Placental histology related to fetal brain sonography

Simple item page
dc.contributor.authorRosier-van Dunne F.M.F.
dc.contributor.authorVan Wezel-Meijler G.
dc.contributor.authorKaschula R.O.C.
dc.contributor.authorWranz P.A.B.
dc.contributor.authorOdendaal H.J.
dc.contributor.authorDe Vries J.I.P.
dc.date.accessioned2011-05-15T16:15:38Z
dc.date.available2011-05-15T16:15:38Z
dc.date.issued2011
dc.description.abstractBackground: Chronic hypoxia and inflammatory processes can induce placental disturbances that may indirectly lead to perinatal brain injury. Objective: To study histological features of the placenta in relation to echogenicity changes in the periventricular white matter, ventricular system and basal ganglia/thalami of the fetal brain. Design: Prospective study of 77 fetuses between 26 and 34 weeks gestational age with their placentas. The pregnancies were complicated by hypertensive disorders (n=42) or preterm labour (n=35). Results: Of the placentas 79% showed uteroplacental hypoperfusion, inflammation or a combination. Transvaginal ultrasound examination of the brain revealed echogenicity changes in 73% of the fetuses (44 mild, 29 moderate). Moderate brain echogenicity changes (periventricular echodensity (PVE) grade IB: increased echogenicity brighter than choroid plexus, intraventricular echodensity (IVE) grade II and III: echodensity filling ventricle respectively <50% and ≥50%; basal ganglia/thalamic echodensity (BGTE): locally increased echogenicity within basal ganglia/thalami) were equally distributed over cases with uteroplacental hypoperfusion and inflammatory features in the placenta. PVE grade IB was always associated with placental pathology. The sensitivity and negative predictive value of placental pathology for moderate echogenicity changes were high (0.91 and 0.88, respectively), while the specificity and positive predictive value were low (0.27 and 0.34, respectively). Conclusions: Normal placental histology predicted no or mild echogenicity changes, supporting the view that the latter are physiological. Placental pathology was always present in cases with grade IB PVE, presumed to represent mild or early forms of white matter injury. Both uteroplacental hypoperfusion and inflammatory features were seen in placentas from pregnancies with hypertensive disorders.
dc.description.versionArticle
dc.identifier.citationArchives of Disease in Childhood: Fetal and Neonatal Edition
dc.identifier.citation96
dc.identifier.citation1
dc.identifier.issn13592998
dc.identifier.other10.1136/adc.2009.181198
dc.identifier.urihttp://hdl.handle.net/10019.1/13420
dc.subjectarticle
dc.subjectbasal ganglion
dc.subjectbrain disease
dc.subjectbrain ventricle
dc.subjectchoroid plexus
dc.subjectdiagnostic imaging
dc.subjectdiagnostic test accuracy study
dc.subjectfetus
dc.subjectfetus disease
dc.subjectfetus echography
dc.subjectgestational age
dc.subjecthuman
dc.subjectimage analysis
dc.subjectmajor clinical study
dc.subjectmaternal hypertension
dc.subjectneuroimaging
dc.subjectplacenta disorder
dc.subjectplacenta perfusion
dc.subjectpredictive value
dc.subjectpremature labor
dc.subjectpriority journal
dc.subjectprospective study
dc.subjectsensitivity and specificity
dc.subjectthalamus
dc.subjecttransvaginal echography
dc.subjectwhite matter
dc.subjectBrain
dc.subjectBrain Injuries
dc.subjectEchoencephalography
dc.subjectEpidemiologic Methods
dc.subjectFemale
dc.subjectGestational Age
dc.subjectHumans
dc.subjectHypertension
dc.subjectObstetric Labor, Premature
dc.subjectPlacenta
dc.subjectPlacental Circulation
dc.subjectPregnancy
dc.subjectPregnancy Complications, Cardiovascular
dc.subjectUltrasonography, Prenatal
dc.subjectUmbilical Cord
dc.titlePlacental histology related to fetal brain sonography
dc.typeArticle
Files
Collections
Stellenbosch University - Scopus Tygerberg Hospital Publications