Unique Clinical and Histological Features of Placental Mesenchymal Dysplasia Complicated by Severe Preeclampsia in the Midtrimester

AJP Rep 2020; 10: e113-e117 DOI: 10.1055/s-0040-1709186Detailed clinical and pathological features of placental mesenchymal dysplasia (PMD) complicated by preeclampsia (PE) are unknown. A 39-year-old nulliparous woman was referred at 19 weeks gestation. Ultrasound examination identified a fetus with severe growth restriction (−2.8 SD) and a markedly thickened placenta with many cystic structures suggestive of PMD. At 21 weeks, the patient developed severe hypertension (180/95 mm Hg) with marked proteinuria and an elevated serum soluble fms-like tyrosine-kinase-1 (sFlt-1) level (47,000 pg/L). The pregnancy was terminated to protect maternal health. Placental weight was 450 g and no histopathological findings of either proliferation or dysplasia were observed in the trophoblast. Villous chromosome examination revealed a 46XX karyotype, consistent with the diagnosis of PMD. In addition to the pathological findings of vascular endothelial dysfunction characteristic of the placenta in PE cases, enhanced expression of sFlt-1 in the syncytiotrophoblast of the enlarged villi was confirmed by immunohistochemistry as a novel finding in this condition. Monitoring of the serum sFlt-1 value is suggested to be a useful predictor of the pathological change associated with extremely early severe PE in PMD cases. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract &...
Source: American Journal of Perinatology Reports - Category: Perinatology & Neonatology Authors: Tags: Case Report Source Type: research

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Abstract BACKGROUND: The traditional definition of preeclampsia (PE) is based on the development of hypertension and proteinuria. This has recently been revised to include cases without proteinuria but with evidence of renal, hepatic or hematological dysfunction. OBJECTIVE: To examine the impact of the new definition of PE on first, the incidence and severity of the disease, and second, the performance of the competing risks model for first-trimester assessment of risk for PE. METHODS: This was a retrospective study of 66,964 singleton pregnancies that were classified as PE, gestational hypertension (GH)...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
Conclusion: Pregnant SLE cases presenting with IH, LN and serositis are challenging concerning the management of SLE activity. IH may be a sign of lupus activity and its resolution coincides with the control of the flare. Lower dose CsA is potentially effective in treating LN in pregnancy with no reported side effects.
Source: The Egyptian Rheumatologist - Category: Rheumatology Source Type: research
Management of pregnancies after combined screening for pre-eclampsia at 19-24 weeks' gestation. Ultrasound Obstet Gynecol. 2018 Jun 25;: Authors: Litwinska M, Syngelaki A, Wright A, Wright D, Nicolaides KH Abstract OBJECTIVE: To estimate the patient-specific risk of pre-eclampsia (PE) at 19-24 weeks' gestation by maternal factors and combinations of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), serum placental growth factor (PlGF) and serum soluble fms-like tyrosine kinase-1 (sFlt-1). On the basis of the risk of PE, the women would be stratified into high-, int...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
Abstract OBJECTIVES: To assess the agreement of home blood-pressure monitoring (HBPM) and office blood pressure measurements in a cohort of pregnant women with Hypertensive Disorders of Pregnancy (HDP). METHODS: This was a cohort study at St George's Hospital, University of London conducted between years 2016 and 2017. The inclusion criteria were chronic hypertension, gestational hypertension or high risk of developing preeclampsia, no significant proteinuria and no hematological or biochemical abnormalities. Each included patient was prescribed a personalized schedule of hospital visits and blood pressure me...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
We report of a patient who presented with enteritis as manifestation of new-onset SLE during the first trimester of pregnancy. Patients concerns: The 23-year nulliparous patient was admitted to a district hospital with abdominal pain, nausea, vomiting and bloody diarrhea at a gestational age (GA) of 10 weeks. Her symptoms improved with symptomatic treatment and she was discharged a few days later. At 15 weeks’ of gestation she was readmitted. Her lab results revealed mild anemia and thrombocytopenia. Ascites, renal failure and proteinuria developed. An infectious cause was suspected, but stool samples and urine cu...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
ABSTRACT ObjectiveThe majority of patients with chronic or gestational hypertension do not develop pre‐eclampsia. Home blood‐pressure monitoring (HBPM) has the potential to offer a more accurate and acceptable means of monitoring hypertensive patients during pregnancy compared with traditional pathways of frequent outpatient monitoring. The aim of this study was to determine whether HBPM reduces visits to antenatal services and is safe in pregnancy. MethodsThis was a case–control study of 166 hypertensive pregnant women, which took place at St George's Hospital, University of London. Inclusion criteria were: chro...
Source: Ultrasound in Obstetrics and Gynecology - Category: Radiology Authors: Tags: Original Paper Source Type: research
Abstract OBJECTIVE: The majority of patients with chronic or gestational hypertension do not develop pre-eclampsia. Home blood-pressure monitoring (HBPM) has the potential to offer a more accurate and acceptable means of monitoring hypertensive patients during pregnancy compared with traditional pathways of frequent outpatient monitoring. The aim of this study was to determine whether HBPM reduces visits to antenatal services and is safe in pregnancy. METHODS: This was a case-control study of 166 hypertensive pregnant women, which took place at St George's Hospital, University of London. Inclusion criteria we...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
Preeclampsia (PE) is characterized by late pregnancy hypertension and proteinuria. PE causes significant morbidity for the maternal-fetal unit. Circulating endothelin-1 (ET-1), a potent vasoconstrictor, is elevated at the time of diagnosis of human PE. In addition, women with PE demonstrate arterial stiffness as early as the end of the first trimester. However, it is unknown if arterial stiffness is associated with a first trimester elevation in ET-1 and post-delivery placental ET-1. We hypothesized that 1) first trimester plasma ET-1 is elevated and is associated with arterial stiffness in women who develop PE; 2) first t...
Source: Hypertension - Category: Cardiology Authors: Tags: Poster Abstract Presentations Source Type: research
Publication date: July 2017 Source:Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, Volume 9 Author(s): Baskaran Thilaganathan Human placentation is uniquely associated with physiological remodelling of the spiral arteries by the invading trophoblast to produce a low resistance uterine circulation. Defective placentation is associated with persistence of a high-resistance uterine circulation, impaired placental perfusion and a placental ‘stress’ response leading to the development of preeclampsia (PE). An imbalance of antigenic and antiangiogenic factors have the highest accur...
Source: Pregnancy Hypertension: An International Journal of Womens Cardiovascular Health - Category: OBGYN Source Type: research
Conclusions: These results suggest that there is a seasonal driver for PE, with effects that are not modified by parity, latitude, fetal sex, or smoking. https://doi.org/10.1289/EHP963 Received: 14 August 2016 Revised: 24 January 2017 Accepted: 25 January 2017 Published: 29 June 2017 Address correspondence to C.R. Weinberg, Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709 USA. Telephone: (919) 541-4927. Email: weinber2@niehs.nih.gov Supplemental Material is available online (https://doi.org/10.1289/EHP963). The authors declare they h...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
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