Assessing and quantifying placental dysfunction in relation to pregnancy outcome in pregnancies complicated by reduced fetal movements.

    Student thesis: Phd

    Abstract

    Currently there is no test to accurately predict stillbirth. It is proposed that better identification of placental disease in utero may aid stillbirth prediction and prevention. Pregnancies complicated by reduced fetal movement (RFM) have increased risk of stillbirth. We hypothesised that RFM is a symptom of placental dysfunction associated with adverse pregnancy outcome (APO) and that this placental abnormality can be detected antenatally and used to identify fetuses at highest-risk of APO. We tested this hypothesis by: 1) comparison of ex vivo placental structure and function between APO RFM pregnancies and their normal outcome RFM counterparts, 2) comparison of in utero estimates of placental size, vascularity, vascular and endocrine functions obtained from placental ultrasound, Doppler waveform analysis and maternal circulating placentally-derived hormone concentrations, to their ex vivo correlates and 3) examination of the predictive potential of placental biomarkers at the time of RFM.Ex vivo placentas from APO RFM pregnancies, compared to normal outcome RFM counterparts, were smaller (diameter, area, weight and volume, p
    Date of Award1 Aug 2015
    Original languageEnglish
    Awarding Institution
    • The University of Manchester
    SupervisorAlexander Heazell (Supervisor), Colin Sibley (Supervisor) & Edward Johnstone (Supervisor)

    Keywords

    • Doppler
    • Reduced fetal movement
    • Fetal growth restriction
    • Stillbirth
    • Placenta
    • Biomarker
    • Adverse pregnancy outcome
    • Ultrasound

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