H. Sameshima, M. Kamitomo, S. Kajiya, M. Kai, T. Ikenoue
{"title":"Insulin-meal interval and short-term glucose fluctuation in tightly controlled gestational diabetes mellitus","authors":"H. Sameshima, M. Kamitomo, S. Kajiya, M. Kai, T. Ikenoue","doi":"10.1080/jmf.10.4.241.245","DOIUrl":"https://doi.org/10.1080/jmf.10.4.241.245","url":null,"abstract":"Objective: To study the effect of two insulin-meal intervals on short-term glucose fluctuations in tightly controlled gestational diabetes mellitus (GDM). Methods: We performed a prospective and paired study in 11 Japanese GDM women requiring insulin for good glycemic control during the third trimester. The women were subjected to test two insulin-meal intervals: 15 min and 30 min. Both regimens were examined in each patient in random order, 2 days apart. Blood glucose was measured by an automated glucose monitor every 2 min. Short-term glucose fluctuations of the two observations were analyzed by two-way ANOVA for repeated measurements with a post hoc t test ( p < 0.05). Data were expressed as mean - SD. Results: Daily glucose profiles of the two groups showed that their glycemic controls on the days of observation were good and that the two glucose profile curves were superimposable. A transient decrease in glucose (nadir 62 - 6 mg/dl) was observed at 6-10 min of meal ingestion in the 30-min regimen, which was significantly different from the glucose fluctuations during the 15-min regimen. The 2-h postprandial glucose levels were similar in both experiments. Conclusions: In women with tightly controlled GDM during the third trimester, insulin-meal intervals of 15 min are beneficial when compared with 30-min intervals, in that they avoid preprandial hypoglycemia without increasing 2-h postprandial hyperglycemia.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"241 - 245"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.4.241.245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60758162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Lembet, C. Saphier, S. Gaddipati, C. Divino, R. Berkowitz
{"title":"Post-splenectomy splenic artery aneurysm rupture in an atypical presentation of pre-eclampsia","authors":"A. Lembet, C. Saphier, S. Gaddipati, C. Divino, R. Berkowitz","doi":"10.1080/jmf.10.5.360.362","DOIUrl":"https://doi.org/10.1080/jmf.10.5.360.362","url":null,"abstract":"Splenic artery aneurysm rupture in pregnancy is an uncommon catastrophic event. We report a patient who presented at 15 3/7 weeks with atypical pre-eclampsia. After termination was recommended, the patient chose to continue the pregnancy. Reversal of clinical and laboratory abnormalities occurred and the patient was discharged. The patient presented again at 24 weeks with severe pre-eclampsia and residual splenic artery aneurysm rupture, at the site of a splenectomy that had been performed 24 years previously.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"360 - 362"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.5.360.362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60758981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ovine intramembranous pathway permeability: use of solute clearance to determine membrane porosity","authors":"S. Mann, J. J. Lee, M. Ross","doi":"10.1080/jmf.10.5.335.340-19","DOIUrl":"https://doi.org/10.1080/jmf.10.5.335.340-19","url":null,"abstract":"Objective: The contribution of the fetal chorioamniotic membranes (i.e. the intramembranous pathway) to the regulation and maintenance of amniotic fluid (AF) volume and composition has yet to be completely understood. Knowledge of membrane permeability properties is vital to understanding how the intramembranous pathway contributes to the overall maintenance of AF homeostasis. Although there are significant data regarding the regulation of intramembranous water flow, there is little understanding of the regulation of intramembranous solute flow. In the present study, we sought to determine the effect of molecular weight or size of non-polar compounds on intramembranous solute movement in the ovine model. Methods: Five singleton ovine fetuses (117 - 3 days) were chronically prepared with bladder, tracheal, amniotic cavity and femoral arterial and venous catheters and an esophageal occluder. The allantoic membranes were excised. After 5 days' recovery, AF volume was calculated by intraamniotic injection of 99 Tc-labelled red blood cells (time m 6 to 0 h). At time 0, AF exchange routes were limited to the intramembranous pathway by inflation of the esophageal occluder and external drainage of fetal urine and lung fluid. Following intra-amniotic injection of creatinine (Cr, 1 g, MW 11 000 Da, 4 Å) and [ 125 I]albumin (RISA, 250 w Ci, MW 69 000 Da, 36 Å), maternal and fetal plasma and AF samples were collected at timed intervals during the subsequent 5 h. AF solute clearance (Cl x) was determined by the changes in AF total solute content. Results: Cr and RISA disappeared from the AF with a corresponding increase in fetal, though not maternal, plasma levels. The mean Cl Cr was significantly greater than Cl RISA (2.0 - 0.3 ml/min vs. 1.0 - 0.2 ml/min; p < 0.04). Conclusion: Solute clearance from the amniotic cavity is inversely proportional to solute molecular weight/size. Although the membrane comprising the ovine intramembranous pathway is size restrictive, membrane pores allow passage of non-polar solutes up to 36 Å. Knowledge of membrane permeability characteristics is essential for the utilization of the intramembranous pathway for fetal therapeutics.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"335 - 340"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.5.335.340-19","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60759249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Gaziano, C. Gaziano, C. Terrell, R. E. Hoekstra
{"title":"The cerebroplacental Doppler ratio and neonatal outcome in diamnionic monochorionic and dichorionic twins","authors":"E. Gaziano, C. Gaziano, C. Terrell, R. E. Hoekstra","doi":"10.1080/jmf.10.6.371.375","DOIUrl":"https://doi.org/10.1080/jmf.10.6.371.375","url":null,"abstract":"Objective: Neonatal outcome in twins was studied in relation to the cerebroplacental ratio (CPR). Methods: Seventy-five infants from twin pregnancies with fetal Doppler data obtained within 3 weeks of delivery were candidates for study (23 infants from diamnionic monochorionic and 52 infants from diamnionic dichorionic twin pregnancies). Multivariate regression analyses were expanded to include 114 twin infants (34 diamnionic monochorionic and 80 diamnionic dichorionic twins). Patients with twin transfusion syndrome were excluded from analysis in the monochorionic group. Targeted ultrasound examination with biometry was performed, and Doppler resistance index (RI) of the umbilical artery (UA) and the middle cerebral artery (MCA) were obtained, and the CPR, a measure of blood flow redistribution, was calculated. Outcome variables included major complications, growth restriction, days of ventilator and oxygen use, days in the neonatal intensive care unit and length of stay. Results: The CPR was correlated more highly with adverse outcomes such as birth weight, special-care nursery days and length of stay than were the UA RI or the MCA RI. The CPR was significantly lower in monochorionic compared with dichorionic twins (1.12 vs. 1.27, p = 0.01). Multivariate regression analyses conducted separately on each twin group also demonstrated that CPR was superior to UA RI and MCA RI in predicting length of stay and restricted growth. Among the Doppler variables, the CPR showed the highest sensitivity for growth restriction (67%). Conclusion: In twins, CPR was superior to UA RI and MCA RI in predicting adverse neonatal events.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"371 - 375"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.6.371.375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60759564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Yamada, K. Fujimori, T. Ishida, M. Sanpei, S. Honda, A. Sato
{"title":"Plasma endothelin-1 and atrial natriuretic peptide levels during prolonged (24-h) non-acidemic hypoxemia in fetal goats","authors":"J. Yamada, K. Fujimori, T. Ishida, M. Sanpei, S. Honda, A. Sato","doi":"10.1080/jmf.10.6.409.413-24","DOIUrl":"https://doi.org/10.1080/jmf.10.6.409.413-24","url":null,"abstract":"Objective: The purpose of this study was to investigate the effects of prolonged (24-h) non-acidemic hypoxemia on plasma endothelin-1 and atrial natriuretic peptide (ANP) in fetal goats. Methods: During continuous infusion of nitrogen into the maternal trachea, fetal plasma endothelin-1 and ANP levels were measured in nine chronically instrumented goat fetuses at 117-129 days' gestation. Endothelin-1 and ANP were measured by radioimmunoassay. Results: Fetal arterial p O 2 decreased significantly from 23.1 - 1.0 mmHg (control) to 15.2 - 0.9 mmHg during the first 2 h of hypoxemia and to 15.7 - 1.1 mmHg at the end of the experimental period of hypoxemia. The plasma endothelin-1 concentration increased from 10.6 - 1.9 pg/ml to 20.4 - 4.3 pg/ml ( p < 0.05) during the first 2 h and was 19.7 - 2.4 pg/ml ( p < 0.01) at the end of the experimental period. The plasma ANP concentration also increased, from 20.3 - 5.5 pg/ml to 23.0 - 4.7 pg/ml in the first 2 h and then to 58.0 - 8.8 pg/ml ( p < 0.05) at the end of the experimental period. There was a significant negative correlation between fetal plasma endothelin-1 and p O 2, but no significant correlation was found between fetal plasma ANP and p O 2 . Conclusions: Prolonged non-acidemic hypoxemia induces a continuous increase in fetal plasma endothelin-1 and ANP levels. Fetal plasma ANP increases time-dependently but endothelin-1 remains constant during hypoxemia.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"409 - 413"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.6.409.413-24","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60760048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Yamamoto, G. Lambert-Messerlian, H. Silver, R. Kudo, L. Kellner, J. Canick
{"title":"Maternal serum levels of type I and type III procollagen peptides in pre-eclamptic pregnancy","authors":"H. Yamamoto, G. Lambert-Messerlian, H. Silver, R. Kudo, L. Kellner, J. Canick","doi":"10.1080/jmf.10.1.40.43","DOIUrl":"https://doi.org/10.1080/jmf.10.1.40.43","url":null,"abstract":"Objective : To compare maternal serum levels of two markers of collagen synthesis, procollagen I carboxy-terminal peptide (PICP) and procollagen III amino-terminal peptide (PIIINP), in patients with pre-eclampsia and in controls. Methods : PICP and PIIINP were measured by radioimmunoassay in maternal serum samples from patients diagnosed with pre-eclampsia at 32 weeks' gestation or later and in controls from the same period of gestation. For PICP, 37 cases and 36 controls were studied; for PIIINP, 12 cases and 19 controls were studied. Results : Both PICP and PIIINP levels were significantly elevated in patients with pre-eclampsia. PICP and PIIINP levels were, on average, 20% and 80% higher than in controls, respectively. Conclusions : These results are in agreement with previous findings that maternal serum levels of PICP and PIIINP are mildly elevated in patients with pre-eclampsia. These markers are unlikely to be useful in the prediction of pre-eclampsia.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"35 1","pages":"40 - 43"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.1.40.43","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60756456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Wiznitzer, E. Reece, Boris Furman, C. Homko, R. Gakman, Moshe Mazor, Joseph Levy
{"title":"Fetal serum levels of insulin, growth hormone and insulin-like growth factor-I in concordant and discordant twin gestations","authors":"A. Wiznitzer, E. Reece, Boris Furman, C. Homko, R. Gakman, Moshe Mazor, Joseph Levy","doi":"10.1080/jmf.10.4.236.240-13","DOIUrl":"https://doi.org/10.1080/jmf.10.4.236.240-13","url":null,"abstract":"Objective: To examine the role of insulin, growth hormone and insulin-like growth factor (IGF)-I in concordant and discordant twin pairs. Methods: Umbilical cord serum samples were obtained from 20 twin pairs with weight discordancy (intertwin birth weight difference > 20%) and from 20 concordant twins (intertwin birth weight difference < 20%), both groups of similar gestational age, gravidity, and parity. The serum samples were analyzed for the levels of IGF-I, growth hormone and insulin in both maternal and fetal compartments. Results: Among the group of discordant twins, the normally grown twin, in all cases, had significantly higher cord serum IGF-I levels than their growth-restricted co-twin (108 - 73 ng/ml vs. 39 - 24 ng/ml; p < 0.01). There were no significant intertwin differences in the cord blood IGF-I levels in the concordant twin pairs (87 - 44 vs. 88 - 48 ng/ml; p = 0.986). Insulin and growth hormone levels did not correlate with intertwin birth weight differences. Conclusion: These data demonstrate that IGF-I is important in the regulation of both normal and restricted fetal growth in utero, and its action appears to be, at least in part, through an endocrine action. The precise role of growth hormone and insulin in fetal growth restriction remains uncertain.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"236 - 240"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.4.236.240-13","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60758117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Rosen, E. Kuczynski, L. O’Neill, E. Funai, C. Lockwood
{"title":"Plasma levels of thrombin-antithrombin complexes predict preterm premature rupture of the fetal membranes","authors":"T. Rosen, E. Kuczynski, L. O’Neill, E. Funai, C. Lockwood","doi":"10.1080/jmf.10.5.297.300","DOIUrl":"https://doi.org/10.1080/jmf.10.5.297.300","url":null,"abstract":"Objective: Decidual hemorrhage (abruption) is strongly associated with preterm premature rupture of fetal membranes (PPROM). Moreover, thrombin enhances decidual matrix metalloproteinase (MMP) expression, and MMP has been strongly linked to PPROM. The current study sought to determine whether increased thrombin activation, as assessed by circulating maternal plasma thrombin-antithrombin (TAT) complexes, predicted subsequent PPROM. Study design: We conducted a nested, case-control study of plasma TAT levels, measured by sensitive immunoassay, among 27 women with a singleton preterm birth preceded by PPROM and 54 matched, term controls. Receiver operating characteristic curve analysis was performed to identify the optimal TAT cut-off level predicting PPROM. Results: Mean gestational age at delivery in cases was 33.3 weeks, compared to 39.7 weeks in controls (p < 0.001). Compared with controls, women with PPROM had increased median plasma TAT levels in both the second trimester (5.1μg/l (range 2.2-26.3 μg/l) vs. 3.2 μg/l (range 1.3-7.3 μg/l); p = 0.001) and third trimester (7.0 μg/l (range 2.6-85.8 μg/dl) vs. 4.8 μg/l (range 1.7-15.4 μg/dl); p = 0.01). In the PPROM group, 16.0% of the women exhibited bleeding during the pregnancy, while the corresponding value among controls was 3.6% (p = 0.07). In the second trimester, the odds ratio for PPROM with a TAT level of > 3.9 μg/l was 6.0 (95% CI 1.67-21.1). This value predicted PPROM with a sensitivity of 88%, specificity of 68% and positive and negative predictive values of 82% and 97%, respectively. Conclusion: Second-trimester elevated plasma TAT concentrations are predictive of subsequent PPROM. These data provide further evidence that PPROM is associated with decidual thrombin activation.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"18 1","pages":"297 - 300"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.5.297.300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60758384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Christensen, C. Gonzalez, J. D. Stewart, W. Rayburn
{"title":"Multiple courses of antenatal betamethasone and cognitive development of mice offspring","authors":"H. Christensen, C. Gonzalez, J. D. Stewart, W. Rayburn","doi":"10.1080/jmf.10.4.269.276","DOIUrl":"https://doi.org/10.1080/jmf.10.4.269.276","url":null,"abstract":"Objective: To measure the effect of multiple courses of antenatal betamethasone, used for lung maturation, on long-term cognition of mice offspring. Methods: Forty gravid CD-1 mice were randomly assigned to receive one of four treatments ( n = 10 per group): 0.1 mg betamethasone or saline placebo, given subcutaneously either once daily on gestational days 13-16 or twice daily on days 14 and 15. This dose of betamethasone given on gestational day 14 causes fetal lung maturation in mice. Three offspring per gender in each litter underwent standard cognitive tasks as juveniles and as adults. Analysis of variance or Kruskal-Wallis testing was used to compare data. Results: Learning acquisition and memory were indistinguishable between the betamethasone-exposed and the corresponding placebo-exposed offspring when performing the following tasks: juvenile runway with adult memory, adult water runway and Morris spatial maze. This lack of difference in task performance between treatment groups persisted after controlling for gender and for each multiple-course regimen. Conclusion: Multiple courses of antenatal corticosteroids did not impact the mouse offsprings' long-term learning and memory.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"269 - 276"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.4.269.276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60758605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Sheiner, I. Shoham-Vardi, M. Hallak, R. Hershkowitz, M. Katz, M. Mazor
{"title":"Placenta previa: obstetric risk factors and pregnancy outcome","authors":"E. Sheiner, I. Shoham-Vardi, M. Hallak, R. Hershkowitz, M. Katz, M. Mazor","doi":"10.1080/jmf.10.6.414.419","DOIUrl":"https://doi.org/10.1080/jmf.10.6.414.419","url":null,"abstract":"Objective: To determine the incidence, obstetric risk factors and perinatal outcome of placenta previa. Study design: All singleton deliveries at our institution between 1990 and 1998 complicated with placenta previa were compared with those without placenta previa. Results: Placenta previa complicated 0.38% ( n = 298) of all singleton deliveries ( n = 78 524). A back-step multiple logistic regression model found the following factors to be independently correlated with the occurrence of placenta previa: maternal age above 40 years (OR 3.1, 95% CI 2.0-4.9), infertility treatments (OR 3.1, 95% CI 1.8-5.6), a previous Cesarean section (OR 1.8, 95% CI 1.4-2.4), a history of habitual abortions (OR 1.3, 95% CI 1.3-2.7) and Jewish ethnicity (OR 1.3, 95% CI 1.1-1.8). Pregnancies complicated with placenta previa had significantly higher rates of second-trimester bleeding (OR 156.0, 95% CI 87.2-277.5), pathological presentations (OR 7.6, 95% CI 5.7-10.1), abruptio placentae (OR 13.1, 95% CI 8.2-20.7), congenital malformations (OR 2.6, 95% CI 1.5-4.2), perinatal mortality (OR 2.6, 95% CI 1.1-5.6), Cesarean delivery (OR 57.4, 95% CI 40.7-81.4), Apgar scores at 5 min lower than 7 (OR 4.4, 95% CI 2.3-8.3), placenta accreta (OR 3.6, 95% CI 1.1-9.9) postpartum hemorrhage (OR 3.8, 95% CI 1.2-10.5), postpartum anemia (OR 5.5, 95% CI 4.4-6.9) and delayed maternal and infant discharge from the hospital (OR 10.9, 95% CI 7.3-16.1) as compared to pregnancies without placenta previa. In a multivariable analysis investigating risk factors for perinatal mortality, the following were found to be independent significant factors: congenital malformations, placental abruption, pathological presentations and preterm delivery. In contrast, placenta previa and Cesarean section were found to be protective factors against the occurrence of perinatal mortality while controlling for confounders. Conclusion: Although an abnormal implantation per se was not an independent risk factor for perinatal mortality, placenta previa should be considered as a marker for possible obstetric complications. Hence, the detection of placenta previa should encourage a careful evaluation with timely delivery in order to reduce the associated maternal and perinatal complications.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"414 - 419"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.6.414.419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60760165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}