(Press-News.org) In an opinion article publishing September 18 in the Cell Press journal Trends in Molecular Medicine, physician-scientists argue that with most placentas discarded after birth, placental pathology is underutilized clinically, should be a routine part of obstetric and neonatal care, and also deserves more research attention.
“Placentas should not be considered a waste tissue,” says senior author Mana Parast, MD, PhD, professor of pathology at University of California San Diego School of Medicine. “They can teach us a lot about not just what went wrong in a pregnancy, but also inform about subsequent pregnancies for the health of the pregnant person and baby.”
The placenta is critical to the exchange of nutrients and waste products between the developing offspring and the pregnant person. If the placenta becomes diseased, it can impact the parent and offspring, both during pregnancy and later in life. At its most severe, placental pathology can cause stillbirths, and this is the medical scenario in which placentas are most often examined clinically. However, different types of placental pathology are also associated with small birth size and neurological issues in infants, and with hypertension (preeclampsia) and other cardiovascular issues in the parent.
“Placental pathology can potentially identify not just the cause of an adverse outcome in the baby, but also insight into why something happened in the mom, and what that means for their health in the future,” says Parast, perinatal pathologist and director of the perinatal pathology service at UC San Diego Health. “For example, we're learning that a particular lesion in the placenta called decidual arteriopathy is potentially a marker for future cardiovascular disease in women, and other lesions can tell you whether preeclampsia or stillbirth is likely to recur in subsequent pregnancies.”
Examining placentas of preterm babies can also inform their immediate care by helping to detect fungal infections that would otherwise take days to identify.
“Preterm babies that go to the neonatal intensive care unit usually receive antimicrobial antibiotics to prevent bacterial infections that might have taken hold, because premature babies don't have a very good immune system, but they're not given antifungals,” says Parast. “Culturing for fungal infections in blood takes a few days, but if we quickly examine the placentas of preterm babies for signs of fungal infection, we can immediately alert the NICU team to add an anti-fungal to the regimen.”
Despite the wealth of information that they provide, placentas are underutilized clinically. To start to remedy this, the researchers suggest that clinicians begin by incorporating placental pathology into the care for complicated pregnancies.
“There are hospitals in the United States where all placentas are examined by the pathologists, even for uncomplicated pregnancies, and sometimes that evaluation prompts additional examination, but that definitely takes a lot more resources,” says Parast.
Though the implications of some patterns of placental pathology are known, others remain unclear, and very little is known about why these placental issues occur. For these reasons, the researchers say that placental research deserves more research funding and needs to be incorporated into prospective clinical trials.
“Incorporating placental evaluations into ongoing clinical trials will provide even more information about how different placental lesions relate to the patients’ current and future health, and the underlying pathophysiology behind these lesions,” says Parast. “If placental pathology isn't incorporated into these trials, it's kind of like if a cancer trial was conducted without pathology—they would just be driving blind.”
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Trends in Molecular Medicine, Roberts et al., “Incorporating Placental Pathology into Clinical Care and Research” https://cell.com/trends/molecular-medicine/fulltext/S1471-4914(24)00216-8
Trends in Molecular Medicine (@TrendsMolecMed), published by Cell Press, is a monthly review journal that facilitates communication between groups of highly trained professionals who share the common goal of understanding and explaining the molecular basis of disease as it relates to new clinical practice. Visit http://www.cell.com/trends/molecular-medicine. To receive Cell Press media alerts, please contact press@cell.com.
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Drug overdose mortality has risen faster among adolescents than the general population in recent years, largely due to fentanyl, a potent opioid pain medication. A new study published in JAMA sheds light on trends in nonfatal opioid overdoses in youth – an area that was not as well characterized, but key to formulating prevention strategies to save lives.
Researchers from Ann & Robert H. Lurie Children’s Hospital of Chicago and colleagues analyzed data using Emergency Medical Services (EMS) encounters from January 2018 to December 2022. They found that opioid overdoses in youth increased at pandemic onset and remained elevated compared to pre-pandemic levels. The majority ...
About The Study: Prehospital encounters for youth opioid overdoses were increasing prior to the pandemic, increased with the onset, and then stabilized, remaining higher than pre-pandemic levels. Although overall patterns were largely driven by those ages 18 through 24, adolescents ages 12 through 17 were the only subgroup with an increasing number of encounters both before and during the pandemic.
Corresponding Author: To contact the corresponding author, Jamie Lim, MD, email jlim@luriechildrens.org.
To access the embargoed study: Visit our ...
** Caltech is hosting an embargoed media zoom about this result on Monday, September 16 at 10am Pacific/1pm Eastern. You can register here:
https://caltech.zoom.us/webinar/register/WN_gYEV5Tl1S0uZkZG1gDIEnQ#/registration
Astronomers have spotted the biggest pair of black hole jets ever seen, spanning 23 million light-years in total length. That's equivalent to lining up 140 Milky Way galaxies back to back.
"This pair is not just the size of a solar system, or a Milky Way; we are talking about 140 Milky Way diameters in total," says Martijn ...
About The Study: In this study, the overall survival of the face transplants is encouraging. These data suggest that the acceptable long-term survival of face transplants makes them a reconstructive option for extensive facial defects.
Quote from corresponding author Pauliina Homsy, MD, PhD:
“A total of 50 face transplants have been performed since 2005. Activity has been concentrated with only 18 centers in 11 countries giving this treatment. Our study demonstrates an overall 5- and 10-year survival of face transplants ...
About The Study: In this cohort study of 1.5 million patients seeking preventive care, denials of insurance claims for preventive care were disproportionately more common among at-risk patient populations. This administrative burden potentially perpetuates inequitable access to high-value health care.
Corresponding Author: To contact the corresponding author, Alex Hoagland, PhD, email alexander.hoagland@utoronto.ca.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2024.33316)
Editor’s ...
About The Study: The results of this randomized clinical trial showed that transitioning insomnia care for older adults away from long-term sedative use and toward cognitive behavioral therapy for insomnia can be achieved using a mailed, direct-to-patient approach.
Corresponding Author: To contact the corresponding author, David M. Gardner, PharmD, MSc CH&E, email david.gardner@dal.ca.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(10.1001/jamapsychiatry.2024.2731)
Editor’s ...
Risk calculators are used to evaluate disease risk for millions of patients, making their accuracy crucial. But when national models are adapted for local populations, they often deteriorate, losing accuracy and interpretability. Investigators from Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, used advanced machine learning to increase the accuracy of a national cardiovascular risk calculator while preserving its interpretability and original risk associations. Their results showed higher accuracy overall in an electronic health records cohort ...
One of the main targets of Russia’s ongoing attacks on Ukraine is the energy infrastructure. The extent of the destruction is enormous. “One year after the start of the war in February 2022, 76 percent of thermal power plants had been destroyed; now the figure is 95 percent,” says Ukrainian scientist Iryna Doronina. “And all the large hydroelectric power plants have also failed.” The breaching of the Kakhovka dam proved to be particularly devastating. The huge outflow of water – the reservoir ...
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After a spinal cord injury, nearby cells quickly rush to action, forming protective scar tissue around the damaged area to stabilize and protect it. But over time, too much scarring can prevent nerves from regenerating, impeding the healing process and leading to permanent nerve damage, loss of sensation or paralysis.
Now, UC San Francisco researchers have discovered how a rarely studied cell type controls the formation of scar tissue in spinal cord injuries. Activating ...
Scientists have pinpointed thousands of genetic changes in a gene that may increase a person’s risk of developing breast and ovarian cancer, paving the way for better risk assessment and more personalised care.
Researchers from the Wellcome Sanger Institute and their collaborators focused on the ‘cancer protection’ gene RAD51C, finding over 3,000 harmful genetic changes that could potentially disrupt its function and increase ovarian cancer risk six-fold and risk of aggressive subtypes of breast ...
