Shoko Hamada

Prediction of early- and late-onset pregnancy-induced hypertension using placental volume on three-dimensional ultrasound and uterine artery Doppler

To determine whether uterine artery (UtA) Doppler findings and three‐dimensional (3D) ultrasound measurement of placental volume during the first trimester allowed prediction of early‐ and late‐onset pregnancy‐induced hypertension (early PIH and late PIH).

Ultrasonographic findings of placenta lacunae and a lack of a clear zone in cases with placenta previa and normal placenta

To evaluate whether the frequencies of placenta lacunae and lack of a clear zone are higher in cases of placenta previa compared with those without it.

Capable of identifying risk factors for placental abruption

Abstract Objective: To clarify the capability of identifying risk factors for placental abruption (PA) during the antenatal and the peripartum period. Methods: Case-controlled study with matched pairs (1:5) was conducted. In total, 123 women with PA and 615 without PA who delivered singleton babies after 24 weeks of gestation were enrolled. The subjects were subdivided into three groups: women with PA during labor and delivery, PA during the antenatal period and clinically small PA. The clinical risk factors for PA in these groups were analyzed. Results: After performing multivariate logistic regression analyses, the risk factors for PA during labor and delivery were identified to be the presence of anemia before 20 weeks [adjusted odds ratio (aOR) 4.05] and small for gestational age (SGA) fetuses (aOR 5.20), while the risk factors for PA during the antenatal period were identified to be SGA fetuses (aOR 5.39), preterm uterine contractions (aOR 5.96) and preeclampsia (aOR 3.37). The risk factor associated with clinically small PA was the presence of anemia before 20 weeks (aOR 6.41). Conclusions: It was likely that the etiologies differ between cases of PA that occur during the antenatal period and cases that occur after the onset of labor.

Prediction of hemorrhage in placenta previa

Placenta previa poses a high risk for massive hemorrhage, from the antenatal period until after Cesarean section. This condition increases the risk of maternal and neonatal mortality and morbidity. In cases of placenta previa, the prenatal prediction of sudden bleeding during pregnancy and blood loss during Cesarean section, and the assessment of risk for adherence of the placenta using an ultrasound examination, can improve the perinatal outcome. Therefore, ultrasonographic findings associated with the prediction of massive bleeding in cases of placenta previa are reviewed in this article.

Gestational weight loss has adverse effects on placental development

Objective: To clarify whether mothers with gestational weight loss (GWL) were likely to have adverse effects on the placenta. Study design: Subjects who delivered viable singleton infants after 24 weeks of gestation were enrolled. A retrospective analysis to evaluate cases of GWL in association with the findings of the placenta and amniotic membrane after delivery was conducted. After consideration of confounders, a case–control study with matched pairs (1:2) was performed. Results: Of all subjects (5551 cases), 83 cases (1.5%) with GWL were found. Since the pre-pregnancy maternal body mass index (BMI) was significantly higher in cases, 166 controls with a matched BMI were selected. The neonatal birth weights, placental weights and the umbilical cord length in cases were significantly smaller than in controls (p < 0.05). Preterm delivery and small for gestational age (SGA) infants were more frequently observed in cases compared with controls [odds ratio (OR) 6.3; 95% confidence interval (CI) 3.3, 12.1, OR 4.3; 95% CI 1.9, 9.9]. pPROM were observed in 10.8% of the cases and 1.8% of the control (OR 6.6; 95% CI 1.7, 25.1). However, the frequencies of chorioamnionitis and the cervical length at second trimester were not different between the two groups. Conclusion: GWL is associated with SGA, small placenta, short umbilical cord length, preterm delivery and pPROM.

Repeated Measurement of Crown-Rump Length at 9 and 11-13 Weeks' Gestation: Association with Adverse Pregnancy Outcome

Aims: To clarify whether ultrasonographic measurements of crown-rump length (CRL) at 11-13 weeks - based on the number of gestational days determined using the CRL at 9 weeks - can predict fetal prognosis. Methods: A prospective cohort study was conducted to evaluate the association between fetal growth in the first trimester and fetal prognosis. Fetal growth in the first trimester was evaluated measuring CRLs at 11-13 weeks determined using the CRL at 9 weeks. The subjects were divided into short CRL (s-CRL) and normal CRL (n-CRL). The prognoses were compared between the two groups. Results: A total of 126 patients in the s-CRL group and 1,130 patients in the n-CRL group were enrolled. Abortion occurred in 7.1% of s-CRL and 0.9% of n-CRL subjects (p < 0.001). Among the patients with chromosomal abnormalities, the incidence of trisomy 18 was significantly greater in s-CRL (4.8 vs. 0.1%, p < 0.001). Without abortion, placental weight, frequency of small for gestational age (SGA) and birth weight in s-CRL were significantly higher than those in the n-CRL group (12.8 vs. 3.6%, p < 0.001). Conclusions: Measuring CRL at 9 weeks is useful for determining gestational days prior to measuring CRL at 11-13 weeks. After reconfirming the gestational age at 9 weeks, measuring CRL at 11-13 weeks is useful for predicting the incidence of trisomy 18 as well as SGA later in pregnancy.

Distribution of nuchal translucency thickness in Japanese fetuses

To establish reference values for the nuchal translucency (NT) thickness in Japanese fetuses.

Relationship between the umbilical cord coiling index and the umbilical blood flow at 11–13 weeks of gestation

The aim of this study was to clarify the effects of umbilical cord coiling on the umbilical blood flow at 11–13 weeks of gestation.

The volume of the chorion villosum is associated with the location of the umbilical cord in the first trimester

To clarify whether villous placental volumes in cases with low cord insertion (CI) are smaller than those with normal cord insertion.

Localization of the Embryo in the Lower Part of the Gestational Sac at 6–7 Weeks’ Gestation Is Associated with Placenta Previa

Objective: To evaluate whether placenta previa is associated with ultrasonographic findings during the first trimester. Methods: A case-control study with 1:5 (34 and 170 cases with placenta previa and normal placenta) matched pairs was conducted to compare ultrasonographic findings, including the position of the gestational sac (GS), that of the embryo in the GS, and placental cord insertion from 5–11 weeks of gestation. Results: Embryos located in the lower part of the GS at 6–7 weeks of gestation were observed in 83.3 and 17.1% of the cases and the controls, respectively. Placental cord insertion in the lower third of the uterus at 9–11 weeks of gestation was observed in 38.3 and 6.7% of the cases and the controls, respectively. Conclusion: Low embryo localization and low placental cord insertion during the first trimester was associated with placenta previa.