Many adverse pregnancy outcomes including preeclampsia, spontaneous preterm birth, fetal growth restriction (FGR), abruptio placenta, stillbirth and recurrent abortion appear to have their origin in placental abnormalities/dysfunction. One major problem hindering our ability to decipher the root causes in the placenta is the lack of appropriate controls for comparison of disease with normal pregnancy. To address this limitation, CoLab is working to assemble a registry of "rare" placental samples.
Our first target is preterm placentas <34 weeks of singleton pregnancies. Criteria for preterm control placentas include an age matched placenta delivered preterm for conditions not associated with placental dysfunction. Examples of clinical conditions that may serve as appropriate placental controls include preterm delivery for: maternal trauma, maternal illness, fetal malformations or congenital disorders and maternal cancer. Among these, the placentas of most clear-cut value are likely the rarest placentas, those from normal pregnancies associated with trauma. We are including pregnancies as a result of assisted reproductive techniques.
We are also interested in other rare placentas and your suggestions are appreciated. Although, we have highlighted preeclampsia, this issue is relevant to study of the other placental mediated disorders. Further, rare placental disorders or placental findings with rare maternal diseases or emerging maternal diseases (i.e., Covid 19) require many more cases than any one center can acquire to allow investigators to determine pertinent morphological changes. We plan to establish a request line for unusual placentas for investigators worldwide.
We believe these rare placentas could be important controls for better understanding the physiology of normal and abnormal pregnancies. The ultimate goal would be to create a specialized database that could be queried for future research. For more information, please contact Peggy Armstrong at armstrongmj2@upmc.edu.