Placenta最新文献

{"title":"Correlation of the umbilical cord coiling pattern and fetal outcome: A single-center observational analytical study","authors":"Diana Burlacu ,&nbsp;Agnes Burlacu ,&nbsp;Paul Călburean ,&nbsp;Bela Szabo ,&nbsp;Tibor Mezei","doi":"10.1016/j.placenta.2025.02.011","DOIUrl":"10.1016/j.placenta.2025.02.011","url":null,"abstract":"<div><h3>Introduction</h3><div>The umbilical cord (UC) anatomically embodies the feto-placental bridge with a major role in fetal development due to the vascular structures embedded in Wharthon's jelly. The helical coiling of the umbilical cord may be counterclockwise, viewed from the fetus, defined as sinistral coiling, while the opposite as dextral coiling. This study aimed to determine any associations between UC coiling patterns and medical disorders of pregnancy.</div></div><div><h3>Material and methods</h3><div>An observational analytical study was conducted at the Clinical Emergency Hospital of Targu-Mures, Romania between January 2023–December 2023. Consecutive singleton placentas with attached UC submitted to the Pathology Department for various feto-maternal conditions were considered for appropriate measurements. The coiling number and direction (sinistral or dextral) of the umbilical cord were assessed per first 10 cm measured at the placental end.</div></div><div><h3>Results</h3><div>Of 187 cases this study included, 57.21 % (97) had sinistral and 42.79 % (90) had dextral UC coiling. The minimum and maximum maternal age group was 12–44 years old. Sinistral UC coiling was associated with an increased risk of spontaneous abortion and stillbirth (25.77 %, p = 0.028). Sinistral coiling was also associated with extreme prematurity (p = 0.013), smaller birth weight (p = 0.040) and lower placental weight (p = 0.029). A lower 1 min (p = 0.045) and 5 min Apgar score (p = 0.017) were associated with sinistral coiling. No relevant risk of premature rupture of membranes (PROM) was observed (p = 0.324). No significant association of sinistral coiling and metabolic or blood-related maternal diseases was observed (p = 0.385 and p = 0.725).</div></div><div><h3>Conclusion</h3><div>According to the literature approximately 25 % of all pregnancies have a dextral UC coiling direction. In contrast, in our study a significantly higher percentage was found (slightly higher than 42 %) to have dextral coiling of the UC. Data from our selected group indicated that certain neonatal pathologies (extreme prematurity, stillbirth, smaller birth weight, and lower Apgar score) were more associated with sinistral coiling as compared to dextral. More extensive studies are necessary to ascertain the clinical relevance of these data, particularly concerning high-risk pregnancies.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 51-58"},"PeriodicalIF":3.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics analysis of placental MRI for prenatal prediction of placenta accreta spectrum in pregnant women in the third trimester: A retrospective study of 594 patients","authors":"Kui Li ,&nbsp;Guohui Yan ,&nbsp;Xiaodan Zhang ,&nbsp;Jianchun Kong ,&nbsp;Yu Zou ,&nbsp;Xiaodong Cheng","doi":"10.1016/j.placenta.2025.02.009","DOIUrl":"10.1016/j.placenta.2025.02.009","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and validate a model based on placental MRI for the prenatal prediction of placenta accreta spectrum (PAS) in pregnant women in the third trimester.</div></div><div><h3>Materials and methods</h3><div>A total of 594 pregnant women who were suspected of having PAS and underwent placental MRI antenatally were included and were allocated into the training cohort and testing cohort at a 2:1 ratio. MRI diagnosis was determined by three experienced radiologists. Radiomic features were extracted from images of T2 weighted imaging for each patient. After a feature selection strategy, a radiomics signature and a clinical-radiomics nomogram combining radiomics score and clinical risk factors were constructed to predict PAS. The performance of each model was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and clinical utility.</div></div><div><h3>Results</h3><div>MRI diagnosis yielded AUCs of 0.77 and 0.79 for predicting PAS in the training and testing cohorts, respectively. The AUCs of the radiomics signature used to predict PAS in both cohorts were 0.80 and 0.83, respectively. The nomogram accurately predicted PAS in both cohorts (AUC = 0.84 and 0.89), with better results than those of MRI diagnosis and radiomics signature in the training (<em>p</em> = 0.009 and 0.003, respectively) and testing cohorts (<em>p</em> = 0.010 and 0.008, respectively), decision curve analysis confirmed its best clinical utility compared to the other models.</div></div><div><h3>Conclusion</h3><div>Radiomics analysis based on placental MRI may serve as an effective tool to predict PAS in patients with possible PAS in the third trimester.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 59-66"},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amniotic fluid-derived exosomal miR-146a-5p ameliorates preeclampsia phenotypes by inhibiting HIF-1α/FLT-1 expression","authors":"Jin Lin ,&nbsp;Xiaohong Huang ,&nbsp;Jing Zhang ,&nbsp;Weiming Yang ,&nbsp;Fan Sun ,&nbsp;Bo Huang ,&nbsp;Wan Lu ,&nbsp;Xiaozhong Wang","doi":"10.1016/j.placenta.2025.02.013","DOIUrl":"10.1016/j.placenta.2025.02.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Preeclampsia (PE) is a pregnancy-specific complication that begins with hypertension and proteinuria and seriously threatens the health of pregnant women and fetuses. Abnormal expression of amniotic fluid-derived exosomal miR-146a-5p was observed in PE. However, the role of human amniotic fluid-derived exosomes (AF-Exos) and miR-146a-5p in PE remains unclear.</div></div><div><h3>Methods</h3><div>We determined the miR-146a-5p expression pattern in the AF-Exos. AF-Exos, Cobalt chloride (CoCl₂) and miR-146a-5p mimic were added to trophoblast cell lines HTR-8/SVneo and JEG-3, respectively. Then the proliferation and migration function of HTR-8/SVneo and JEG-3 cells were examined. The expression of miR-146a-5p, HIF-1α and FLT-1 in HTR-8/SVneo and JEG-3 cells were detected by RT-qPCR and western blotting. Finally, we determined the effect of AF-Exos in PE rat models.</div></div><div><h3>Results</h3><div>MiR-146a-5p was down-regulated in AF-Exos of PE compared to normal. Co-cultured with normal AF-Exos significantly promoted proliferation and migration of HTR-8/SVneo and JEG-3 cells. CoCl₂ inhibited proliferation and migration of HTR-8/SVneo and JEG-3 cells, while miR-146a-5p mimic reversed them by suppressing HIF-1α/FLT-1 expression. After treatment of AF-Exos, the blood pressure and 24-h urinary protein of PE rats were substantially decreased, the quality of fetuses and placenta exhibited improved, and HIF-1α/FLT-1 expression of placenta, sFlt-1 and sEng levels of blood, were substantial suppressed.</div></div><div><h3>Conclusion</h3><div>The study provided experimental evidence for the protective effects of normal AF-Exos on ameliorating preeclampsia phenotypes, and miR-146a-5p may act an important role in enhancing the proliferation and migration of trophoblast cells by targeting HIF-1α.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 35-44"},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difference in adverse neonatal outcomes between preterm singletons and twins possibly explained by placental abnormalities","authors":"Salma El Emrani ,&nbsp;Jacqueline U.M. Termote ,&nbsp;Esther J.S. Jansen ,&nbsp;Jelle J. Goeman ,&nbsp;Enrico Lopriore ,&nbsp;Nicoline E. Schalij-Delfos ,&nbsp;Lotte E. van der Meeren","doi":"10.1016/j.placenta.2025.02.010","DOIUrl":"10.1016/j.placenta.2025.02.010","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this study was to compare microscopic placental characteristics between preterm twins and singletons, and between preterm monochorionic and dichorionic twins, in order to explore the effect of placental pathology on adverse neonatal outcomes.</div></div><div><h3>Methods</h3><div>This study included 566 neonates born ≤32 weeks and/or ≤1500 g, of whom 429 were singletons and 137 were twins (38 monochorionic and 99 dichorionic). Clinical data was retrospectively collected, and placentas were prospectively examined for maternal vascular malperfusion, fetal vascular malperfusion and placental inflammation (acute and chronic).</div></div><div><h3>Results</h3><div>Singletons had increased rates of maternal vascular malperfusion, fetal hypoxia, funisitis (in umbilical cord and chorial plate), chronic deciduitis, and villitis of unknown etiology compared to twins. Delayed villous maturation and ischemia were more frequently present in monochorionic placentas than in dichorionic. Singletons had a significant lower birthweight and were more often small for gestational age than twins. Multivariate linear regression analysis adjusting for singleton pregnancy, gestational hypertension and placental abnormalities showed that gestational hypertension (β = −114.8), infarct (β = −130.1), decidual necrosis (β = −115.4), fetal hypoxia (β = −59.3) and chronic deciduitis (β = −118.8) were independently associated with lower birthweight. Multivariate regression analysis revealed five independent risk factors of small for gestational age: gestational hypertension (OR 4.4), infarct (OR 3.7), decidual necrosis (OR 2.7), fetal hypoxia (OR 1.9) and villitis (OR 5.2).</div></div><div><h3>Discussion</h3><div>Singleton pregnancies vary in histological placental abnormality rates from twin pregnancies. This study demonstrated that differences in birthweight and small for gestational age rates between preterm twins and singletons can be attributed to gestational hypertension and histological placental abnormalities.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 45-50"},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental transcriptome analysis in opioid-exposed versus non-opioid exposed pregnancies","authors":"Aneya Sousa ,&nbsp;Ojong Tabi Ojong Besong ,&nbsp;Elisha M. Wachman ,&nbsp;Elizabeth S. Taglauer ,&nbsp;Jennifer E. Beane ,&nbsp;Yohana Kefella ,&nbsp;Ji Sun Koo ,&nbsp;Kelley Saia ,&nbsp;Hendree E. Jones ,&nbsp;Huiping Zhang","doi":"10.1016/j.placenta.2025.02.012","DOIUrl":"10.1016/j.placenta.2025.02.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Opioid exposure during pregnancy may significantly alter gene expression in the placenta, potentially disrupting its function and influencing fetal brain development. These alterations may contribute to adverse outcomes such as neonatal opioid withdrawal syndrome (NOWS). In this study, we aim to systematically investigate the changes in placental gene expression associated with maternal opioid exposure to better understand the underlying molecular mechanisms and their implications for fetal health.</div></div><div><h3>Methods</h3><div>Fresh placental tissue samples were collected from 18 opioid-exposed pregnancies and 26 non-opioid-exposed control pregnancies. Transcriptomic changes related to opioid exposure were assessed using RNA sequencing (RNA-seq).</div></div><div><h3>Results</h3><div>Among the 16,172 genes detected, 55 showed differential expression (<em>P</em>_adjusted &lt; 0.25 or <em>P</em>_unadjusted &lt; 0.001) in opioid-exposed placentas. Gene Set Enrichment Analysis (GSEA) revealed that the differentially expressed genes were primarily associated with immune responses, neuronal development and function, as well as cell replication and division. Computational deconvolution using the PlacentaCellEnrich program identified significant enrichment of upregulated genes in decidual NK cells. Furthermore, integrative analysis of DNA methylation and gene expression showed an enrichment of differentially methylated genes among downregulated genes in opioid-exposed placentas.</div></div><div><h3>Discussion</h3><div>Our findings suggest that opioid exposure during pregnancy may disrupt critical placental pathways, particularly those involved in immune responses. Future studies focusing on transcriptomic changes in specific placental cell types will be essential for fully understanding the structural and functional alterations in the placenta due to opioid exposure during pregnancy.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 27-34"},"PeriodicalIF":3.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective analysis of placental histopathological findings in gestational diabetes mellitus (GDM)","authors":"Joseph Byrne ,&nbsp;Niccole Ranaei-Zamani ,&nbsp;J. Ciaran Hutchinson ,&nbsp;Sara Hillman","doi":"10.1016/j.placenta.2025.02.008","DOIUrl":"10.1016/j.placenta.2025.02.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The placenta plays a pivotal role in supporting fetal growth and disruptions in its development and function can impact fetal outcomes. While placental pathology has been extensively studied in clinical conditions such as pre-eclampsia and fetal growth restriction (FGR), the association between placental abnormalities and gestational diabetes mellitus (GDM) is still unclear. This study aims to explore the placental pathology associated with GDM, shedding light on potential links to adverse perinatal outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using electronic patient data from the Fetal Medicine and Neonatal Units at University College London Hospital. Placental samples were obtained and analysed at Great Ormond Street Hospital. Maternal demographics, obstetric history and placental histopathology were reviewed. Statistical analyses were performed to identify associations and risk factors.</div></div><div><h3>Results</h3><div>Of the 2580 pregnancies analysed, 341 were GDM pregnancies, 549 had FGR and 66 had both GDM and FGR. GDM pregnancies required increased rates of obstetric intervention and neonatal care admission. Placental pathology in GDM revealed a higher prevalence of maternal vascular malperfusion (MVM) lesions, whilst GDM-related FGR showed further associations with MVM lesions and adverse perinatal outcomes.</div></div><div><h3>Discussion</h3><div>Our study highlights MVM lesions as a prominent feature in the placentas of GDM pregnancies, especially when associated with FGR. These lesions are linked to adverse perinatal outcomes, emphasizing the need for enhanced antenatal care in these cases. The study contributes insights into the complex relationship between GDM, placental pathology and adverse fetal outcomes, laying the foundation for future investigations into early interventional strategies.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 20-26"},"PeriodicalIF":3.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research design and tissue collection considerations for investigation of placenta accreta spectrum.","authors":"Stacy Zamudio, Nicholas P Illsley","doi":"10.1016/j.placenta.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.placenta.2025.02.006","url":null,"abstract":"<p><p>Placenta accreta spectrum (PAS) is a group of pregnancy pathologies characterized by loss/absence of decidua and trophoblast over-invasion penetrating into the myometrium beyond the normal depth. It is associated with expansion of deeper branches of the uterine arteries and placental adherence to the uterus. Undetected PAS leads frequently to massive and potentially fatal hemorrhage at delivery. For the more severe forms of PAS (increta, percreta), the most frequent solution is caesarean delivery-hysterectomy. The etiology of PAS is, however, unclear at best. While there is increasing research interest, the clinical intricacies of this pathology pose significant challenges for the researcher. In this communication we present the elements which we believe should be considered when undertaking (or interpreting) research into PAS, particularly when biological samples and molecular techniques are involved.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stillbirth at term in Iceland: Causes of death and patterns of placental injury","authors":"Ragnheidur I. Bjarnadottir ,&nbsp;Thora Steffensen ,&nbsp;Karin Pettersson ,&nbsp;Nikos Papadogiannakis ,&nbsp;Alexander K. Smarason ,&nbsp;Johanna Gunnarsdottir","doi":"10.1016/j.placenta.2025.02.007","DOIUrl":"10.1016/j.placenta.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Iceland is a high-income country with &lt;400.000 inhabitants and low stillbirth rate (SBR). Increased antenatal risk assessment and interventions in high-risk pregnancies doubled the induction rate after 2008.</div></div><div><h3>Objective</h3><div>Estimate the SBR at term, comparing an earlier (1996–2008) and latter (2009–2021) 13-year period, and describe causes of death and patterns of placental injury of infants stillborn at term.</div></div><div><h3>Study design</h3><div>Stillbirth at term was defined as antepartum or intrapartum death of an infant that was diagnosed after ≥37 weeks of gestation. All cases (n = 125) had placental examination. Histopathological slides were reviewed, and pattern of placental injury classified according to the Amsterdam consensus. Medical records were found for all mothers who had stillbirth at term and cause of death assigned according to the Stockholm classification of stillbirth.</div></div><div><h3>Results</h3><div>No decrease in the SBR at term was found between periods. Majority of deaths (72 %) were caused by cord complications and/or placental insufficiency and deaths attributed to placental insufficiency increased in the latter period. Placentas weighing under the 10th percentile were more common in the latter period, 43.5 % vs. 30.2 % (p &lt; 0.05) as was chronic villitis of unknown etiology (VUE), 40.3 % vs. 12.7 % (p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Stillbirth at term has not decreased in Iceland, despite increased antenatal surveillance and induction rate, with more deaths attributed to placental insufficiency and VUE increasingly found in the later period. Further research is needed on the correlation of patterns of placental injury with clinical phenotypes of mothers and infants.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 14-19"},"PeriodicalIF":3.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary trophoblastic deportation in the hystricomorph rodent Lagostomus maximus","authors":"Francisco Acuña ,&nbsp;Gimena Gomez Castro ,&nbsp;Daniel González Gómez ,&nbsp;Agostina Terraza ,&nbsp;Mirta Alicia Flamini ,&nbsp;Claudio Gustavo Barbeito","doi":"10.1016/j.placenta.2025.02.004","DOIUrl":"10.1016/j.placenta.2025.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Trophoblast has been reported in the lungs of gestating eutherian mammals with hemochorial placenta, including humans, cotton rats, and American hares. This study describes the discovery of trophoblastic-like cells in the lungs of <em>Lagostomus maximus</em>.</div></div><div><h3>Methods</h3><div>Lung and placenta samples from non-pregnant and pregnant plains viscachas were analyzed using histology and immunohistochemistry.</div></div><div><h3>Results</h3><div>Macroscopically, the lungs of females in both groups showed no alterations, but microscopic examination of the lungs from pregnant females revealed lesions and trophoblast-like cells. Markers such as pancytokeratin, MMP-2, MMP-9, and progesterone receptors were found in both pulmonary trophoblastic cells and the various types of trophoblasts in the placenta and subplacenta. Notably, cytokeratin-7 showed similarity with the placenta but not with the subplacenta. Cells identified in the lungs that were positive for markers similar to trophoblast giant cells in the maternal blood chambers suggest that the trophoblast that reaches the lungs may originate from giant cells that enter maternal blood circulation rather than those that invade the uterine artery. Immunohistochemical analysis indicated that, unlike placental trophoblast, the lung cells exhibited no proliferative activity.</div></div><div><h3>Discussion</h3><div>The lack of this process in mice and the difficulty of developing <em>in vivo</em> experimental models have prompted the exploration of <em>in vitro</em> models. <em>L. maximus</em> may serve as an alternative model to study this process, necessitating further research to determine the timing of this phenomenon during gestation and whether pulmonary alterations persist after parturition.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 1-8"},"PeriodicalIF":3.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coagulation and fibrinolytic system of umbilical venous blood in hyper-coiled umbilical cord: A single center cohort study","authors":"Shota Saji ,&nbsp;Masatomo Doi ,&nbsp;Junki Koike ,&nbsp;Nao Suzuki ,&nbsp;Junichi Hasegawa","doi":"10.1016/j.placenta.2025.02.003","DOIUrl":"10.1016/j.placenta.2025.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>We aimed to clarify whether the coagulation-fibrinolytic system is activated in a hyper-coiled umbilical cord (HCC).</div></div><div><h3>Methods</h3><div>This prospective cohort study was conducted at a single perinatal center in Japan, including singleton pregnant women who delivered after 37 weeks of gestation between January and July 2024. Umbilical venous blood was collected immediately after birth and before placental delivery. The coagulation and fibrinolytic systems were measured, and variables were compared between patients with and without HCC.</div></div><div><h3>Results</h3><div>As a variable of cell blood count and hemostatic function, platelet concentration was significantly lower in the HCC group [median (range): 25.5 (17.3–32.1) vs 30.4 (18.5–39.55) x100000/μl, p = 0.020]. For coagulation variables, fibrinogen concentration [105 (63–116) vs 137.5 (56–229) mg/dl, p &lt; 0.001] and antithrombin III [35 (27–51) vs 47.5 (31–62) %, p = 0.022] were significantly lower in the HCC group. Regarding fibrinolytic variables, plasmin inhibitor complex concentration was significantly higher in HCC group [1.3 (1.0–6.9) vs 0.7 (0.3–5.2) μg/ml, p = 0.036]; however, plasminogen concentration was significantly lower in HCC group [40 (32–46) vs 50 (25–64), p &lt; 0.001].</div></div><div><h3>Discussion</h3><div>This is the first report where the coagulation-fibrinolytic system in the umbilical venous blood in cases with HCC was demonstrated. Findings reveal an activated coagulation-fibrinolytic system even in cases without severe fetal growth restriction due to HCC after 37 weeks of gestation.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 9-13"},"PeriodicalIF":3.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}