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Publications from the Placenta Clinic

Utility of head/abdomen circumference ratio in the evaluation of severe early-onset intrauterine growth restriction. Al Riyami et al. (2011) 
Fetuses with severe placental IUGR in the second trimester are more likely to have an asymmetric phenotype. This is in contrast to the current belief that asymmetric IUGR is confined to third trimester IUGR. 

Unfractionated heparin for second trimester placental insufficiency: a pilot randomized trial. Kingdom et al (2011).
Our study design identified women at high risk of adverse maternal-infant outcomes attributable to placental insufficiency. Women with evidence of placental insufficiency were willing to undergo randomization, and self-administration of UFH, without increased maternal anxiety. 

Placental infarction and thrombophilia. Franco et al (2011).
In comparison with maternal thrombophilia tests, this study indicates additional pathological evidence of abnormal placentation assicuates stongly with placental infarction.

Angiogenic response of placental villi to heparin.Sobel et al (2011).
The nonanticoagulant actions of heparin may be relevant to the prevention of severe preeclampsia.

Sonographic findings and clinical outcomes in women with massive subchorionic hematoma detected in the second trimester. Windrim et al (2011).
Large intrauterine hematomas may be acutely detrimental to maternal health in the second trimester. Ultrasound assessment of the placenta is useful to define the perinatal prognosis and may demonstrate gradual resolution.

Sonographic maturation of the placenta at 30 to 34 weeks is not associated with second trimester markers of placental insufficiency in low-risk pregnancies. Walker et al (2010).
Placental maturaion at 30 to 34 weeks' gestation is associated with mild IUGR at delivery in low-risk wmean and with smoking.

Pathologic basis of echogenic cystic lesions in the human placenta: role of ultrasound-guided wire localization. Proctor et al. (2010)
A retrospective study of women with echogenic cystic lesions (ECLS) indicates that ultrasound-guided wire localization could be a promising research tool for large-scale cohort studies needed to define the clinical utility of placental ultrasound findings.

Antithrombotic therapy for improving maternal or infant health outcomes in women considered at risk of placental dysfunction. Dodd et al (2010).
Heparin treatment, antenatal antithrombotic therapy, was associated with a reduction in the risk of pre-eclampsia, eclampsia and infant birth weight less than the 10th centile for gestational age.

Incorporation of femur length leads to underestimation of fetal weight in asymmetric preterm growth restriction. Proctor et al (2010).
In women with assymettric intrauterine growth restriction and abnormal umbilical artery waveforms, biometry methods to determine fetal weight that exclude femur length should be considered.

Heparin therapy for complications of placental dysfunction: a systematic review of the literature. Dodd et al. (2008)
Following a review of available literature, it was concluded that there is insufficient information to recommend the use of antenatal antithrombotic therapy for women at risk of adverse pregnancy outcomes associated with placental dysfunction.

Placental size and the prediction of severe early-onset intrauterine growth restriction in women with low pregnancy-associated plasma protein-A. Proctor et al (2009).
In women with low PAPP-A, a small placental size (small, thick placenta instead of long, flat placenta) can identify women at a high risk of intrauterine growth restriction, extreme pre-term delivery, and stillbirth.

Arterial embolization for primary postpartum hemorrhage.  Kirby et al (2009).
Arterial embolization is a safe and effective intervention treatment for postpartum hemorrhage.

Determinants of adverse perinatal outcome in high-risk women with abnormal uterine artery Doppler images. Toal et al (2008).
High-risk pregnant women with abnormal uterine artery Doppler measurements have an elevated risk of perinatal mortality, extreme pre-term delivery, and intrauterine growth restriction if they also have evidence of abnormal placental morphology (abnormal shape and/or abnormal texture).

Ultrasound detection of placental insufficiency in women with elevated second trimester serum alpha-fetoprotein or human chorionic gonadotropin. Toal et al (2008).
Patients with elevated AFP combined with abnormal uterine artery Doppler or abnormal placental morphology are at increased risk of adverse pregnancy outcome, including perinatal mortality, extreme pre-term birth, small for gestational age (low birthweight) infants, and intrauterine growth restriction (IUGR).

Screening for placental insufficiency in high-risk pregnancies: is earlier better? Costa et al (2008).
In high-risk women, placental function testing is more effective at predicting adverse perinatal outcomes when performed in the second trimester compared with the first trimester.

Usefulness of a placental profile in high-risk pregnancies. Toal et al (2007).
Multiple abnormalities in the placental function test (MSS, uterine artery Doppler, placental morphology) can identify women who are at increased risk of adverse perinatal outcomes.

Ultrasound detection of placental insufficiency in women with 'unexplained' abnormal maternal serum screening results.  Whittle et al (2005).
The combination of MSS results, uterine artery Doppler, and placental morphology assessments can predict a subset of women who are at risk of adverse outcome. Early recognition of these patients can improve maternal and fetal outcome.

The fetal cardiovascular response to antenatal steroids in severe early-onset intrauterine growth restriction.  Simchen et al (2002).
Growth restricted fetuses can respond differently to administration of prenatal steroids.  Doppler testing can identify a subset of fetuses that may be at risk of cardiovascular decompensation following steroid administration.