Cited by 22Pregnancy and preeclampsia studiesMaternal and fetal healthcareNeonatal and fetal brain pathology

Placental histopathology and pregnancy outcomes in “early” vs. “late” placental abruption

Gonen, Noa, Levy, Michal, Kovo, Michal, Schreiber, Letizia, Noy, Lilach Kornblit, Volpert, Eldar, Bar, Jacob, Weiner, Eran·2021·Reproductive Sciences

Abstract

Placenta-associated pregnancy complications (fetal growth restriction and preeclampsia) are traditionally classified as "early" and "late" due to their different pathophysiology, histopathology, and pregnancy outcomes. As placental abruption (PA) represents another placenta-associated complication, we aimed to study if this categorization can be applied to PA as well. Pregnancy and placental reports of all pregnancies complicated by PA between November 2008 and January 2019 were reviewed. Maternal background, pregnancy outcomes, and placental histopathology were compared between cases of PA < 34 weeks (early PA group) vs. > 34 weeks (late PA group). Placental lesions were classified according to the "Amsterdam" criteria. The primary outcome was severe neonatal morbidity (≥ 1 severe neonatal complications: seizures, IVH, HIE, PVL, blood transfusion, NEC, or death). Included were 305 cases of PA, 71 (23.3%) in the early group and 234 (76.7%) in the late group. The early PA group was characterized by higher rates of vaginal bleeding upon presentation (p = 0.003), DIC (p = 0.018), and severe neonatal morbidity (p < 0.001). The late PA group was characterized by a higher rate of urgent Cesarean deliveries (p < 0.001). The early PA group was characterized by higher rates of placental maternal vascular malperfusion (MVM) lesions (p < 0.001), maternal inflammatory response (MIR) lesions (p < 0.001), placental hemorrhage (p < 0.001), and a lower feto-placental ratio (p < 0.001). Using regression analysis, we found that severe neonatal morbidity was independently associated with early abruption (aOR = 5.3, 95% CI = 3.9-7.6), placental MVM (aOR = 1.5, 95% CI = 1.2-1.9), placental MIR (aOR = 1.9, 95% CI = 1.4-2.3), and inversely associated with antenatal corticosteroids (aOR = 0.9, 95% CI = 0.6-0.98). "Early" and "late" PA significantly differ in their presentation, placental pathology, and pregnancy outcomes.

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Crossref · 10.1007/s43032-020-00287-3

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  • In a retrospective study of 305 cases of abruption, abruption ≥34 weeks' gestation was characterized by fewer placental maternal vascular malperfusion lesions, maternal inflammatory response lesions, and placental hemorrhages compared to abruption <34 weeks.

    “A retrospective study of 305 cases of abruption that characterized placental histopathology found that abruption ≥34 week’s gestation were characterized by fewer placental maternal vascular malperfusion lesions, maternal inflammatory response lesions, and placental hemorrhages compared to abruption <34 weeks (76).”

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Authors
Gonen, N., Levy, M., Kovo, M., Schreiber, L., Noy, L. K., Volpert, E., Bar, J., & Weiner, E.
Affiliations
Tel Aviv University (IL)
Corresponding author
Weiner, Eran
Venue
Reproductive Sciences
Published
2020-08-18
Volume
28
Issue
2
Pages
351-360
ISSN
  • 1933-7191 (ISSN-L)
  • 1933-7205
OpenAlex
W3067375198
Cited by
22
References
63
Citations by year
2026: 4 · 2025: 5 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 3
FWCI
1.52
Type
journal article
Language
en
Open access
closed
Locations
  • Reproductive Sciences (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
Keywords
placental abruption, placental pathology, Amsterdam criteria, maternal vascular malperfusion, maternal inflammatory response, antenatal corticosteroids, pregnancy outcomes, fetal growth restriction, preeclampsia, disseminated intravascular coagulation, placental hemorrhage, preterm birth
MeSH terms
Abruptio Placentae, Adult, Cesarean Section, Female, Gestational Age, Humans, Infant, Infant Mortality, Infant, Newborn, Infant, Newborn, Diseases, Infant, Premature, Placenta, Pregnancy, Pregnancy Outcome, Retrospective Studies, Risk Factors, Time Factors, Risk Assessment, Premature Birth

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