fibrin and Birth-Weight

Topics: Animals; Autopsy; Birth Weight; Blood Coagulation Disorders; Bradykinin; Cardiovascular Diseases; Female; Fibrin; Gestational Age; Humans; Hyaline Membrane Disease; Immune System Diseases; Infant, Newborn; Nervous System Diseases; Neurotransmitter Agents; Oxygen; Pregnancy; Respiratory Tract Diseases; Steroids; Water-Electrolyte Balance

Topics: Birth Weight; Clinical Trials as Topic; Fibrin; Fibrinolysis; Humans; Hyaline Membrane Disease; Infant, Newborn; Injections, Intravenous; Placebos; Plasminogen; Pulmonary Alveoli; Respiratory Distress Syndrome, Newborn; Respiratory Insufficiency; Umbilical Veins

Topics: Amino Acids; Apnea; Birth Weight; Blood Glucose; Body Weight; Chromatography, Thin Layer; Fibrin; Gestational Age; Glucose; Humans; Infant, Newborn; Infant, Premature; Nitrogen; Osmolar Concentration; Parenteral Nutrition; Protein Hydrolysates

Chronic histiocytic intervillositis (CHI) is a rare histopathological lesion in the placenta that is associated with poor reproductive outcomes. The intervillous infiltrate consists mostly of maternal mononuclear cells and fibrin depositions, which are both indicators for the severity of the intervillous infiltrate. The severity of the intervillous infiltrate as well as the clinical outcomes of pregnancy differ between cases. Our objective is to determine the relation between the severity of the intervillous infiltrate and the clinical outcomes of CHI.. Cases of CHI were semi-quantitatively graded based on histopathological severity scores. Hereto, CD68 positive mononuclear cells were quantified, fibrin depositions visualized by both a PTAH stain and an immuohistochemical staining, and placental dysfunction was assessed via thrombomodulin staining.. This study included 36 women with CHI. A higher CD68 score was significantly associated with a lower birthweight. Loss of placental thrombomodulin was associated with lower gestational age, lower birthweight, and a lower placenta weight. The combined severity score based on CD68 and PTAH was significantly associated with fetal growth restriction, and the joint score of CD68 and fibrin was associated with birthweight and placental weight.. More severe intervillous infiltrates in CHI placentas is associated with a lower birth weight and placental weight. Furthermore, this study proposes thrombomodulin as a possible new severity marker of placental damage. More research is needed to better understand the pathophysiology of CHI.

Topics: Birth Weight; Chorionic Villi; Female; Fetal Weight; Fibrin; Gestational Age; Humans; Placenta; Placenta Diseases; Pregnancy; Thrombomodulin

Massive perivillous fibrin deposition (MPDD) is an uncommon placental lesion which has been associated with an increased risk of adverse pregnancy outcome in retrospective series. The purpose of the study was to evaluate the frequency and consequences of MPFD in pregnancies complicated by fetal growth restriction (FGR).. A cohort study of 355 pregnancies complicated by FGR diagnosed according to standard ultrasonographic criteria, enrolled, followed and delivered at a single obstetric unit. Pathological placental lesions were classified according to the Amsterdam Placental Workshop Consensus. Penalized logistic regression models were used to evaluate the association of MPFD with maternal risk factors, other pathological lesions and neonatal outcome.. Moderate-to-severe MPFD was relatively common among FGR pregnancies and was associated with morphometric modifications of placenta and with an increased risk of severe adverse neonatal outcome.

Topics: Adult; Birth Weight; Chorionic Villi; Cohort Studies; Female; Fetal Growth Retardation; Fibrin; Gestational Age; Humans; Infant, Newborn; Infant, Small for Gestational Age; Male; Placenta; Placenta Diseases; Pregnancy; Pregnancy Outcome; Prognosis; Retrospective Studies; Severity of Illness Index

Hypoplastic left heart syndrome (HLHS) is a severe cardiovascular malformation (CVM) associated with fetal growth abnormalities. Genetic and environmental factors have been identified that contribute to pathogenesis, but the role of the placenta is unknown. The purpose of this study was to systematically examine the placenta in HLHS with and without growth abnormalities.. HLHS term singleton births were identified from a larger cohort when placenta tissue was available. Clinical data were collected from maternal and neonatal medical records, including anthropometrics and placental pathology reports. Placental tissues from cases and controls were analyzed to assess parenchymal morphology, vascular architecture and leptin signaling.. HLHS cases (n = 16) and gestational age-matched controls (n = 18) were analyzed. Among cases, the average birth weight was 2993 g, including 31% that were small for gestational age. When compared with controls, gross pathology of HLHS cases demonstrated significantly reduced placental weight and increased fibrin deposition, while micropathology showed increased syncytial nuclear aggregates, decreased terminal villi, reduced vasculature and increased leptin expression in syncytiotrophoblast and endothelial cells.. Placentas from pregnancies complicated by fetal HLHS are characterized by abnormal parenchymal morphology, suggesting immature structure may be due to vascular abnormalities. Increased leptin expression may indicate an attempt to compensate for these vascular abnormalities. Further investigation into the regulation of angiogenesis in the fetus and placenta may elucidate the causes of HLHS and associated growth abnormalities in some cases.

Topics: Birth Weight; Female; Fibrin; Humans; Hypoplastic Left Heart Syndrome; Leptin; Organ Size; Placenta; Placenta Growth Factor; Pregnancy; Pregnancy Proteins; Receptors, Leptin; Retrospective Studies; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factor Receptor-2

Topics: Administration, Inhalation; Animals; Birth Weight; Bronchopulmonary Dysplasia; Clinical Trials as Topic; Fibrin; Humans; Infant, Newborn; Lung; Nitric Oxide

We assessed soluble fibrin polymer longitudinally in normal pregnancy, thrombophilic pregnancy and twin gestation Thirty-three thrombophilic pregnancies, 34 uncomplicated multiple gestations and 23 singleton normal pregnancies were studied. Maternal plasma samples were collected in the first (6-12 weeks), 2nd (13-25 weeks) and 3rd trimesters of pregnancy (26-40 weeks) and were stored at -70 degrees C until assay. Soluble fibrin polymer was assayed by enzyme-linked immunosorbent assay (ABS, Copiague, New York, USA). Statistical analysis were made by Spearman test and Levine's test for equality of variance (P < 0.05). First soluble fibrin polymer maternal levels in twin gestation were significantly higher than in normal pregnancy and thrombophilic pregnancy, (23.8 +/- 4.5 mug/ml versus 9.2 +/- 3.1 and 10.0 +/- 2.0 mug/ml respectively, P < 0.005). Second and third trimester maternal levels of SFP in twins were also significantly higher than in normal pregnancy. First trimester soluble fibrin polymer was highly correlated with birthweight in twin gestation (r = -1, P < 0.01). In the third trimester, maternal soluble fibrin polymer correlated with placental weight in twin gestation (r = 0.639, P < 0.01). Overall, soluble fibrin polymer was correlated with placental weight and birthweight in the three groups but this did not reach statistical significance. Elevated maternal plasma levels of soluble fibrin polymer in twin gestation may derive from an accelerated coagulation process due to extensive vascular remodelling. Current studies are underway to determine the utility of soluble fibrin polymer in assessing fetal growth abnormalities.

Topics: Adult; Birth Weight; Case-Control Studies; Female; Fibrin; Gestational Age; Humans; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, First; Pregnancy, Multiple; Twins

Maternal anemia and low birth weight (LBW) may complicate malaria in pregnancy, and placental monocyte infiltrates have been associated with LBW, and anecdotally with anemia. We examined placental pathology from 357 Malawian women. Intervillous monocyte infiltrates were frequent in placental malaria and were not seen in uninfected placentas. Histology was grouped according to a 5-point scale. Dense monocyte infiltrates and presence of intramonocytic malaria pigment were associated with anemia and LBW. Of factors associated with LBW and/or anemia in univariate analysis, gravidity (P = 0.002), number of antenatal clinic (ANC) visits (P < 0.001), malaria pigment in fibrin (P = 0.03), and monocyte malaria pigment (P = 0.0001) remained associated with lower birth weight by multivariate analysis. Associated with maternal anemia were HIV infection (P < 0.0001), intervillous monocyte numbers (P < 0.0001), number of ANC visits (P = 0.002), and recent febrile symptoms (P = 0.0001). Pigment-containing placental monocytes are associated with anemia and LBW due to malaria, and may have a causative role in their development.

Topics: Adolescent; Adult; Anemia; Animals; Birth Weight; Female; Fibrin; Hemoglobins; Humans; Infant, Low Birth Weight; Infant, Newborn; Malaria, Falciparum; Middle Aged; Monocytes; Pigments, Biological; Placenta; Pregnancy; Pregnancy Complications, Parasitic; Pregnancy Outcome; Prospective Studies; Risk Factors

Maternal malaria is associated with reduced birth weight, which is thought to be effected through placental insufficiency, which leads to intrauterine growth retardation (IUGR). The impact of malaria on preterm delivery is unclear. The effects of placental malaria-related changes on birth weight and gestational age were studied in 1177 mothers (and their newborns) from Tanzania. Evidence of malaria infection was found in 75.5% of placental samples. Only massive mononuclear intervillous inflammatory infiltration (MMI) was associated with increased risk of low birth weight (odds ratio ¿OR, 4.0). Maternal parasitized red blood cells and perivillous fibrin deposition both were associated independently with increased risk of premature delivery (OR, 3.2; OR, 2.1, respectively). MMI is an important mechanism in the pathogenesis of IUGR in malaria-infected placentas. This study also shows that placental malaria causes prematurity even in high-transmission areas. The impact of maternal malaria on infant mortality may be greater than was thought previously.

Topics: Birth Weight; Chorionic Villi Sampling; Female; Fetal Growth Retardation; Fibrin; Gestational Age; Humans; Infant, Low Birth Weight; Infant, Newborn; Infectious Disease Transmission, Vertical; Malaria, Falciparum; Odds Ratio; Placenta; Pregnancy; Pregnancy Complications, Parasitic; Tanzania

Pregnant women are more likely to contract malaria than their non-pregnant counterparts. The aim of this study was to develop a simple classification system for the histopathological diagnosis of placental malaria infection applicable to placentas collected in field conditions. The placentas were classified into four groups depending on the presence and distribution of parasites and malaria pigment: active infection, active-chronic infection, past-chronic infection, not infected. The frequency of parasitized placentas (26.4%) was in keeping with the prevalence of placental parasitaemia documented in epidemiological studies. An additional 29.8% placentas showed pigment in fibrin only, indicating past-chronic infection. Chronic placental malaria infection was most common in primigravidae, possibly reflecting ineffective clearance of parasites from the placenta. Seasonal fluctuations between infection categories support progression of placental infection with delayed clearance of pigment from fibrin. The proposed classification system has allowed diagnosis of different categories of placental malaria infection by two independent observers. A standardized method of diagnosis may enhance understanding of placental pathology and reduced birth weight in malaria infection during pregnancy.

Topics: Adolescent; Adult; Africa, Western; Animals; Antibodies, Protozoan; Birth Weight; Enzyme-Linked Immunosorbent Assay; Female; Fibrin; Humans; Immunoglobulin G; Immunoglobulin M; Incidence; Malaria, Falciparum; Parity; Placenta; Placenta Diseases; Plasmodium falciparum; Pregnancy; Pregnancy Complications, Parasitic; Seasons

Malaria in pregnancy is associated with reduced birth weight. Most pathological studies of placental malaria infection have focused on severe Plasmodium falciparum infection. In the present study of 121 placentas delivered in a rural area of The Gambia, malaria infection was diagnosed in tissue sections using a simple classification system and severity of pathology was ranked semiquantitatively. Deposition of malaria pigment in circulating cells was associated with active infections whereas pigment in fibrin was a feature of active-chronic infections. Primigravidae had higher levels of pigment at all sites, although these observations were not always significant. Thickening of the trophoblast basement membrane occurred in all infection categories but fibrinoid necrosis of chorionic villi was a feature of active and active-chronic infection. Both birth weight and placental weight were increased in infected placentas but widespread trophoblast basement membrane thickening was associated with decreased birth weight. Both birth weight and placental weight decreased with increased fibrinoid necrosis and cytotrophoblast prominence but the results were not significant. By this approach it has been possible to correlate placental pathology with different infection categories and to analyse the pathological features associated with decreased birth weight.

Topics: Adolescent; Adult; Basement Membrane; Birth Weight; Female; Fibrin; Humans; Malaria, Falciparum; Organ Size; Parity; Pigmentation Disorders; Placenta; Placenta Diseases; Pregnancy; Severity of Illness Index

Premature infants who have self-limited respiratory distress syndrome (RDS) rapidly improve, whereas infants with a complicated respiratory course are more likely to develop bronchopulmonary dysplasia (BPD), a chronic lung disorder that is the result of prolonged lung injury and impaired healing. The balance of competing activities of coagulation and fibrinolysis may contribute to the premature lung's response to acute injury and determine, in part, whether there is early resolution or protracted alveolar inflammation. To determine the relative activities of the coagulation and fibrinolytic pathways in neonatal lung injury, procoagulant (PC) and plasminogen activator (PA) activities were measured in undiluted cell-free lung lavage samples obtained serially over the first 28 days of life from 11 infants with self-limited RDS, 11 infants with evolving BPD, and 5 mechanically ventilated control infants without lung disease. Lung lavage from all three groups contained readily detectable procoagulant activity due mainly to the tissue factor-Factor VII complex. Plasminogen activator activity was relatively high in control lavage samples but depressed on the first day of life in the two groups of infants with lung disease: median, 0.3814 IU/ml (control); 0.0541 IU/ml (RDS); and 0.0454 IU/ml (BPD), p < 0.05 in each case compared with control. Two infants with severe lung disease had no detectable plasminogen activator activity in lung lavage on the first day of life. Depressed fibrinolytic activity correlated with severity of lung disease assessed radiographically and by pulmonary function measurements. Plasminogen activator activity was due to both tissue plasminogen activator and urokinase.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Apgar Score; Baltimore; Birth Weight; Bronchoalveolar Lavage Fluid; Bronchopulmonary Dysplasia; Evaluation Studies as Topic; Female; Fibrin; Fibrinolysis; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Male; Plasminogen Activator Inhibitor 1; Plasminogen Activator Inhibitor 2; Predictive Value of Tests; Respiratory Distress Syndrome, Newborn; Risk Factors; Tissue Plasminogen Activator; Urokinase-Type Plasminogen Activator

Topics: Birth Weight; Extraembryonic Membranes; Female; Fibrin; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Male; Maternal-Fetal Exchange; Placenta; Placenta Diseases; Pregnancy

Topics: Apgar Score; Birth Weight; Blood Cell Count; Blood Coagulation Disorders; Blood Coagulation Tests; Blood Platelets; Disseminated Intravascular Coagulation; Female; Fibrin; Gestational Age; Humans; Hypothermia; Infant, Newborn; Infant, Newborn, Diseases; Male

Topics: Birth Weight; Blood Vessels; Female; Fibrin; Gestational Age; Glycosaminoglycans; Hematoma; Humans; Myofibrils; Placenta; Placenta Diseases; Pregnancy; Pregnancy Complications; Rupture, Spontaneous; Thromboembolism; Thrombosis; Umbilical Arteries

Fifty-two surviving low-birth-weight infants who had low Thrombotest (Owren) results on the first day, together with the same number of matched controls with higher Thrombotest results, were examined for the integrity of their central nervous system. Gross abnormalities were found in 13.5% of the low Thrombotest group compared with 1.9% in the higher group. Minor brain damage syndromes were more common in the low Thrombotest group. The combined brain damage syndromes were 23.1% in the low Thrombotest group compared with 3.8% in the higher group.It is suggested that the causes of the brain damage in the low Thrombotest group are either non-fatal cerebral haemorrhage or intravascular fibrin deposition associated with disseminated intravascular coagulation.

Topics: Birth Weight; Brain Diseases; Cerebral Hemorrhage; Child Development; Child, Preschool; Fibrin; Humans; Hypoprothrombinemias; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intelligence Tests; Intracranial Embolism and Thrombosis; Neurologic Examination; Prognosis

Topics: Birth Weight; Blood; Blood Coagulation Factors; Cesarean Section; Female; Fibrin; Hemorrhage; Humans; Immunoelectrophoresis; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infections; Labor Presentation; Labor, Obstetric; Maternal-Fetal Exchange; Pregnancy; Respiratory Distress Syndrome, Newborn; Time Factors; Umbilical Cord