Placental Pathology in Patients Using Cocaine: An Observational Study |
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| Affiliation: | 1. Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina;2. Department of Internal Medicine, Section on Hospital Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina;3. Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina;1. AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, Paris, France;2. APHP, Centre de référence Malformations Cardiaques Congénitales Complexes - M3C, Hôpital Necker, Paris, France;3. AP-HP, Hôpital Hôtel-Dieu, Centre d''Epidémiologie Clinique, Paris, France;4. Université Paris Descartes-Sorbonne Paris Cité, Paris, France;5. Service de Médecine Interne, CHU Nantes, France;6. CHU de Reims, Centre de compétence maladies auto-immunes et systémiques rares, Reims, France;7. UPMC, AP-HP, Hôpital Pitié-Salpêtrière, Centre de référence maladies auto-immunes et systémiques rares, Paris, France;8. AP-HM, Hôpital Timone Enfants, Unité de Réanimation Pédiatrique, Marseille, France;9. UPMC, AP-HP, Hôpital Saint Antoine, Paris, France;10. Rhumatologie, Centre de référence maladies auto-immunes et systémiques rares, Strasbourg, France;11. Hôpital Louis Pradel, Lyon, France;12. Unité Fonctionnelle de Cardiologie Pédiatrique et Congénitale, CHU Angers, France;13. UPMC, Hôpital Tenon, Paris, France;14. CHU Fort de France, Martinique, France;15. Centre de référence maladies auto-immunes et systémiques rares, Lille, France;p. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA;q. French Cochrane Centre, Paris, France;r. AP-HP, Gynécologie, Hôpital Necker, Paris, France;s. Cardiopédiatrie, CHU de Nantes, France;1. Department of Pathology, Emory University School of Medicine, Atlanta, GA 30322, USA;2. Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;3. Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;4. Department of Pathology, Veterans Affairs Medical Center, Oklahoma City, OK 73014, USA;5. Department of Pathology, Indiana University School of Medicine, Indianapolis, IN 46202, USA;6. Department of Urology, Emory University School of Medicine, Atlanta, GA 30322, USA;7. Department of Pathology, Veterans Affairs Medical Center, Decatur, GA 30033, USA;8. Winship Cancer Institute of Emory University, Atlanta, GA 30322, USA |
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| Abstract: | Objective: Although retroplacental hemorrhage is a major cause of fetal death, its etiology often remains obscure. In some reports, cocaine use by pregnant women has been associated with retroplacental hemorrhage and clinical abruptio placentae. This study was designed to assess the occurrence of chorionic villus hemorrhage, an entity shown recently to be associated with retroplacental hemorrhage, in the placentas of cocaine users.Methods: Twenty-nine placentas from cocaine users and 15 placentas from drug-free controls, as determined by questionnaire and urine toxicology screen, were examined prospectively, and pathological findings documented. The prevalence of retroplacental hemorrhage, chorionic villus hemorrhage, edema, chorioamnionitis, funisitis, infarction, fetal vessel thrombosis, and intervillus hemorrhage was examined in the two groups.Results: Chorioamnionitis was the most frequent finding in both groups (58% of cocaine users, 66% of controls). Edema of moderate severity or greater was found only in the cocaine-using group (17%). The prevalence of chorionic villus hemorrhage among women using cocaine also was 17%.Conclusion: Cocaine use during pregnancy may be associated with chorionic villus hemorrhage and villus edema, even in the absence of clinical abruptio placentae. The relationship between abnormal placental morphology and adverse perinatal outcomes remains to be determined. |
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