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Fertility and Sterility May 2003
Topics: Female; Fertilization in Vitro; Humans; Placenta Previa; Pregnancy; Pregnancy, Multiple; Risk Factors
PubMed: 12738534
DOI: 10.1016/s0015-0282(02)04943-9 -
Ultrasound in Obstetrics & Gynecology :... Sep 2022
Topics: Female; Fetus; Humans; Pregnancy; Ultrasonography, Prenatal; Vasa Previa
PubMed: 35748883
DOI: 10.1002/uog.24982 -
Medicina (Kaunas, Lithuania) Sep 2023: Vasa previa (VP) is a significant perinatal complication that can have serious consequences for the fetus/neonate. Velamentous cord insertion (VCI) is a crucial...
: Vasa previa (VP) is a significant perinatal complication that can have serious consequences for the fetus/neonate. Velamentous cord insertion (VCI) is a crucial finding in prenatal placental morphology surveillance as it is indicative of comorbid VP. Assisted reproductive technology (ART) has been identified as a risk factor for VCI, so identifying risk factors for VCI in ART could improve VP recognition. This study aims to evaluate the displacement of umbilical cord insertion (CI) from the placental center and to examine the relationship between the modes of conception. : We conducted a retrospective study at the Obstetrics Department of Osaka Metropolitan University Hospital in Japan between May 2020 and June 2022. The study included a total of 1102 patients who delivered after 22 weeks of gestation. They were divided into three groups: spontaneous pregnancy, conventional in vitro fertilization (cIVF), and in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). We recorded patient background information, perinatal complications, perinatal outcomes, and a numerical "displacement score", indicating the degree of separation between umbilical CI and the placental center. : The displacement score was significantly higher in the cIVF and IVF/ICSI groups compared with the spontaneous conception group. Additionally, the IVF/ICSI group showed a significantly higher displacement score than the cIVF group. : Our study provides the first evidence that the methods of ART can affect the location of umbilical CI on the placental surface. Furthermore, we found that IVF/ICSI may contribute to greater displacement of CI from the placental center.
Topics: Infant, Newborn; Pregnancy; Humans; Male; Female; Sperm Injections, Intracytoplasmic; Vasa Previa; Retrospective Studies; Placenta; Semen; Umbilical Cord; Reproductive Techniques, Assisted; Vascular Diseases
PubMed: 37893433
DOI: 10.3390/medicina59101715 -
International Journal of Women's Health 2022Retained products of conception and placenta accreta spectrum are causes of postpartum hemorrhage. Placenta accreta spectrum is frequently managed with cesarean...
BACKGROUND
Retained products of conception and placenta accreta spectrum are causes of postpartum hemorrhage. Placenta accreta spectrum is frequently managed with cesarean hysterectomy, but conservative approaches are emerging. We present a case of delayed postpartum hemorrhage secondary to a retained placenta increta.
CASE
A 29-year-old G3P2 presented with heavy vaginal bleeding 20 days postoperatively following an uncomplicated classical cesarean delivery at 27 5/7 weeks' gestation for preterm labor in the setting of a vasa previa. On workup, imaging showed retained products of conception and concern for placenta accreta. A hypervascular area in the lower uterine segment was identified at the time of postpartum laparotomy. Total abdominal hysterectomy was performed due to postpartum hemorrhage and clinical suspicion for placenta accreta spectrum disorder. Pathology confirmed a placenta increta.
CONCLUSION
Diagnosis of placenta accreta spectrum in the remote postpartum period is uncommon but should be a considered etiology in delayed postpartum hemorrhage. Careful inspection and documentation of the placenta implantation site should occur in cesarean sections because placenta accreta spectrum disorders can remain unnoticed during delivery.
PubMed: 35497261
DOI: 10.2147/IJWH.S359857 -
Case Reports in Obstetrics and... 2014Vasa previa is a rare but clinically important obstetrical complication that can be associated with a low-lying placenta or placenta previa. We aim to convey the...
Vasa previa is a rare but clinically important obstetrical complication that can be associated with a low-lying placenta or placenta previa. We aim to convey the challenges in diagnosing this condition by presenting 2 cases of pseudo vasa previa diagnosed antenatally as vasa previa using standard and color Doppler ultrasonography. Both patients were falsely diagnosed; only a low-lying placenta was revealed after delivery. These reports emphasize that accurate identification of vasa previa on cervical imaging is important for determining an appropriate treatment strategy.
PubMed: 24971183
DOI: 10.1155/2014/903920 -
Journal of Perinatal Medicine Nov 2023To investigate the incidence and risk factors of bilobate placenta, as well as to assess its impact on preeclampsia (PE), preterm delivery (PTD) and...
OBJECTIVES
To investigate the incidence and risk factors of bilobate placenta, as well as to assess its impact on preeclampsia (PE), preterm delivery (PTD) and small-for-gestational age (SGA) neonates.
METHODS
A prospective study of singleton pregnancies, undergoing routine anomaly scan at 20-23 gestational weeks, was conducted, between 2018 and 2022. The impact of prenatally diagnosed bilobate placenta on PE, PTD and SGA was assessed. Multivariate logistic regression models were employed to assess the independent association between bilobate placenta and the main pregnancy outcomes, using specific confounders. Additionally, a risk factor analysis was performed.
RESULTS
The study population included 6,454 pregnancies; the incidence of prenatally diagnosed bilobate placenta was 2.0 % (n=129). Bilobate placenta was associated with PE (aOR: 1.721; 95 % CI: 1.014-2.922), while no statistically significant association was found between this anatomical variation and SGA (aOR: 1.059; 95 % CI: 0.665-1.686) or PTD (aOR: 1.317; 95 % CI: 0.773-2.246). Furthermore, pregnancies with prenatally diagnosed bilobate placenta had an increased prevalence of abnormal cord insertion (marginal or velamentous) (9.8 vs. 27.1 %; p<0.001) and increased mean UtA PI z-score (0.03 vs. 0.23; p=0.039). Conception via ART (aOR: 3.669; 95 % CI: 2.248-5.989), previous history of 1st trimester miscarriage (aOR: 1.814; 95 % CI: 1.218-2.700) and advancing maternal age (aOR: 1.069; 95 % CI: 1.031-1.110) were identified as major risk factors for bilobate placenta.
CONCLUSIONS
Bilobate placenta, excluding cases of co-existing vasa previa, is associated with higher incidence of PE, increased mean UtA PI z-score and higher probability of abnormal cord insertion, but not with increased risk for SGA or PTD. It is more common in pregnancies following ART and in women with a previous 1st trimester miscarriage.
Topics: Pregnancy; Infant, Newborn; Humans; Female; Pregnancy Outcome; Prospective Studies; Abortion, Spontaneous; Incidence; Prenatal Diagnosis; Fetal Growth Retardation; Placenta Diseases; Risk Factors; Pre-Eclampsia; Premature Birth; Placenta; Gestational Age; Ultrasonography, Prenatal
PubMed: 37548399
DOI: 10.1515/jpm-2023-0122 -
The Pan African Medical Journal 2015Vasa previa is a rare but clinically important obstetrical complication that can be associated with a low-lying placenta or placenta previa. We aim to present one case...
Vasa previa is a rare but clinically important obstetrical complication that can be associated with a low-lying placenta or placenta previa. We aim to present one case of vasa previa diagnosed during the placenta examination after the caesarean indicated for triple uterus scar. A 26-year-old female was referred to our hospital at 30 weeks of gestation to provide a scheduled caesarean. Trans-abdominal ultrasound was performed; the placenta was positioned in the posterior side of the fundus. Fetal growth was found to be appropriate for gestational age. A healthy male infant weighing was successfully delivered via cesarean section at 38 weeks of gestation. This operation helped to prevent complications due to acute fetal bleeding. The identification and exclusion of vasa previa using trans-vaginal ultrasound are essential to ensure appropriate and timely treatment.
Topics: Adult; Cesarean Section; Female; Humans; Infant, Newborn; Male; Placenta; Pregnancy; Ultrasonography, Prenatal; Vasa Previa
PubMed: 26405470
DOI: 10.11604/pamj.2015.21.34.6697 -
Journal of Obstetrics and Gynaecology... Jun 2016
PubMed: 27298529
DOI: 10.1007/s13224-015-0751-4 -
Medicine Dec 2022To investigate the relationship between abnormal umbilical cord insertion and birthweight discordance in monochorionic diamnionic (MCDA) twins. A total of 137 pairs of...
To investigate the relationship between abnormal umbilical cord insertion and birthweight discordance in monochorionic diamnionic (MCDA) twins. A total of 137 pairs of MCDAs were retrospectively analyzed who delivered and survived in Hangzhou Women's Hospital from January 2016 to December 2021. According to different insertion methods, they were divided into normal cord insertion group (n = 57), marginal cord insertion (MCI) group (n = 34) and velamentous cord insertion (VCI) group (n = 46). The correlation was analyzed between different insertion methods of umbilical cord and the discordant birth weight of MCDAs. The gestational age of delivery with velamentous cord insertion was significantly earlier than those with normal and marginal insertion (P < .05). There were significant differences in birthweight between large fetus (F1) and small fetus (F2) with different umbilical insertion methods (P < .05). The birthweight of F1 and F2 in normal insertion group was significantly higher than those in MCI and VCI group (P < .05). Logistic regression analysis showed that VCI was significantly associated with birth weight in F1/F2, birthweight discordance ≥ 20%, and birthweight discordance ≥ 25%, however MCI and VCI were not an independent factor for discordance in birthweight of MCDAs (P > .05). Umbilical cord insertion method can lead to inconsistency in birthweight of MCDA twins, however they were not an independent factor for discordance in birthweight.
Topics: Pregnancy; Female; Humans; Birth Weight; Retrospective Studies; Placenta; Umbilical Cord; Gestational Age; Vasa Previa; Twins, Monozygotic; Pregnancy, Twin
PubMed: 36550827
DOI: 10.1097/MD.0000000000032316 -
Case Reports in Obstetrics and... 2021Monochorionic diamniotic twins and vasa previa are uncommon. We present a case that was followed from ultrasound diagnosis to delivery.
Monochorionic diamniotic twins and vasa previa are uncommon. We present a case that was followed from ultrasound diagnosis to delivery.
PubMed: 33880195
DOI: 10.1155/2021/5513139