ascorbic-acid and Abruptio-Placentae

Preeclampsia, intrauterine growth restriction (IUGR), and placental abruption are obstetrical conditions that constitute the syndrome of ischemic placental disease or IPD, the leading cause of indicated preterm birth and an important cause of neonatal morbidity and mortality. While the phenotypic manifestations vary significantly for preeclampsia, IUGR, and abruption, these conditions may share a common underlying etiology as evidenced by: (1) shared clinical risk factors, (2) increased recurrence risk across pregnancies as well as increased co-occurrence of IPD conditions within a pregnancy, and (3) findings that suggest the underlying pathophysiologic processes may be similar. IPD is of major clinical importance and accounts for a large proportion of indicated preterm delivery ranging from the periviable to late preterm period. Successful prevention of IPD and resultant preterm delivery could substantially improve neonatal and maternal outcomes. This article will review the following topics: (1) The complicated research literature on aspirin and the prevention of preeclampsia and IUGR. (2) Research evidence on other medical interventions to prevent IPD. (3) New clinical interventions currently under investigations, including statins. (4) Current clinical recommendations for prevention of ischemic placental disease.

Topics: Abruptio Placentae; Anticoagulants; Ascorbic Acid; Aspirin; Calcium, Dietary; Dietary Supplements; Fatty Acids, Omega-3; Female; Fetal Growth Retardation; Fibrinolytic Agents; Humans; Ischemia; Placenta; Placenta Diseases; Pre-Eclampsia; Pregnancy; Premature Birth; Risk Factors; Vitamin E

Smoking and pre-eclampsia (PE) are associated with increases in preterm birth, placental abruption and low birthweight. We evaluated the relationship between prenatal vitamin C and E (C/E) supplementation and perinatal outcomes by maternal self-reported smoking status focusing on outcomes known to be impacted by maternal smoking.. A secondary analysis of a multi-centre trial of vitamin C/E supplementation starting at 9-16 weeks in low-risk nulliparous women with singleton gestations.. We examined the effect of vitamin C/E by smoking status at randomisation using the Breslow-Day test for interaction.. The trial's primary outcomes were PE and a composite outcome of pregnancy-associated hypertension (PAH) with serious adverse outcomes. Perinatal outcomes included preterm birth and abruption.. There were no differences in baseline characteristics within subgroups (smokers versus nonsmokers) by vitamin supplementation status. The effect of prenatal vitamin C/E on the risk of PE (P = 0.66) or PAH composite outcome (P = 0.86) did not differ by smoking status. Vitamin C/E was protective for placental abruption in smokers (relative risk [RR] 0.09; 95% CI 0.00-0.87], but not in nonsmokers (RR 0.92; 95% CI 0.52-1.62) (P = 0.01), and for preterm birth in smokers (RR 0.76; 95% CI 0.58-0.99) but not in nonsmokers (RR 1.03; 95% CI 0.90-1.17) (P = 0.046).. In this cohort of women, smoking was not associated with a reduction in PE or the composite outcome of PAH. Vitamin C/E supplementation appears to be associated with a reduction in placental abruption and preterm birth among smokers.

Topics: Abruptio Placentae; Adolescent; Adult; Ascorbic Acid; Dietary Supplements; Double-Blind Method; Female; Humans; Hypertension, Pregnancy-Induced; Pre-Eclampsia; Pregnancy; Premature Birth; Smoking; Vitamin E; Vitamins; Young Adult

Topics: Abruptio Placentae; Ascorbic Acid; Dietary Supplements; Female; Humans; Pregnancy; Premature Birth; Smoking Cessation; Tobacco Use Cessation Devices; Vitamin E

Concentrations of histamine and total ascorbic acid (L-ascorbic acid plus dehydroascorbic acid) in the antecubital vein blood of women in abruptio placentae (normally situated placentae) and placenta praevia have been measured. The results show that blood ascorbic acid in abruptio placentae is significantly (P less than 0.05) lower than the values found in placenta praevia. This may reflect impaired absorption and/or increased breakdown of ascorbic acid in abruptio placentae. Histamine levels in the two conditions are similar to one another.

Topics: Abruptio Placentae; Adult; Ascorbic Acid; Female; Hemorrhage; Histamine; Humans; Placenta Diseases; Placenta Previa; Pregnancy; Pregnancy Trimester, Third

Topics: Abruptio Placentae; Ascorbic Acid; Blood Chemical Analysis; Female; Hemolysis; Humans; Metabolism; Pre-Eclampsia; Pregnancy