Abnormal Placental Findings Associated with Non-Reassuring Fetal Monitoring and Excellent Neonatal Outcomes
ABSTRACT
Objective: Obstetricians, Neonatologists, and Pathologists have studied gross histological analysis of human placentas in search of specific alterations in placental functions that can be correlated with neonatal outcomes. Our study assessed the prevalence of abnormal placental findings associated with non-reassuring fetal monitoring in labor requiring emergent instrumental or cesarean delivery, followed by an excellent neonatal outcome. Study Design: One hundred consecutive emergency deliveries, instrumental or cesarean, performed due to non-reassuring fetal monitoring while in labor were retrospectively evaluated. All patients were low-risk for obstetric complications, and had a singleton, term pregnancy. They had a normal antenatal routine testing and a normal anatomy ultrasound scan at 20 to 22 weeks gestation. Results: There were 35 placentas (35%) with gross placental anomalies at the delivery triage. Additionally 7 placentas (7%) were reported to be abnormal at the pathology examination. Conclusion: The prevalence of abnormal placental findings in our studied population was 42%.
Objective: Obstetricians, Neonatologists, and Pathologists have studied gross histological analysis of human placentas in search of specific alterations in placental functions that can be correlated with neonatal outcomes. Our study assessed the prevalence of abnormal placental findings associated with non-reassuring fetal monitoring in labor requiring emergent instrumental or cesarean delivery, followed by an excellent neonatal outcome. Study Design: One hundred consecutive emergency deliveries, instrumental or cesarean, performed due to non-reassuring fetal monitoring while in labor were retrospectively evaluated. All patients were low-risk for obstetric complications, and had a singleton, term pregnancy. They had a normal antenatal routine testing and a normal anatomy ultrasound scan at 20 to 22 weeks gestation. Results: There were 35 placentas (35%) with gross placental anomalies at the delivery triage. Additionally 7 placentas (7%) were reported to be abnormal at the pathology examination. Conclusion: The prevalence of abnormal placental findings in our studied population was 42%.
Cite this paper
nullG. Ventolini, S. Ramesh, S. Barhan and R. Neiger, "Abnormal Placental Findings Associated with Non-Reassuring Fetal Monitoring and Excellent Neonatal Outcomes," International Journal of Clinical Medicine, Vol. 2 No. 3, 2011, pp. 310-312. doi: 10.4236/ijcm.2011.23053.
nullG. Ventolini, S. Ramesh, S. Barhan and R. Neiger, "Abnormal Placental Findings Associated with Non-Reassuring Fetal Monitoring and Excellent Neonatal Outcomes," International Journal of Clinical Medicine, Vol. 2 No. 3, 2011, pp. 310-312. doi: 10.4236/ijcm.2011.23053.
References
[1] Aladjem, S.; Perrin, E.; Fanaroff, A. “Placental score and neonatal outcome: a clinical and pathologic study.” Obstetrics & Gynecology, v. 39 issue 4, 1972, p. 591-602. [2] Kent, AL.; Dahlstrom, JE. “Placental assessment: simple techniques to enhance best practice.” Australian & New Zealand Journal of Obstetrics & Gynaecology, v. 46 issue 1, 2006, p. 32-7. [3] Ventolini, G MD Samlowski, R M.D. Hood, D L. M.D. Placental Findings in Low-Risk, Singleton, Term Pregnancies after Uncomplicated Deliveries. American Journal of Perinatology. 21(6): 325-328, 2004. [4] Rhone, SA.; Magee, F.; Remple, V.; Money, D. “The association of placental abnormalities with maternal and neonatal clinical findings: a retrospective cohort study.” Journal of obstetrics and gynaecology Canada JOGC, v. 25 issue 2, 2003, p. 123-8. [5] Roberts, D MD, & Oliva, E MD. Clinical significance of placental examination in perinatal medicine. The Journal of Maternal-Fetal & Neonatal Medicine. 19(5), 255-64, 2006. [6] Benirschke K. The placenta in the litigation process. Am J Obstet Gynecol. 1990; 162: 1445-1450. [7] Kraus FT. Perinatal pathology, the placenta, and litigation. Hum Pathol. 2003; 34: 517-521. [8] Lavery JP. The role of placental examination and its pathology in obstetric risk management. J Healthc Risk Manag. 1997; 17: 15-20. [9] Redline RW. Placental pathology and cerebral palsy. Clin Perinatol .2006 Jun; 33(2):503-16. [10] Redline RW, Heller D, Keating S, Kingdom J. Placental diagnostic criteria and clinical correlation--a workshop report. Placenta. 2005 Apr; 26 Suppl A: S114-7and fetal outcomes.Acta Obstet Gynecol Scand. 2005 Jan; 84(1):7-10.
[1] Aladjem, S.; Perrin, E.; Fanaroff, A. “Placental score and neonatal outcome: a clinical and pathologic study.” Obstetrics & Gynecology, v. 39 issue 4, 1972, p. 591-602. [2] Kent, AL.; Dahlstrom, JE. “Placental assessment: simple techniques to enhance best practice.” Australian & New Zealand Journal of Obstetrics & Gynaecology, v. 46 issue 1, 2006, p. 32-7. [3] Ventolini, G MD Samlowski, R M.D. Hood, D L. M.D. Placental Findings in Low-Risk, Singleton, Term Pregnancies after Uncomplicated Deliveries. American Journal of Perinatology. 21(6): 325-328, 2004. [4] Rhone, SA.; Magee, F.; Remple, V.; Money, D. “The association of placental abnormalities with maternal and neonatal clinical findings: a retrospective cohort study.” Journal of obstetrics and gynaecology Canada JOGC, v. 25 issue 2, 2003, p. 123-8. [5] Roberts, D MD, & Oliva, E MD. Clinical significance of placental examination in perinatal medicine. The Journal of Maternal-Fetal & Neonatal Medicine. 19(5), 255-64, 2006. [6] Benirschke K. The placenta in the litigation process. Am J Obstet Gynecol. 1990; 162: 1445-1450. [7] Kraus FT. Perinatal pathology, the placenta, and litigation. Hum Pathol. 2003; 34: 517-521. [8] Lavery JP. The role of placental examination and its pathology in obstetric risk management. J Healthc Risk Manag. 1997; 17: 15-20. [9] Redline RW. Placental pathology and cerebral palsy. Clin Perinatol .2006 Jun; 33(2):503-16. [10] Redline RW, Heller D, Keating S, Kingdom J. Placental diagnostic criteria and clinical correlation--a workshop report. Placenta. 2005 Apr; 26 Suppl A: S114-7and fetal outcomes.Acta Obstet Gynecol Scand. 2005 Jan; 84(1):7-10.