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Medicina
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Placenta: Anatomopathological Examination, Biology, Immunological Features, Role in Guiding Fetal...
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Placenta: Anatomopathological Examination, Biology, Immunological Features, Role in Guiding Fetal Development, Imaging and Placental Invasion Abnormalities

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 12977

Special Issue Editors

Prof. Dr. Simone Ferrero

E-Mail Website
Guest Editor
1. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Genova, Italy
2. Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino – IST, Genova, Italy
Interests: gynecology; endometriosis; fibroids; laparoscopy; hormonal therapy; hysteroscopy; ultrasonography; gynecological surgery; minimally invasive surgery; infertility
Special Issues, Collections and Topics in MDPI journals
Dr. Carolina Scala

E-Mail Website
Guest Editor
Ospedale Gaslini, Genova, Italy
Interests: Amniotic fluid; intrauterine growth restriction; obstetrics ultrasonography; prenatal diagnosis; preeclampsia
Dr. Valerio Gaetano Vellone

E-Mail Website
Guest Editor
1. Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy
2. Anatomic Pathology University Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
Interests: gynecologic pathology; placental & fetal pathology; molecular pathology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The placenta is a temporary organ that represents the interface between the maternal and fetal vascular beds. The placenta mediates nutrients and oxygen exchange, removes harmful waste, provides immune protection, and produces hormones to support fetal development. Placental cells (trophoblasts) accomplish this by invading and remodeling the uterine vasculature. Despite being of a fetal origin, trophoblasts do not trigger a significant maternal immune response. The placenta influences not just the health of a woman and her fetus during pregnancy, but it may also affect the lifelong health of both mother and child. In fact, the placenta has a pivotal role in guiding fetal development and metabolism. Despite this, the placenta is the least understood and least studied of all human organs.

Trophoblast invasion may sometimes be abnormal, infiltrating the myometrium of the uterine wall; this condition is named “invasive placenta” (accreta, increta, and percreta). Because of the abnormal attachment, invasive placenta is associated with an increased risk of massive bleeding and organ damage. The antenatal diagnosis of invasive placenta allows for referring patients to adequate centres for delivery. Ultrasonography and magnetic resonance imaging can be used for the diagnosis of placental invasion abnormalities. Unfortunately, placenta accrete cannot always be diagnosed before delivery. Maternal morbidity and mortality can occur because of severe and sometimes life-threatening haemorrhage, which often requires blood transfusions. Patients with placenta accreta spectrum are more likely to require a hysterectomy at the time of delivery or during the postpartum period and have longer hospital stays. The management of placenta accreta requires a multidisciplinary team accustomed to manage this condition.

The purpose of this Special Issue is to update the knowledge on the placenta. We encourage the submission of original manuscripts and reviews on this subject.

Prof. Dr. Simone Ferrero
Dr. Carolina Scala
Prof. Dr. Valerio Gaetano Vellone
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 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

  • endometrium
  • endometrial epithelium
  • immunology of implantation
  • implantation
  • placenta accreta
  • placental barrier
  • placental development
  • placenta previa
  • ultrasonography
  • magnetic resonance imaging
  • trophoblast

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Published Papers (3 papers)

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9 pages, 963 KiB  
Article
Preoperative Prophylactic Balloon-Assisted Occlusion of the Internal Iliac Arteries in the Management of Placenta Increta/Percreta
by Soo Buem Cho, Seok Jin Hong, Sangmin Lee, Jung Ho Won, Ho Cheol Choi, Ji Young Ha, Jin Il Moon, Ji Kwon Park, Ji Eun Park and Sung Eun Park
Medicina 2020, 56(8), 368; https://doi.org/10.3390/medicina56080368 - 23 Jul 2020
Cited by 11 | Viewed by 2835
Abstract
Background and Objectives: Preoperative prophylactic balloon-assisted occlusion (PBAO) of the internal iliac arteries minimizes blood loss and facilitates surgery performance, through reductions in the rate of uterine perfusion, which allow for better control in hysterectomy performance, with decreased rates of bleeding and [...] Read more.
Background and Objectives: Preoperative prophylactic balloon-assisted occlusion (PBAO) of the internal iliac arteries minimizes blood loss and facilitates surgery performance, through reductions in the rate of uterine perfusion, which allow for better control in hysterectomy performance, with decreased rates of bleeding and surgical complications. We aimed to investigate the maternal and fetal outcomes associated with PBAO use in women with placenta increta or percreta. Material and Methods: The records of 42 consecutive patients with a diagnosis of placenta increta or percreta were retrospectively reviewed. Of 42 patients, 17 patients (40.5%) with placenta increta or percreta underwent cesarean delivery after prophylactic balloon catheter placement in the bilateral internal iliac artery (balloon group). The blood loss volume, transfusion volume, postoperative hemoglobin changes, rates of hysterectomy and hospitalization, and infant Apgar score in this group were compared to those of 25 similar women who underwent cesarean delivery without balloon placement (surgical group). Results: The mean intraoperative blood loss volume in the balloon group (2319 ± 1191 mL, range 1000–4500 mL) was significantly lower than that in the surgical group (4435 ± 1376 mL, range 1500–10,500 mL) (p = 0.037). The mean blood unit volume transfused in the balloon group (2060 ± 1154 mL, range 1200–8000 mL) was significantly lower than that in the surgical group (3840 ± 1464 mL, range 1800–15,200 mL) (p = 0.043). There was no significant difference in the postoperative hemoglobin change, hysterectomy rates, length of hospitalization, or infant Apgar score between the groups. Conclusion: PBAO of the internal iliac artery prior to cesarean delivery in patients with placenta increta or percreta is a safe and minimally invasive technique that reduces the rate of intraoperative blood loss and transfusion requirements. Full article
(This article belongs to the Special Issue Placenta: Anatomopathological Examination, Biology, Immunological Features, Role in Guiding Fetal Development, Imaging and Placental Invasion Abnormalities)
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8 pages, 8051 KiB  
Case Report
CD133 Expression in Placenta Chorioangioma Presenting as a Giant Asymptomatic Mass
by Gianluca Di Massa, Guglielmo Stabile, Federico Romano, Andrea Balduit, Alessandro Mangogna, Beatrice Belmonte, Pina Canu, Emma Bertucci, Giuseppe Ricci and Tiziana Salviato
Medicina 2021, 57(2), 162; https://doi.org/10.3390/medicina57020162 - 11 Feb 2021
Cited by 5 | Viewed by 2916
Abstract
Background: Placental chorioangioma is the most common benign non-trophoblastic neoplasm of the placenta. Its clinical relevance lies in the size of the tumor since larger masses cause pregnancy complications, including an unfavorable neonatal outcome. Case presentation: We report the case of a [...] Read more.
Background: Placental chorioangioma is the most common benign non-trophoblastic neoplasm of the placenta. Its clinical relevance lies in the size of the tumor since larger masses cause pregnancy complications, including an unfavorable neonatal outcome. Case presentation: We report the case of a 34-year-old second gravida and nullipara at the 35th week of gestation, admitted to the gynecological department for antibiotic-resistant fever. The cardiotocography performed during hospitalization showed an abnormal fetal pattern. A 2250 g newborn was delivered by cesarean section. No complications were observed during childbirth and postpartum was insignificant. On gross inspection a white fleshy intraparenchymal mass blooming on the maternal surface was noted; routinely stained sections revealed features consistent with chorioangioma with vascular channels lined by inconspicuous endothelial cells immunoreactive for CD31 and CD133. Focal expression of CD133 was also observed in placental villi. Discussion: CD133 expression indicated the presence of stem cells in chorioangioma, suggesting their possible role in the development of mesenchymal lesions including chorioangioma. Full article
(This article belongs to the Special Issue Placenta: Anatomopathological Examination, Biology, Immunological Features, Role in Guiding Fetal Development, Imaging and Placental Invasion Abnormalities)
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9 pages, 1900 KiB  
Case Report
Report of Positive Placental Swabs for SARS-CoV-2 in an Asymptomatic Pregnant Woman with COVID-19
by Antonella Ferraiolo, Fabio Barra, Chiara Kratochwila, Michele Paudice, Valerio Gaetano Vellone, Elisabetta Godano, Serena Varesano, Giovanni Noberasco, Simone Ferrero and Cesare Arioni
Medicina 2020, 56(6), 306; https://doi.org/10.3390/medicina56060306 - 22 Jun 2020
Cited by 55 | Viewed by 6006
Abstract
Currently, limited data on maternal and neonatal outcomes of pregnant women with infection and pneumonia related to SARS coronavirus 2 (SARS-CoV-2) are available. Our report aims to describe a case of placental swabs positive for the molecular research on severe acute respiratory syndrome [...] Read more.
Currently, limited data on maternal and neonatal outcomes of pregnant women with infection and pneumonia related to SARS coronavirus 2 (SARS-CoV-2) are available. Our report aims to describe a case of placental swabs positive for the molecular research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 RNA in an asymptomatic woman with positive rhino-pharyngeal swab for SARS-CoV-2 who underwent an urgent cesarean section in our obstetrics unit. Sample collection, processing, and laboratory testing were conducted in accordance with the World Health Organization (WHO) guidance. In the next months, conclusive data on obstetrical outcomes concerning the gestational age and pregnancy comorbidity as well as the eventual maternal–fetal transmission are needed. Full article
(This article belongs to the Special Issue Placenta: Anatomopathological Examination, Biology, Immunological Features, Role in Guiding Fetal Development, Imaging and Placental Invasion Abnormalities)
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