass, and abnormal vascularization of the placental bed. Results: The US and MRI signs analyzed in our study presented adequate sensitivities and specificities for PAS, but no sign proved to be a useful predictor by itself. The presence of three or more US markers for accretion was associated with a sensitivity of 84.6.6% and a specificity of 92.3% (p < 0.001). The presence of three or more MRI signs supplemented these results and were associated with a sensitivity of 92.3% and a specificity of 61.5% for predicting PAS (p < 0.001). Moreover, US and MRI findings were correlated with FIGO grading and severity of PAS. Conclusions: Even though no US or MRI finding alone can predict PAS with high sensitivity and specificity, our study proves that the presence of three or more imagistic signs could significantly increase the diagnostic accuracy of this condition. Furthermore, US and MRI could be useful tools for evaluating prognostic and perinatal planning.

Disordered Maternal and Fetal Iron Metabolism Occurs in Preterm Births in Human

Background Increasing evidence reveals that iron deficiency during pregnancy causes adverse pregnancy outcomes. Thus far, the mechanisms underlying iron deficiency-associated preterm birth are mostly limited to animal studies. Whether the suggested mechanisms exist in human requires further investigation. The goal of this study was to characterize the iron metabolism in both the maternal side and fetal side in pregnant women with preterm birth. Methods Serum and placenta samples were collected from 42 pregnant women divided into four groups according to the gestational week. Indicators of iron metabolism, including serum iron, serum hepcidin, placental tissue iron, ferroportin (FPN), transferrin receptor 1 (TfR1), and ferritin, were surveyed using enzyme-linked immunosorbent assays (Elisa), Western blots, and real-time quantitative polymerase chain reactions (qRT-PCR). Results Significant reduction of maternal serum iron was observed in women with preterm birth relative to those with full-term birth, indicative of worsen iron deficiency in those mothers with preterm birth. Meanwhile, the maternal hepcidin levels were notably diminished in women with preterm birth, whereas the fetal hepcidin levels were comparable between the two groups. Moreover, the placental iron stores were remarkably reduced in the preterm group, associated with reduced concentration of TfR1 and increased FPN concentration relative to the normal controls. In other words, the ratio of placental FPN mass to TfR1 mass (PIDI index) was strikingly increased in the preterm group. Conclusions Dysregulated iron homeostasis in both the maternal and fetal sides was implicated in preterm births, and disordered regulations in maintaining the placental iron equilibrium were also presumed to account for the compromised fetal iron supply.

Ultrasound features of placental chorioangioma detected by SMI technology before and after thrombosis of feeding vessels: analysis of a clinical case

Objective: Placental chorioangioma is the most common non-trophoblastic vascular benign tumor of the placenta, with an estimated incidence of 1% of all pregnancies. Most chorioangiomas are small asymptomatic lesions that are found incidentally only postnatally during histologic examination of the placenta. Voluminous chorioangiomas (&gt;4–5 cm), however, are less common and are more often diagnosed prenatally, through ultrasound imaging. Color Doppler demonstrates either a single blood vessel feeding the lesion or substantial vascularity within the mass. Large tumors have been associated with multiple adverse perinatal outcomes, including fetal growth restriction, preterm birth, polyhydramnios, fetal congestive heart failure, fetal anemia, fetal hydrops and intrauterine death. Case(s): A 35-years-old primigravida woman with uncomplicated pregnancy was referred to the Ultrasound Centre of Obstetric and Gynecologic of Sant’Anna Hospital, Turin, due to a suspect placental mass seen during the ultrasound performed at 32 weeks of gestation. In this case, detailed ultrasound scans with grey scale and Doppler examination were performed (using Aplio 550; Canon Medical Systems Europe BV, Zoetermeer, The Netherlands). We also decided to study the vascularization of the mass with SMI (superb microvascular imaging) technology. In particular, with the use of SMI, it was possible to visualize the vascularization of the mass more completely which was conspicuous at first but disappeared after thrombosis of feeding vessels with favorable pregnancy outcome. Conclusion: SMI is a new vascularity imaging method that can visualize vessels that exhibit slow flow rates. It uses a system to reduce artifacts by greatly reducing interference from tissue movement.

Sex-specific effects of maternal dietary carbohydrate quality on fetal development and offspring metabolic phenotype in mice.

ObjectivesIn utero glycemia is an important determinant of fetal growth. Women with gestational diabetes are more likely to deliver large-for-gestational age babies that are at increased risk for obesity. The maternal nutritional state modulates the development of offspring biological systems during the critical periods of gestation and lactation. Carbohydrate typically contributes most of the dietary energy, however, there are very few mechanistic studies investigating the effects of maternal dietary carbohydrate quality on fetal and offspring outcomes. Therefore, we sought to investigate the direct effects of maternal carbohydrate quality on sex-specific offspring metabolic programming.MethodsFemale C57BL/6 mice were fed one of five isocaloric diets: four high-sugar diets based on glucose, sucrose, isomaltulose or fructose (all containing 60% energy as carbohydrate), or a standard, minimally processed, chow diet, and were mated with chow-fed males. Half of the dams were sacrificed for fetus dissection and placental collection, with the remaining giving live birth. All dams were metabolically profiled before and during pregnancy, and pups were similarly profiled at 12 weeks of age.ResultsOverall, glucose-fed dams were heavier and fatter than chow or isomaltulose-fed dams. Female fetuses from glucose and isomaltulose-fed mothers weighed less and had smaller livers, than those from chow-fed mothers, with isomaltulose-fed female fetuses also having decreased placental mass. In contrast, male fetuses responded differently to the maternal diets, with heart mass being significantly increased when their mothers were fed fructose-containing diets, that is, sucrose, isomaltulose and fructose. High-sugar fed female offspring weighed the same, but were significantly fatter, than chow-fed offspring at 12 weeks of age, while glucose and isomaltulose-fed male pups displayed a similar phenotype to their mothers’.ConclusionWhile both glucose and isomaltulose diets constrained fetal growth in females, only placentas from isomaltulose-fed dams were significantly smaller than those from chow-fed mothers, suggesting the mechanisms through which fetal growth is reduced may be different. Female fetuses of isomaltulose-fed mothers were also lighter than sucrose-fed fetuses suggesting the glycemic index, or rate of glucose digestion and absorption, may be an important factor in determining nutrient availability to the growing fetus.

Pregnancy with choriangioma: a placental disorder that causes fetal death

Introduction: Chorioangioma is the most common non-trophoblastic vascular tumor of the placenta. It was estimated that the incidence of chorioangioma was 1%. Although the incidence was not widely large, it has high mortality and morbidity. Commonly, chorioangiomas is a small asymptomatic lesion found only after birth after careful excision of the placenta. In making it easier to visualize the food vessels entering the placental mass and peritumoral diffuse vasculature we could use the color doppler. The wide range of outcomes and limited studies related to this case makes it quite difficult to handle. Thus, this study aimed to provide information on chorioangioma from diagnosis to the management. Case description: Mother A is our referral patient who was recommended to do an ultrasound, with a diagnosis of 20 weeks gestation with suspected IUFD and a cyst in the placenta measuring 6.5cm x 4.1cm x 5.4 cm, the mother has not felt fetal movement. Ultrasound examination revealed a hematoma at the time of insertion of the umbilical cord in the placenta. The location of the placenta in the corpus anterior grade 1. No heartbeat was found in the baby, and the baby's weight was 529 grams. Conclusion: The adverse outcome is known to be associated with chorioangioma. It depends on the mass size, and the existence of fetal hydrops. The worst prognosis that we found in this case was no heartbeat when the baby was born.

Gq Signaling in the Placental Syncytiotrophoblast Layer During Preeclampsia

Preeclampsia is a pregnancy‐associated cardiovascular disorder characterized by hypertension and proteinuria after 20 weeks of gestation. Generalized cellular ‘stress’ (oxidative, mitochondrial, etc.) within the syncytiotrophoblast (STB) layer of placenta is theorized to drive its pathogenesis. Hormones implicated in preeclampsia such as angiotensin, endothelin, and vasopressin signal via receptors that typically couple to the Gq second‐messenger cascade, and Regulator of G protein Signaling‐2 (RGS2) buffers this signaling. We have published that RGS2 expression is decreased in human preeclamptic placenta, and reducing RGS2 expression in placenta is sufficient to cause development of key features of this disorder in mice. Unpublished in situ hybridization data indicate that in both humans and mice, RGS2 is present in the STB layer – and that RGS2 expression in the STB layer is reduced during preeclampsia in humans. Collectively, these findings lead us to generally hypothesize that excess Gq signaling specifically within the STB layer, whether due to excessive hormonal activation or loss of RGS2‐mediated buffering, causes STB‐Stress and thereby contributes to the pathogenesis of preeclampsia. Therefore, the objective of this study was to test whether artificial, exogenous activation of Gq signaling only within STB cells is sufficient to induce placental and maternal phenotypes of preeclampsia in mice.CAG‐FLEX‐hM3Dq+/+ (Gαq DREADD, Jax 026943) or C57BL/6J dams were bred with Gcm1‐Cre+/‐ sires (Jax 026625) or non‐transgenic littermates to elicit STB‐restricted hM3Dqexpression in ≍50% or 0% of placentas. The synthetic DREADD ligand clozapine N‐oxide (CNO) or saline vehicle was administered (2 mg/kg/d, ip) mid‐gestation (GD 12.5‐14.5). Placental and maternal phenotypes were compared between Cre– and Cre+ placentas within a dam, CNO‐ vs saline‐injected double‐transgenic dams, and double‐ vs single/non‐transgenic dams treated with CNO. Activation of Gq in the STB layer caused maternal proteinuria (n=4‐9, 49±6 mg/day vs 28±4 mg/day; p=0.01). Labyrinth vascularization, assessed by percentage of CD31+ area, was reduced with Gq activation (n=5, Cre+ 21±1%, Cre– 27±2%; p=0.01), while other regions remained unaffected (Decidua: Cre+ 14±4%, Cre– 14±3%; Junctional Zone: Cre+ 11±4%, Cre– 12±3%). Possible reductions in placental mass (n=5 Cre+ 0.12±0.01g, Cre– 0.15±0.01g; p=0.06), and placental vascular endothelial growth factor protein levels (n=6‐7 117±67 ng/g vs 151±12 ng/g; p=0.06) were noted, but no obvious trend in fetal growth restriction was observed (n=5 Cre+ 0.21±0.06g, Cre– 0.29±0.04g). These data support the pathological significance of excess Gq signaling specifically within the STB layer. Ongoing studies are aimed at further characterizing maternal phenotypes (blood pressure, circulating factors) in these models, and the synergistic effects of simultaneous STB‐specific deletion of RGS2 upon sensitivity to Gq stimulation in this cell type.

Neonatal outcomes of twins &lt;29 weeks gestation of mothers with hypertensive disorders of pregnancy.

Hypertensive disorders of pregnancy (HDP) are associated with dysfunctional placentation and are a major cause of maternal and neonatal morbidity and mortality. Twin pregnancies have a larger placental mass and are a risk factor for HDP. The effect of HDP on neonatal outcomes in twin pregnancies is unknown. Retrospective cohort study using the Canadian Neonatal Network database from 2010-2018 of twin infants &lt;29 weeks gestation born to mothers with HDP and normotensive pregnancies. Using multivariable models, we determined adjusted odds ratios (AORs) and 95% confidence intervals (CI) for mortality, bronchopulmonary dysplasia, severe neurologic injury, severe retinopathy of prematurity (ROP), necrotizing enterocolitis, and nosocomial infection in twin infants of mothers with HDP compared to twin infants of normotensive mothers. Of the 2414 eligible twin infants &lt;29 weeks gestational age, 164 (6.8%) were born to mothers with HDP and had higher odds of severe ROP (AOR 2.48, 95% CI 1.34-4.59). Preterm twin infants born to mothers with HDP also had higher odds of mortality (AOR 2.02, 95% CI 1.23-3.32). There was no difference in other outcomes. Preterm twin infants &lt;29 weeks gestation of HDP mothers have higher odds of severe ROP and mortality. Hypertensive disorders of pregnancy, associated with placental dysfunction, are a major cause of maternal and neonatal morbidity and mortality. Twin pregnancy, associated with a larger placental mass, is a risk factor for hypertensive disorders of pregnancy. The effect of hypertensive disorders of pregnancy on outcomes of preterm twins is unknown. Preterm twins of mothers with hypertensive disorders of pregnancy are at higher risk of severe retinopathy of prematurity and mortality. Our data can be used to counsel parents and identify infants at higher risk of severe retinopathy of prematurity and mortality.

Maternal serum leptin in the pregnant rat: fetal-placental implantation number and progesterone.

This study was designed to determine whether there is a role of the placenta in the regulation of maternal serum leptin levels in the pregnant rat. We have adjusted the number of fetal-placental implants on day 9 in the pregnant rat by aspirating fetal-placental units to adjust the number to 1-2, 4-5 per rat or >10 in controls. Serum levels of leptin and progesterone were determined by radioimmunoassay. A separate group of pregnant rats were ovariectomized and maintained with progesterone silastic capsules (10, 20 or 40 mm). In the pregnant rats with varied fetal-placental implant numbers, the maternal serum leptin were greatest in the group with the smallest number (1-2) of implants; intermediate in the midgroup (4-5 implants); and lowest in the group with a full complement of implantations (>10) (p < 0.001). Serum progesterone levels are lowest in the 1-2 implantation group. In the ovariectomized rats there was a stepwise decline in serum leptin (p < 0.05) as the dose of progesterone increased (p < 0.01). Both of these studies suggest that progesterone suppressed maternal serum leptin levels. Increasing placental mass is not associated with increasing maternal serum leptin levels in the pregnant rat; the contrary condition is observed with the least placental implants having the highest leptin levels. Progesterone seems to suppress serum leptin levels in several physiological models.

Lactogenic hormones in relation to maternal metabolic health in pregnancy and postpartum: protocol for a systematic review

IntroductionMaternal metabolic disease states (such as gestational and pregestational diabetes and maternal obesity) are reaching epidemic proportions worldwide and are associated with adverse maternal and fetal outcomes. Despite this, their...

ASSOCIATION BETWEEN PLACENTAL MORPHOMETRIC PARAMETERS AND BIRTH WEIGHT IN DICHORIONIC DIAMNIOTIC TWINS

The aim: To assess morphometric parameters of placentas and to evaluate the correlation between the placental disk shape, the site of the umbilical cord insertion and the birth weight of dichorionic twins. Materials and methods: The geometry of placentas, distances between umbilical cord insertion sites and the centroids of the disks were measured in 135 pairs of dichorionic diamniotic twins. The impact of the above-mentioned parameters on the birth weight and placental mass was analyzed. Results: In terms of weight and geometric parameters of placentas, no proven discrepancy between different types of twins and inside pairs was found. A strong correlation was established between the placental weight and birth weight (r = 0.71, p &lt; 0.05). Both the placental weight and birth weight showed the strong correlation with S*Circ (r = 0.62, p &lt; 0.05). The displacement of the umbilical cord insertion site from the centroid of the placenta was negatively correlated with its mass (r = -0.428, p &lt; 0.0001) and birth weight (r = -0.6115, p &lt; 0.0001). The displacement along the maximum axis proved to play a significant role. Conclusions: In dichorionic diamniotic twins, the area of the placentas plays the determining role in the functional activity of the organ, which increases when its shape approaches the circle. The area of the placenta multiplied by its circularity had the strongest correlation with birth weight and placental mass. The farther from the centre the umbilical cord is inserted, the lower the functional capacity of the placenta is.

THE RELATIONSHIP BETWEEN PLACENTAL GROWTH RATES AND THE BIRTH WEIGHT IN DICHORIONIC DIAMNIOTIC TWINS

Relevance. Birth weight is one of the main indicators of intrauterine fetal development. The condition of the placenta reflects the influence of the maternal environment on the fetus. It is important to find out which placental growth parameters significantly affect the mass of dichorionic diamniotic (DHDA) twins.&#x0D; Objective: to investigate the relationship between indicators of placental growth and birth weight of dichorionic diamniotic twins.&#x0D; Materials and methods. One hundred thirty-five DCDA twin pairs were studied during 2016-2020: 68 pairs were opposite-sex, 32 – same-sex females and 35 – same-sex males. The gestational age ranged from 29 to 39.5 weeks, averaging 36,4 ± V1,74 weeks. The influence of such parameters as maximum and minimum placental diameters, as well as perimeter, area, circularity (Circ), roundness, thickness, mass (PM), volume (V), displacement of the umbilical cord insertion site from the placental disc centre along its maximum (XCD) and the minimum axis (YCD).&#x0D; Results. A strong positive correlation was found between PM and birth weight in the whole cohort of DCDA twins (r = 0.7059, p &lt; 0.0001). It was strongest in the same-sex female group (r = 0.7886, p &lt; 0.0001), then in the opposite-sex pairs (r = 0.7093, p &lt; 0.0001), slightly weaker – in the same-sex male couples (r = 0.6065, p &lt; 0.0001). The birth weight and PM correlated with almost all indicators that characterize the placental shape. The strongest correlation was with V (rV_BW = 0.66, p &lt; 0.0001; rV_PM = 0.59, p &lt; 0.0001) and the area*Circ (rS*Circ_BW = 0.64; p &lt; 0.0001; rS*Circ_PM = 0.62; p &lt; 0.0001). The multiple regression analysis of the effect of different morphometric parameters of the placentas on the birth weight has demonstrated the statistical significance of the following parameters: XCD, PM, V, YCD and Circ. The general regression model for the whole DCDA group: birth weight = 2242,3 + 0,8*МП + V – 10,0* XCD (R2 = 0,7002). Similar equations were calculated for different types of DCDA tweens. Thus, morphometric measures account for the 67-85% variances of the birth weight of the DCDA tweens.&#x0D; Conclusion. In the DCDA pairs, placental mass strongly positively correlated with birth weight. Both indicators are in strong relationship with V and their area*Circ. The closer the placental shape is to the circle, the higher its functional ability. Deterioration of the latter may be due to the far fixation of the umbilical cord from the center of the placental disc. The displacement along the maximum axis has a stronger impact comparing to the displacement relative to the minimum axis. The multiple regression analysis has revealed that statistical significance had XCD and PM or V in the whole types of twins. Proposed models demonstrate that 67-85% of the variability of birth weight may be accounted for by the three or four simple placental measures

Influence of the placental cord insertion site on the placental mass and the birth weight in dichorionic diamniotic twins

The aim of the study was to determine the effect of the displacement of the umbilical cord insertion site from the centre of the placenta on the placental mass and the birth weight of dichorionic diamniotic twins and to consider the importance of the direction of the displacement, as well as to assess the influence of the umbilical cord displacement on the placental mass and the birth weight of dichorionic diamniotic twins taking into account the direction of displacement.&#x0D; Material and methods. The study was performed on 135 dichorionic diamniotic pairs: 68 opposite-sex, 35 same-sex males, and 32 same-sex females. The impact of an absolute cord displacement from the centroid of the placental disc and the direction of its shifting were compared with the birth weight and the placental mass.&#x0D; Results. In the investigated group, a central insertion was revealed in 6 (2.2 %), eccentric – in 224 (83.0 %), marginal – in 31 (11.5 %), and velamentous – in 9 (3.3 %) cases. The first two types of cord insertion are considered to be normal, the third and the fourth are seen as abnormal. The placental mass was in a strong positive correlation with the birth weight (r=0.71, p&lt;0.0001). The placentas with an eccentric cord insertion had a smaller surface area. A negative correlation was established between the displacement of the cord insertion site and the placental mass (r=-0.4284, p&lt;0.0001) as well as the birth weight (r=-0.6115, p&lt;0.0001). The shift along the long axis was of greater importance than in relation to the shorter one. The placental mass and the birth weight were higher in the new-borns with a normal cord insertion site. In the abnormal cord insertion group, 32.5 % of the infants were under the 10th birth weight percentile, in the normal cord insertion group – only 8.3 %.&#x0D; Conclusions. The birth weight of dichorionic diamniotic twins and their placental mass are negatively correlated with the distance of the umbilical cord insertion site from the placental centre. The insertion site displacement along the long axis has a stronger negative effect on the birth weight and the placental mass in comparison with the shifting along the short axis. The placentas with an eccentric cord insertion have a smaller surface area.

Placental morphology in different types of diabetes mellitus

AIM: The aim of this study was to compare placental morphological features from women with different types of diabetes mellitus considering method of DM correction.&#x0D; MATERIALS AND METHODS: A retrospective, single-center, cohort study was carried out. We analyzed morphological examination results of 3300 placentas, which made uр the following comparison groups: type 1 diabetes mellitus on continuous subcutaneous insulin infusion (n = 60), type 1 diabetes mellitus on multiple subcutaneous insulin injections (n = 446), type 2 diabetes mellitus on diet (n = 95), type 2 diabetes mellitus on insulin therapy (n = 134), gestational diabetes mellitus on diet (n = 1652), gestational diabetes mellitus on insulin therapy (n = 735), preeclampsia (n = 39), and the control group (n = 139). The examined placentas were weighed, with their sizes (two diameters and thickness), cotyledon structure and defects assessed. We determined the umbilical cord junction and external characteristics of extraembryonic membranes. Fragments of the placenta (5 pieces) were fixed in 10% neutral buffered formalin (pH 7.2), processed with the Leica TP1020 tissue processor and embedded in paraffin. Histological sections (3-4 m thick) were prepared and stained with hematoxylin-eosin. Statistical analysis was performed using the SPSS 23.0 and GraphPad Prism 8.0 software.&#x0D; RESULTS: Following characteristics were typical for all types of diabetes mellitus: increased placental mass metrics, chronic placental insufficiency, dissociated villous maturation disorder with prevalent immaturity, as well as involutive-dystrophic and circulatory disorders of varying severity. Placentas from women with type 1 diabetes mellitus had the specific sings: the predominance of intermediate immature villi and stem villi stromal fibrosis. The frequency of placental infarcts and fibrinoid content in the intervillous space were comparable to those in placentas from women with type 2 diabetes mellitus. Inflammatory changes and moderate placental calcification were most consistently associated with type 2 diabetes mellitus, while gestational diabetes mellitus was characterized by soft damages. Placentas with preeclampsia showed higher prevalence of premature villous maturation, compensated placental insufficiency, and fibrinoid depositions in the intervillous and subchorionic spaces.&#x0D; CONCLUSIONS: Understanding relationships between placental histological features and clinical aspects of diabetes mellitus makes it possible not only to clarify the pathophysiological processes occurring in this pathology but also to optimize the algorithm for the rational management of the neonatal period of children from mothers with diabetes mellitus.