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- W2022037523 abstract "Our objective was to describe differences in placental pathology between singletons and twins with PPROM, and correlate these findings with clinical outcomes. Singleton and dichorionic twin pregnancies complicated by PPROM at <34 weeks from 1/2002 to 6/2006 were identified. Outcomes were obtained through chart review. H&E slides were reviewed and scored for signs of ascending infection: 0=none, 1=mild, 2=moderate/severe. Separate scores were given for maternal chorioamnionitis (CA) (extraplacental membranes, chorionic plate), fetal CA involving chorionic plate vessels, and fetal CA involving the umbilical cord (acute funisitis). In twins, only the placenta of Twin A was used for comparison with singleton placentas. Analysis was done using Spearman rho, Mann-Whitney U, and Fisher's exact test. Placentas from 34 singleton and 38 twin pregnancies were reviewed. Median gestational ages at PROM were 30 weeks and 31 weeks for singletons and twins. Intervals from PROM to delivery were longer in singletons vs. twins (median 4 vs. 0 days;p.001). There was a significant correlation between latency and composite placental score in twins (rho = .50;p = .001) but not singletons (rho = .004;p = 1.0). Overall rates of histologic changes associated with ascending infection were not significantly different in singletons vs. twins (50% vs. 32%;p = .16); funisitis was more common in singletons (24% vs. 3%;p = .01), however. In pregnancies with latency <2 days between PROM and delivery, histologic changes were more common in singletons vs. twins (57% vs. 13%;p=.03). With latency ≥2 days no such difference were seen (48% vs. 60%;p = .53). With short intervals between PROM and delivery, histologic changes seen in most singleton pregnancies were much less common in twins. These changes were common in twins only with increased latency. Our data suggest the etiology of PPROM may be different in singletons and twins. While ascending infection may be a significant factor in the etiology of PPROM in singletons, it may represent a secondary event when present in twins." @default.
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- W2022037523 date "2006-12-01" @default.
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- W2022037523 title "Placental pathology and PPROM: Singleton vs. twins" @default.
- W2022037523 doi "https://doi.org/10.1016/j.ajog.2006.10.125" @default.
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