Maternal Perception of Reduced Fetal Movements Is Associated with Altered Placental Structure and Function

被引:93
作者
Warrander, Lynne K. [1 ]
Batra, Gauri [2 ]
Bernatavicius, Giovanna [3 ]
Greenwood, Susan L. [1 ]
Dutton, Philip [1 ]
Jones, Rebecca L. [1 ]
Sibley, Colin P. [1 ]
Heazell, Alexander E. P. [1 ]
机构
[1] Univ Manchester, Manchester Acad Hlth Sci Ctr, Sch Biomed, Maternal & Fetal Hlth Res Ctr, Manchester, Lancs, England
[2] Royal Manchester Childrens Hosp, Dept Paediat Histopathol, Manchester M27 1HA, Lancs, England
[3] Cent Manchester Univ Hosp NHS Fdn Trust, St Marys Hosp, Manchester, Lancs, England
来源
PLOS ONE | 2012年 / 7卷 / 04期
基金
美国国家卫生研究院; 英国惠康基金;
关键词
INTRAUTERINE GROWTH RESTRICTION; APOPTOSIS; PREGNANCIES; MANAGEMENT; WOMEN; PREECLAMPSIA; EXPRESSION; TRANSPORT; FETUSES; SYSTEM;
D O I
10.1371/journal.pone.0034851
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Maternal perception of reduced fetal movement (RFM) is associated with increased risk of stillbirth and fetal growth restriction (FGR). DFM is thought to represent fetal compensation to conserve energy due to insufficient oxygen and nutrient transfer resulting from placental insufficiency. To date there have been no studies of placental structure in cases of DFM. Objective: To determine whether maternal perception of reduced fetal movements (RFM) is associated with abnormalities in placental structure and function. Design: Placentas were collected from women with RFM after 28 weeks gestation if delivery occurred within 1 week. Women with normal movements served as a control group. Placentas were weighed and photographs taken. Microscopic structure was evaluated by immunohistochemical staining and image analysis. System A amino acid transporter activity was measured as a marker of placental function. Placentas from all pregnancies with RFM (irrespective of outcome) had greater area with signs of infarction (3.5% vs. 0.6%; p<0.01), a higher density of syncytial knots (p<0.001) and greater proliferation index (p<0.01). Villous vascularity (p<0.001), trophoblast area (p<0.01) and system A activity (p<0.01) were decreased in placentas from RFM compared to controls irrespective of outcome of pregnancy. Conclusions: This study provides evidence of abnormal placental morphology and function in women with RFM and supports the proposition of a causal association between placental insufficiency and RFM. This suggests that women presenting with RFM require further investigation to identify those with placental insufficiency.
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页数:9
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