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Location of the placenta or the umbilical cord insertion site in the lowest uterine segment is associated with low maternal blood pressure
Author(s) -
Hasegawa J,
Sekizawa A,
Farina A,
Nakamura M,
Matsuoka R,
Ichizuka K,
Okai T
Publication year - 2011
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2011.03051.x
Subject(s) - medicine , placenta , obstetrics , umbilical cord , blood pressure , eclampsia , pregnancy , cord blood , cord , placenta previa , gynecology , fetus , surgery , anatomy , biology , genetics
Please cite this paper as: Hasegawa J, Sekizawa A, Farina A, Nakamura M, Matsuoka R, Ichizuka K, Okai T. Location of the placenta or the umbilical cord insertion site in the lowest uterine segment is associated with low maternal blood pressure. BJOG 2011;118:1464–1469. Objective  To evaluate whether placental abnormalities and umbilical cord insertion site affect the occurrence of pre‐eclampsia and maternal blood pressure. Design  Case–control study. Setting  Showa University Hospital, Tokyo, Japan. Population  A total of 5722 consecutive women who delivered singleton infants were included in the study. Methods  The associations of placental abnormalities, the location of the placenta, the location of the cord insertion site, and maternal background with the occurrence of pre‐eclampsia and maternal blood pressure at the term of pregnancy were analysed. Main outcome measure  Pre‐eclampsia and maternal blood pressure at the term of pregnancy. Results  Pre‐eclampsia was observed in 236 women (4.1%). Pre‐eclampsia was frequently observed in women with placental form abnormalities (odds ratio 3.0) and infarction of the placenta (odds ratio 5.3). Pre‐eclampsia was observed in 0 and 4.1% of women with and without placenta praevia, respectively ( P  = 0.004), and in 0 and 2.5% of women with and without low cord insertion during the first trimester, respectively ( P  = 0.018). After adjustment for confounding variables, the multivariate regression analyses revealed reductions of 8.4 and 5.0 mmHg in systolic and diastolic blood pressure, respectively, in women with placenta praevia compared with women without placenta praevia, and reductions of 4.3 and 3.1 mmHg in systolic and diastolic blood pressure, respectively, in women with low cord insertion during the first trimester compared with women without low cord insertion. Conclusion  Not only placenta praevia but also low cord insertion are associated with low frequencies of pre‐eclampsia and low maternal blood pressure.

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