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Placenta-Mediated Conditions of Pregnancy: Prevention, Diagnosis and Management
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Placenta-Mediated Conditions of Pregnancy: Prevention, Diagnosis and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (31 May 2024) | Viewed by 9120

Special Issue Editor

Dr. Amihai Rottenstreich

E-Mail Website
Guest Editor
1. Maternal Fetal Medicine Service, Northwell Health, New York, NY 11042, USA
2. Allen and Frances Adler Laboratory of Blood and Vascular Biology, Rockefeller University, New York, NY 10065, USA
Interests: maternal fetal medicine; obstetric medicine; placenta-mediated complications; bleeding and thrombotic complications of pregnancy; preterm birth; perinatology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Placenta-mediated conditions include hypertensive disorders of pregnancy, fetal growth restriction, placental abruption, and late pregnancy loss. These complications are leading causes of maternal, fetal, and neonatal morbidity and mortality worldwide. In recent decades, many efforts have been made in order to improve the prevention, diagnosis and management of placenta-mediated conditions. Despite significant advancements and the accumulation of a large body of evidence, many other issues remain that must be addressed.

In this Special Issue of the Journal of Clinical Medicine, we are offering a platform to highlight the broad diversity of research performed across this field. This Special Issue will focus on new insights, current challenges and controversies, recent advances, and future perspectives in the field of placenta-mediated conditions. We anticipate that the research presented will promote fruitful discussions in the maternal–fetal medical community that will translate into the adoption of best practice applications in clinical, public health and policy settings.

Dr. Amihai Rottenstreich
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • placenta-mediated conditions
  • preeclampsia
  • fetal growth restriction
  • placental abruption
  • pregnancy loss

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Published Papers (6 papers)

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Editorial

Jump to: Research, Review

3 pages, 139 KiB  
Editorial
Placenta-Mediated Conditions: Past, Present, and Future Perspectives
by Amihai Rottenstreich
J. Clin. Med. 2024, 13(16), 4631; https://doi.org/10.3390/jcm13164631 - 7 Aug 2024
Viewed by 728
Abstract
Pregnancy is a highly regulated biological condition in which a successful outcome is heavily dependent on maintaining a delicate balance through maternal–fetal dialog at various levels [...] Full article
(This article belongs to the Special Issue Placenta-Mediated Conditions of Pregnancy: Prevention, Diagnosis and Management)

Research

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11 pages, 2006 KiB  
Article
The Relationship between Placental Shear Wave Elastography and Fetal Weight—A Prospective Study
by Erika Cavanagh, Kylie Crawford, Jesrine Gek Shan Hong, Davide Fontanarosa, Christopher Edwards, Marie-Luise Wille, Jennifer Hong, Vicki L. Clifton and Sailesh Kumar
J. Clin. Med. 2024, 13(15), 4432; https://doi.org/10.3390/jcm13154432 - 29 Jul 2024
Viewed by 1010
Abstract
Background/Objectives: The utility of shear wave elastography (SWE) as an adjunct to ultrasound biometry and Doppler velocimetry for the examination of placental dysfunction and suboptimal fetal growth is unclear. To date, limited data exist correlating the mechanical properties of placentae with fetal [...] Read more.
Background/Objectives: The utility of shear wave elastography (SWE) as an adjunct to ultrasound biometry and Doppler velocimetry for the examination of placental dysfunction and suboptimal fetal growth is unclear. To date, limited data exist correlating the mechanical properties of placentae with fetal growth. This study aimed to investigate the relationship between placental shear wave velocity (SWV) and ultrasound estimated fetal weight (EFW), and to ascertain if placental SWV is a suitable proxy measure of placental function in the surveillance of small-for-gestational-age (SGA) pregnancies. Methods: This prospective, observational cohort study compared the difference in placental SWV between SGA and appropriate-for-gestational-age (AGA) pregnancies. There were 221 women with singleton pregnancies in the study cohort—136 (61.5%) AGA and 85 (38.5%) SGA. Fetal biometry, Doppler velocimetry, the deepest vertical pocket of amniotic fluid, and mean SWV were measured at 2–4-weekly intervals from recruitment to birth. Results: There was no difference in mean placental SWV in SGA pregnancies compared to AGA pregnancies, nor was there any relationship to EFW. Conclusions: Although other studies have shown some correlation between increased placental stiffness and SGA pregnancies, our investigation did not support this. The mechanical properties of placental tissue in SGA pregnancies do not result in placental SWVs that are apparently different from those of AGA controls. As this study did not differentiate between constitutionally or pathologically small fetuses, further studies in growth-restricted cohorts would be of benefit. Full article
(This article belongs to the Special Issue Placenta-Mediated Conditions of Pregnancy: Prevention, Diagnosis and Management)
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9 pages, 220 KiB  
Article
The Outcome after Laser Therapy of Monochorionic Twin Pregnancies Complicated by Twin-Twin Transfusion Syndrome with Coexistent Selective Fetal Growth Restriction
by Javier U. Ortiz, Johanna Guggenberger, Oliver Graupner, Eva Ostermayer, Bettina Kuschel and Silvia M. Lobmaier
J. Clin. Med. 2024, 13(8), 2432; https://doi.org/10.3390/jcm13082432 - 21 Apr 2024
Viewed by 1451
Abstract
Background: Most previous studies evaluated outcomes of twin–twin transfusion syndrome (TTTS) without considering the coexistence of selective fetal growth restriction (sFGR). The objectives of this study were to compare twin survival and pregnancy complications after laser therapy of TTTS with and without sFGR. [...] Read more.
Background: Most previous studies evaluated outcomes of twin–twin transfusion syndrome (TTTS) without considering the coexistence of selective fetal growth restriction (sFGR). The objectives of this study were to compare twin survival and pregnancy complications after laser therapy of TTTS with and without sFGR. Methods: For this purpose, a retrospective cohort study including 98 monochorionic diamniotic twins and three dichorionic triamniotic triplets treated in a single tertiary center was conducted. Results: Overall, 46 twins had selective fetal growth restriction (26 type I, 13 type II, 7 type III). At birth, donor survival (61% vs. 91%), double survival (57% vs. 82%), and overall survival (75% vs. 88%) were significantly lower in the group with coexistent sFGR. Recipient survival (89% vs. 86%), miscarriage (7% vs. 2%), PPROM < 32 weeks (48% vs. 29%), and preterm delivery < 32 weeks (52% vs. 45%) were not significantly higher in the group with coexistent sFGR. Donor twins with sFGR type I (69% vs. 91%) and types II–III (50% vs. 91%) showed significantly lower survival than those without sFGR. Multivariate regression analysis identified sFGR and its subtypes as independent predictors of donor demise. Conclusions: the coexistence of sFGR in TTTS pregnancies was associated with poor donor outcomes and is probably the most important predictor of donor survival. Full article
(This article belongs to the Special Issue Placenta-Mediated Conditions of Pregnancy: Prevention, Diagnosis and Management)
19 pages, 565 KiB  
Article
Role of IL-6, IL-10 and TNFα Gene Variants in Preterm Birth
by Mirta Kadivnik, Deni Plečko, Kristina Kralik, Nena Arvaj and Jasenka Wagner
J. Clin. Med. 2024, 13(8), 2429; https://doi.org/10.3390/jcm13082429 - 21 Apr 2024
Cited by 1 | Viewed by 1331
Abstract
Background: The association of gene variants for interleukin 6 (IL-6) (rs1800796), interleukin 10 (IL-10) (rs1800896) and tumor necrosis factorα (TNFα (rs1800629) with the occurrence of spontaneous preterm birth (PTB) was investigated to determine whether these genetic variants are a risk factor. Methods: A [...] Read more.
Background: The association of gene variants for interleukin 6 (IL-6) (rs1800796), interleukin 10 (IL-10) (rs1800896) and tumor necrosis factorα (TNFα (rs1800629) with the occurrence of spontaneous preterm birth (PTB) was investigated to determine whether these genetic variants are a risk factor. Methods: A total of 199 blood samples from pregnant women who had given birth prematurely and 200 control blood samples were analyzed to determine single nucleotide polymorphisms (SNPs) of genes for IL-6 (rs1800796), IL-10 (rs1800896) and TNFα (rs1800629). The control samples were samples from pregnant women with term delivery. The isolation of DNA was performed on mini-spin columns according to the manufacturer’s protocol. The quality and purity of the isolated DNA were tested using a Qubit 3 fluorometer. Genotyping was performed with an ABI PRISM 7500 SDS using TaqMan SNP genotyping assays. The genotypes obtained were analyzed using the 7500 Software v2.3 package. Results: Carriers of the A/A genotype for the rs1800629 SNP of the TNFα gene have a 4.81 times greater chance of late-onset PTB compared to carriers of the G/G and A/G genotypes in the recessive inheritance model. The presence of the G/G genotype in the recessive inheritance model compared with the G/A and A/A genotypes for the rs1800896 SNP of the IL-10 gene represents a potentially protective factor, with mothers in the term-birth group having an almost 2-fold lower odds of PTB in general and an almost 10-fold lower odds of early PTB. On the other hand, carriers of the A/G genotype of rs1800896 have a 1.54-fold higher chance of preterm birth in general and a 1.6-fold higher chance of late preterm birth in the superdominant inheritance model compared to the A/A and G/G genotypes in the group of mothers with PTB. In this study, no association was found between PTB and the rs1800796 SNP of the IL-6 gene. Conclusions: rs1800629 in mothers was associated with PTB. rs1800896 shows a potentially protective effect for the occurrence of PTB in this study. No association was found between PTB and rs1800796. Full article
(This article belongs to the Special Issue Placenta-Mediated Conditions of Pregnancy: Prevention, Diagnosis and Management)
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13 pages, 2253 KiB  
Article
COVID-19 and Pregnancy: A Dangerous Mix for Bone Turnover and Metabolism Biomarkers in Placenta and Colostrum
by Javier Diaz-Castro, Juan M. Toledano, Javier Sanchez-Romero, Africa Caño Aguilar, Estefanía Martín-Alvarez, Maria Puche-Juarez, Jorge Moreno-Fernandez, Maria Pinar-Gonzalez, Sonia Prados, María Paz Carrillo, Susana Ruiz-Duran, Catalina De Paco Matallana and Julio J. Ochoa
J. Clin. Med. 2024, 13(7), 2124; https://doi.org/10.3390/jcm13072124 - 6 Apr 2024
Viewed by 2421
Abstract
Background: In pregnant women, COVID-19 can alter the metabolic environment, cell metabolism, and oxygen supply of trophoblastic cells and, therefore, have a negative influence on essential mechanisms of fetal development. The purpose of this study was to investigate, for the first time, [...] Read more.
Background: In pregnant women, COVID-19 can alter the metabolic environment, cell metabolism, and oxygen supply of trophoblastic cells and, therefore, have a negative influence on essential mechanisms of fetal development. The purpose of this study was to investigate, for the first time, the effects of COVID-19 infection during pregnancy with regard to the bone turnover and endocrine function of several metabolic biomarkers in colostrum and placenta. Methods: One hundred and twenty-four pregnant mothers were recruited from three hospitals between June 2020 and August 2021 and assigned to two groups: Control group and COVID-19 group. Metabolism biomarkers were addressed in placental tissue and colostrum. Results: Lipocalin-2 and resistin levels were higher in the placenta, revealing an underlying pro-inflammatory status in the gestation period for mothers suffering from COVID-19; a decrease in GLP-1 and leptin was also observed in this group. As for adiponectin, resistin, and insulin, their concentrations showed an increase; a decrease in GLP-1, leptin, and PYY was also reported in the colostrum of mothers suffering from COVID-19 compared with the control group. Conclusions: As for bone turnover, placental samples from mothers with COVID-19 showed lower levels of OPG, while DKK-1 increased compared with the control group. Colostrum samples showed higher levels of OPG, SOST, and PTH in the COVID-19 group, a fact that could have noteworthy implications for energy metabolism, fetal skeletal development, and postnatal bone density and mineralization. Further research is needed to explain the pathogenic mechanism of COVID-19 that may affect pregnancy, so as to assess the short-term and long-term outcomes in infants’ health. Full article
(This article belongs to the Special Issue Placenta-Mediated Conditions of Pregnancy: Prevention, Diagnosis and Management)
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Review

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11 pages, 265 KiB  
Review
Controversies and Clarifications Regarding the Role of Aspirin in Preeclampsia Prevention: A Focused Review
by Amihai Rottenstreich
J. Clin. Med. 2024, 13(15), 4427; https://doi.org/10.3390/jcm13154427 - 29 Jul 2024
Viewed by 1586
Abstract
Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. In recent decades, many studies have evaluated different interventions in order to prevent the occurrence of preeclampsia. Among these, administration of low-dose aspirin from early pregnancy showed consistent [...] Read more.
Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. In recent decades, many studies have evaluated different interventions in order to prevent the occurrence of preeclampsia. Among these, administration of low-dose aspirin from early pregnancy showed consistent evidence of its prophylactic role. In this article, we review the scientific literature on this topic, highlighting the rationale for aspirin use, who should be treated, the timing of initiation and cessation of therapy, the importance of proper dosing, and its role in the prevention of other adverse outcomes. Full article
(This article belongs to the Special Issue Placenta-Mediated Conditions of Pregnancy: Prevention, Diagnosis and Management)
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