- Email: [email protected]
The Influence of normal placental locational on Intrapartum Hemorrhage in nulliparous
326
Abstracts / Placenta 57 (2017) 225e335
P2.106. FETAL THROMBOTIC VASCULAR PATHOLOGY IN A POPULATION BASED COHORT: CLINICAL CORRELATIONS Manish Bastakoti 1, Hardik Bhatt 1, Gina Auriccio 1, Sarah Baluta 1, Sylvia Dygulska 1, Sanford Lederman 1, Pramod Narula 1, Debbie SukGray 1, Carolyn Salafia 1, 2. 1 New York Presbyterian-Brooklyn Methodist Hospital, Brooklyn, NY, USA; 2 Placental Analytics LLC, New Rochelle, NY, USA Background: Fetal thrombotic vascular (FTV) pathology has been linked to fetal compromise and to longterm risk of neurodevelopental impairment. However, placental studies have been confined to only those placentas will “indications” for placental examination. Does the FTV lesion family have any clinical significance in regards to maternal and/or immediate newborn measures in a population based cohort? Methods: Our hospital practice instituted mandated universal placental examination in 2010. We have initiated a population sample, selecting pregnancies delivering at 37-41 weeks, singleton, non-anomalous infants. Pathology reports were searched for diagnoses made at birth. The maternal and newborn EMR were extracted for pertinent variables. Comparisons of categorical variables used chi-square, and of continuous variables with ANOVA or correlation, with p<0.05 considered significant. Results: 200 cases currently comprise this on-going data collection. 18 (7%) had identified FTV pathology, identified as any of the following: thrombus in fetal chorionic plate vessels or vessels of fetal stems, “hemorrhagic endovasculitis”, defined by red cell fragmentation and vascular damage, and dusty stromal karyorrhectic debris within the stroma or avascular villi. 35% with FTV pathology were delivered by cesarean section, compared to 26% without this lesion family (p¼0.007). Each of the two cases of chorionic vessel thrombi and all 3 cases with fetal stem vessel thrombi had chronic villitis (p¼0.001, p¼0.018, respectively). 47% of cases with FTV pathology had meconium laden macrophages in membranes compared to 37% without this lesion type (p¼0.017). No other associations were observed. Conclusions: In this preliminary analysis of a 1000 mother-child pair cohort based in a community hospital population, histologic FTV pathology was associated with chronic villitis, and with meconium laden histiocytes in membranes, but in this generally “well” population, no other correlations were observed. The frequency of FTV (7%) is higher than has been previously reported. http://dx.doi.org/10.1016/j.placenta.2017.07.318
P2.108. HUMAN AMNIOTIC EPITHELIAL CELLS: EVALUATION OF SURVIVAL DURING THEIR HEPATIC DIFFERENTIATION rez-Pe rez 2, Bernardo Rodrigo Riedel 1, Malena Schanton 1, Antonio Pe nchez-Margalet 2, Cecilia Maskin 3, Ornella Parolini 4, Víctor Sa 1. 1 Departamento de Química Biolo gica, FCEN, Varone 1, Julieta Maymo UBA, IQUIBICEN CONICET, Buenos Aires, Argentina; 2 Departamento de Bioquímica M edica y Biología Molecular, Universidad de Sevilla, Sevilla, Spain; 3 Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina; 4 Centro de Ricerca E. Menni, Brescia, Italy
differentiation. The aim of this work was to study the proliferation and survival of hAECs, during hepatic differentiation. Hepatic differentiation was assayed by specific factors (EGF + dexamethasone) or by HepG2 conditioned medium (CM). We have analyzed the expression of some key cell cycle proteins (Cyclin D1, p53 and p21). After specific factors treatment, we observed a significant increase in cyclin D1 mRNA expression and a decrease in p53 and p21 expression, measured by qRT-PCR. This treatment also caused a down regulation in p53 and p21 expression and an increment in cyclin D1, measured by western-blot. The opposite effects were observed with CM treatment. Finally, we have evaluated the MAPK signaling pathway activation, which is intimately linked to cell growth and proliferation. Immunofluorescence and western blot analysis revealed hepatic differentiation with specific factors significant increased ERK 1/2 phosphorylation while CM diminished it. Our results suggest hepatic differentiation with specific factors promotes the proliferation and survival of hAECs, improving their quality and quantity for an eventual future transplant. http://dx.doi.org/10.1016/j.placenta.2017.07.319
P2.109. THE INFLUENCE OF NORMAL PLACENTAL INTRAPARTUM HEMORRHAGE IN NULLIPAROUS
LOCATIONAL
ON
Changbo Jin, Huiping Hu, Huishu Liu. Guangzhou Women and Children’s Medical Center, guangzhou, China Objective: The aim of the study is to evaluate whether placental location at term is associated with intrapartum hemorrhage,gestational weeks orlength of delivery. Methods: A prospective study including 1171 patients with nulliparous pregnancy at term admitted for vaginal delivery was conducted. Maternal characteristics and delivery outcome such as age,prenatal BMI,gestational weeks,birth weight,neonatal Apgar score,intrapartum hemorrhageand length of delivery were determined for groups of patients with anterior, posterior, lateral and fundal placental locations.After delivery of fetus and placenta, estimation of blood loss was made of blood collected in a plastic drape under each patient.Measurement ofgestationalweeks and length of delivery were determined according to the last menstrual period and timing durin delivery. Results: Among women enrolled, there were no significant differences (P>0.05)between placental location groups in terms of age,prenatal BMI, gestational weeks,birth weight, Apgar score and length of delivery. Figure shows blood loss from the various groups (right and left lateral groups combined). Note that the lateral placental group has the greatest blood loss and the fundal group has the lowest blood loss. Women with lateral placenta locations show a significantly higher value (P¼0.0001) of 2 hours and 24 hours intrapartum hemorrhage. Discussion: Pregnant women with laterally located placentas show higher bleeding which indicates a higher incidence of 2 hours and 24 hours postpartum hemorrhage (PPH). The reason for the influence of the placental position on the bleedingoutcome remains to be elucidated.However, gestational length and duration of delivery show no significant relationship with placental location. http://dx.doi.org/10.1016/j.placenta.2017.07.320
The placenta and fetal membranes have recently been proposed as an important stem cells source for regenerative medicine. Amniotic epithelial cells isolated from human amnion (hAECs) offer considerable advantages that make them stand out between other stem cells. In addition to their virtually unlimited potential supply of, the easy access to such tissues, and the minimal ethical and legal barriers associated with their collection, they express embryonic stem cells markers and have the ability to differentiate toward all three germ layers. Moreover, they are not tumorigenic and have immunosuppressive properties. These characteristics would make hAECs ideal candidates for tissue engineering and application in regenerative medicine. Hepatic failure is one of the major causes of morbidity and mortality worldwide. Recently, stem cells have been spotlighted as alternative source of hepatocytes because their specific potential for
P2.111. THE FREQUENCY AND CLINICOPATHOLOGICAL CHARACTERISTICS OF MISCARRIAGES FEATURING PLACENTAL MASSIVE PERIVILLOUS FIBRIN DEPOSITION Eun Na Kim 1, Joong Yeup Lee 2, Doyeong Hwang 2, Ki Chul Kim 2, Chong Jai Kim 1. 1 Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; 2 Hamchoon Women’s Clinic, Seoul, Republic of Korea
Abstracts / Placenta 57 (2017) 225e335
P2.106. FETAL THROMBOTIC VASCULAR PATHOLOGY IN A POPULATION BASED COHORT: CLINICAL CORRELATIONS Manish Bastakoti 1, Hardik Bhatt 1, Gina Auriccio 1, Sarah Baluta 1, Sylvia Dygulska 1, Sanford Lederman 1, Pramod Narula 1, Debbie SukGray 1, Carolyn Salafia 1, 2. 1 New York Presbyterian-Brooklyn Methodist Hospital, Brooklyn, NY, USA; 2 Placental Analytics LLC, New Rochelle, NY, USA Background: Fetal thrombotic vascular (FTV) pathology has been linked to fetal compromise and to longterm risk of neurodevelopental impairment. However, placental studies have been confined to only those placentas will “indications” for placental examination. Does the FTV lesion family have any clinical significance in regards to maternal and/or immediate newborn measures in a population based cohort? Methods: Our hospital practice instituted mandated universal placental examination in 2010. We have initiated a population sample, selecting pregnancies delivering at 37-41 weeks, singleton, non-anomalous infants. Pathology reports were searched for diagnoses made at birth. The maternal and newborn EMR were extracted for pertinent variables. Comparisons of categorical variables used chi-square, and of continuous variables with ANOVA or correlation, with p<0.05 considered significant. Results: 200 cases currently comprise this on-going data collection. 18 (7%) had identified FTV pathology, identified as any of the following: thrombus in fetal chorionic plate vessels or vessels of fetal stems, “hemorrhagic endovasculitis”, defined by red cell fragmentation and vascular damage, and dusty stromal karyorrhectic debris within the stroma or avascular villi. 35% with FTV pathology were delivered by cesarean section, compared to 26% without this lesion family (p¼0.007). Each of the two cases of chorionic vessel thrombi and all 3 cases with fetal stem vessel thrombi had chronic villitis (p¼0.001, p¼0.018, respectively). 47% of cases with FTV pathology had meconium laden macrophages in membranes compared to 37% without this lesion type (p¼0.017). No other associations were observed. Conclusions: In this preliminary analysis of a 1000 mother-child pair cohort based in a community hospital population, histologic FTV pathology was associated with chronic villitis, and with meconium laden histiocytes in membranes, but in this generally “well” population, no other correlations were observed. The frequency of FTV (7%) is higher than has been previously reported. http://dx.doi.org/10.1016/j.placenta.2017.07.318
P2.108. HUMAN AMNIOTIC EPITHELIAL CELLS: EVALUATION OF SURVIVAL DURING THEIR HEPATIC DIFFERENTIATION rez-Pe rez 2, Bernardo Rodrigo Riedel 1, Malena Schanton 1, Antonio Pe nchez-Margalet 2, Cecilia Maskin 3, Ornella Parolini 4, Víctor Sa 1. 1 Departamento de Química Biolo gica, FCEN, Varone 1, Julieta Maymo UBA, IQUIBICEN CONICET, Buenos Aires, Argentina; 2 Departamento de Bioquímica M edica y Biología Molecular, Universidad de Sevilla, Sevilla, Spain; 3 Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina; 4 Centro de Ricerca E. Menni, Brescia, Italy
differentiation. The aim of this work was to study the proliferation and survival of hAECs, during hepatic differentiation. Hepatic differentiation was assayed by specific factors (EGF + dexamethasone) or by HepG2 conditioned medium (CM). We have analyzed the expression of some key cell cycle proteins (Cyclin D1, p53 and p21). After specific factors treatment, we observed a significant increase in cyclin D1 mRNA expression and a decrease in p53 and p21 expression, measured by qRT-PCR. This treatment also caused a down regulation in p53 and p21 expression and an increment in cyclin D1, measured by western-blot. The opposite effects were observed with CM treatment. Finally, we have evaluated the MAPK signaling pathway activation, which is intimately linked to cell growth and proliferation. Immunofluorescence and western blot analysis revealed hepatic differentiation with specific factors significant increased ERK 1/2 phosphorylation while CM diminished it. Our results suggest hepatic differentiation with specific factors promotes the proliferation and survival of hAECs, improving their quality and quantity for an eventual future transplant. http://dx.doi.org/10.1016/j.placenta.2017.07.319
P2.109. THE INFLUENCE OF NORMAL PLACENTAL INTRAPARTUM HEMORRHAGE IN NULLIPAROUS
LOCATIONAL
ON
Changbo Jin, Huiping Hu, Huishu Liu. Guangzhou Women and Children’s Medical Center, guangzhou, China Objective: The aim of the study is to evaluate whether placental location at term is associated with intrapartum hemorrhage,gestational weeks orlength of delivery. Methods: A prospective study including 1171 patients with nulliparous pregnancy at term admitted for vaginal delivery was conducted. Maternal characteristics and delivery outcome such as age,prenatal BMI,gestational weeks,birth weight,neonatal Apgar score,intrapartum hemorrhageand length of delivery were determined for groups of patients with anterior, posterior, lateral and fundal placental locations.After delivery of fetus and placenta, estimation of blood loss was made of blood collected in a plastic drape under each patient.Measurement ofgestationalweeks and length of delivery were determined according to the last menstrual period and timing durin delivery. Results: Among women enrolled, there were no significant differences (P>0.05)between placental location groups in terms of age,prenatal BMI, gestational weeks,birth weight, Apgar score and length of delivery. Figure shows blood loss from the various groups (right and left lateral groups combined). Note that the lateral placental group has the greatest blood loss and the fundal group has the lowest blood loss. Women with lateral placenta locations show a significantly higher value (P¼0.0001) of 2 hours and 24 hours intrapartum hemorrhage. Discussion: Pregnant women with laterally located placentas show higher bleeding which indicates a higher incidence of 2 hours and 24 hours postpartum hemorrhage (PPH). The reason for the influence of the placental position on the bleedingoutcome remains to be elucidated.However, gestational length and duration of delivery show no significant relationship with placental location. http://dx.doi.org/10.1016/j.placenta.2017.07.320
The placenta and fetal membranes have recently been proposed as an important stem cells source for regenerative medicine. Amniotic epithelial cells isolated from human amnion (hAECs) offer considerable advantages that make them stand out between other stem cells. In addition to their virtually unlimited potential supply of, the easy access to such tissues, and the minimal ethical and legal barriers associated with their collection, they express embryonic stem cells markers and have the ability to differentiate toward all three germ layers. Moreover, they are not tumorigenic and have immunosuppressive properties. These characteristics would make hAECs ideal candidates for tissue engineering and application in regenerative medicine. Hepatic failure is one of the major causes of morbidity and mortality worldwide. Recently, stem cells have been spotlighted as alternative source of hepatocytes because their specific potential for
P2.111. THE FREQUENCY AND CLINICOPATHOLOGICAL CHARACTERISTICS OF MISCARRIAGES FEATURING PLACENTAL MASSIVE PERIVILLOUS FIBRIN DEPOSITION Eun Na Kim 1, Joong Yeup Lee 2, Doyeong Hwang 2, Ki Chul Kim 2, Chong Jai Kim 1. 1 Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; 2 Hamchoon Women’s Clinic, Seoul, Republic of Korea