Comparing placentas from normal and abnormal pregnancies

A problem presented at the UK MMSG Strathclyde 2010.

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Presented by:
Dr Alexander Heazell (Maternal and Fetal Health Research Centre, University of Manchester)
Participants:
SL Cotter, LS Gallimore, D Greenhalgh, AEP Heazell, S Kennedy, V Klika, MV Kritz, PF Nielsen, KF Preedy, IM Pu, A Setchi, JH Siggers, RJ Whittaker

Problem Description

A healthy placenta is essential for a normal outcome of pregnancy. The human placenta is described as a discoid organ approximately 3cm thick. The human placenta consists of a villous tree which is bathed in maternal blood. The villous tree contains fetal vessels, carrying fetal blood into terminal villi where it is brought into close proximity with maternal blood to optimise the transfer of nutrients and oxygen from mother to fetus and waste products in the opposite direction.

We have collected data on placentas from women with normal pregnancies and from pregnancies complicated by reduced fetal movements (RFM). Women with reduced fetal movements are at increased risk of stillbirth and intra-uterine growth restriction, so represent a group with a high possibility of abnormal placental structure. Our preliminary data show that women with RFM have lighter, smaller placentas than women with normal pregnancies.

To enable the comparison of placentas from normal and RFM pregnancies, we are specifically interested in developing measures of:

  1. The circularity of the placenta
  2. The centrality of the umbilical cord insertion
  3. The network of vessels on the fetal surface of the placenta

If this is successful we can then use these formulas to compare other pregnancy complications such as preterm labour and stillbirth.

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Study Group Report

In this report we propose a number of possible measure of placental shape, form, and efficiency, which can be computed from images already obtained. We also consider various models for the early development of placentas and the growth of the villous tree.

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Follow-Up Activities

The following publications have been written as a result of this problem:

A Stochastic Model for Early Placental Development
S Cotter, V Klilka, L Kimpton, S Collins & A Heazell (2014)
Journal of the Royal Society Interface 11 (97), 20140149.

The following follow-up meetings have occured to continue work on aspects of this problem:

2011 Placental Growth Follow-up Meeting
Thursday 26th to Friday 27th May 2011, University of Oxford