Relationship between placental hemodynamics and placental histological analysis in third trimester.

AIM: To investigate whether vascularization index (VI), flow index (FI), and vascularization flow index (VFI) correlate with the pathological structure of the placenta and whether there were any differences in VI, FI, VFI, and placental pathological structure between the normal and preeclampsia (PE) groups. METHODS: Fifty-five pregnant women (normal group, n = 27; PE group, n = 28) underwent VI, FI, and VFI at four locations in the placenta during the second and third trimesters. Two hematoxylin and eosin (HE)-stained specimens of the postpartum placenta were prepared. We randomly selected two of these locations and used ImageJ, an open-source image package, to quantify intervillous blood vessels (IBV), intervillous spaces (IS), and intervillous blood vessels + intervillous spaces (IBV + IS) per unit placenta and analyzed their correlation with VI, FI, and VFI. RESULTS: There was no positive correlation between VI, FI, VFI, IBV, IS, and IBV + IS. There were no significant differences in VI, FI, and VFI between the normal and PE groups; however, there were significant differences in IBV, IS, and IBV + IS in the PE group compared to those in the normal group. CONCLUSIONS: Placental hemodynamics measured by VI, FI, and VFI were not positively correlated with placental morphology in the third trimester. There were no differences in the VI, FI, and VFI in the third trimester between the normal and PE groups, suggesting that these may reflect placental circulatory insufficiency.

A case of preeclampsia developing massive ascites after delivery.

We experienced a case of preeclampsia in which massive ascites became apparent in the postpartum period. The patient had isolated proteinuria without hypertension before delivery. The infant had fatal growth restriction and neonatal distress. Massive ascites and isolated proteinuria are important symptoms for predicting the aggravation of PE.

Impact of the Induction of Labor on Hemophilia Carriers and Their Newborn Infants.

Hemophilia is a risk for severe hemorrhage in newborns during the perinatal period and excessive postpartum hemorrhage (PPH) in hemophilia carriers. Vacuum extraction or use of forceps should be avoided to prevent neonatal intracranial hemorrhage (ICH). Optimal modes of delivery such as vaginal or cesarean section are open to debate. The safety of the induction of labor is also worthy of investigation. Here we ask if labor induction is a safe delivery mode for pregnant women who are hemophilia carriers and their infants. We looked at 13 deliveries by hemophilia carriers at our hospital from 2005 to 2018. Two of the five male neonates complicated by hemophilia suffered ICH complications (40%). Both were delivered by induced labor. No deliveries by carriers had PPH which required treatment. Our data indicate that the induction of labor may provoke ICH in infants with hemophilia. We suggest that induction of labor is not a preferable delivery method for hemophilia carriers to avoid neonatal ICH.