The association between isolated oligohydramnios at term and placental pathology in correlation with pregnancy outcomes. (15th January 2020)

• Record Type: Journal Article
• Authors: Miremberg, Hadas; Grinstein, Ehud; Herman, Hadas Ganer; Marelly, Cindy; Barber, Elad; Schreiber, Letizia; Bar, Jacob; Kovo, Michal; Weiner, Eran
• Is Part Of: Placenta. Volume 90(2020)
• Page Start: 37
• Page End: 41
• Publication Date: 2020-01-15
• Subjects: Isolated term oligohydramnios -- Placental pathology -- Placental insufficiency; Placenta -- Periodicals; Reproduction -- Periodicals; Placenta -- Periodicals; Placenta -- Périodiques; Reproduction -- Périodiques; 612.63
• DOI: 10.1016/j.placenta.2019.12.004
• Languages: English
• ISSNs: 0143-4004

Abstract

Abstract: Introduction: Isolated term oligohydramnios (ITO) is an obstetrical complication of which the etiology, management, and clinical importance are controversial. In attempt to deepen our understanding, we aimed to study placental pathology and pregnancy outcomes in pregnancies complicated by ITO. Materials and methods: – Maternal demographics, neonatal outcomes, and placental histopathology reports of all pregnancies complicated by ITO at 37 0/7 to 41 0/7 weeks were reviewed. Excluded were cases complicated by hypertensive disorders, intrauterine fetal growth restriction, placental abruption, and deliveries of undiagnosed small for gestational age neonates. Results were compared between the ITO group and a control group matched for gestational age and mode of delivery. Placental lesions were classified according to the current "Amsterdam" criteria. Composite adverse neonatal outcome was defined as one or more of the following early complications: neonatal intensive care unit admission, sepsis, blood transfusion, phototherapy, respiratory morbidity, cerebral morbidity, necrotizing enterocolitis, or death. Results: The study group included 108 patients with ITO that were compared to matched controls. Placentas from the ITO group were characterized by higher rates of placental weights <10th centile (p < 0.001), abnormal cord insertion (p < 0.001), and maternal vascular malperfusion (MVM) lesions (p < 0.001). Neonates from the ITO group had lower birth weights (p < 0.002), and worse composite adverse neonatal outcome (p = 0.028) compared to controls. Conclusion: – The current study demonstrates higher rates of placental MVM lesions, and worse neonatal outcome in pregnancies complicated by ITO. These novel findings suggest that ITO should be seen as part of the "placental insufficiency" spectrum. Highlights: Pregnancies with isolated oligohydramnios have a higher rate of maternal vascular malperfusion lesions. Worse neonatal outcome is seen in pregnancies with isolated term oligohydramnios. Neonates from pregnancies with isolated term oligohydramnios had lower birthweights.