Placental blood flow and pregnancy outcomes in women with abnormal placental localization and absence of placental "migration"

Placental blood flow and pregnancy outcomes in women with abnormal placental localization and absence of placental "migration"

We investigated the arcuate artery blood flow in the region of the abnormally localized placenta in women who had undergone insertion of an obstetric pessary and were receiving micronized progesterone. The study included 120 pregnant women with high perinatal risks and abnormal placental localizatio...

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Bibliographic Details
Published in:The journal of maternal-fetal & neonatal medicine Vol. 34; no. 21; pp. 3496 - 3502
Main Authors: Barinov, S. V., Tirskaya, Y. I., Shamina, I. V., Ledovskikh, I. O., Atamanenko, O. J.
Format: Journal Article
Language:English
Published: England Taylor & Francis 02-11-2021
Subjects:
Abnormal placental attachment
abnormal placental location
Administration, Intravaginal
Female
Humans
obstetric pessary
Placenta - diagnostic imaging
Placental Circulation
placental migration
Pregnancy
Pregnancy Outcome
Premature Birth
preterm birth
Progestins
preterm birth
placental migration
abnormal placental location
obstetric pessary
Abnormal placental attachment
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Summary:We investigated the arcuate artery blood flow in the region of the abnormally localized placenta in women who had undergone insertion of an obstetric pessary and were receiving micronized progesterone. The study included 120 pregnant women with high perinatal risks and abnormal placental localization. The patients were randomized to receive the Arabin's pessary and vaginal micronized progesterone (Group A, n = 60) or vaginal micronized progesterone only (Group B, n = 60). Randomization was carried based on the order of hospital admission: odd patient numbers were allocated to Group A and even numbers to Group B. Patients underwent a series of ultrasound scans to evaluate the placental migration and presence of abnormal placental attachment. Depending on the results of the scan, study participants were divided into the following groups: (1) patients without placental migration: A 1 (n = 23) and B 1 (n = 42); and (2) patients with placental migration: A 2 (n = 37) and B 2 (n = 18). Women in subgroups A 1 and B 1 were further divided into the subgroups based on the presence of abnormal placental attachment: A 1 x (n = 5) and B 1 x (n = 12) with abnormal placental attachment; and A 1O (n = 18) and B 1O (n = 30) without the abnormal placental attachment. In patients with abnormal placental attachment, the resistance of blood flow in the arcuate arteries was significantly higher than in those with normal placental attachment. A significant increase in the blood flow resistance occurred between 24 and 28 weeks of gestation. The combined use of the obstetric pessary and vaginal micronized progesterone in women with abnormal placental localization helped maintain the resistivity index at low levels and reduce the rate of abnormal placental attachment by 1.3-fold (OR 0.694 (95% CI: 0.21-2.29)).
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ISSN:1476-7058
1476-4954
DOI:10.1080/14767058.2019.1685973