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Safety of Ultrasound in Pregnancy

Researchers have identified higher concentrations of microplastics and nanoplastics in the placentae of infants born prematurely compared to those born at term, according to a study presented at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy Meeting.

Microplastics, which are less than 5 mm in size, and nanoplastics, which are too small to be seen with the naked eye, are pervasive in the environment. 

Previous research has shown that exposure to plastics can be harmful to both humans and the environment. 

The new study suggests that these tiny plastic particles may accumulate in the placenta during pregnancy and could potentially play a role in preterm births.

In collaboration with investigators at the University of New Mexico, researchers analyzed 175 placentae—100 from full-term births and 75 from preterm births (less than 37 weeks of pregnancy). Using highly sensitive mass spectrometry, they detected significantly higher levels of microplastics and nanoplastics in the placentae of preterm infants.

“Advanced technology now enables us to accurately measure microplastics in ways we haven’t been able to in the past,” said senior study author Kjersti Aagaard, MD, PhD, MSCI, a maternal-fetal subspecialist and research professor at Boston Children’s Hospital and the HCA Institute. Aagaard also serves as the medical director of the Gulf Coast Division of HCA Healthcare.

One of the study’s key findings was that plastic accumulation was not simply a byproduct of a longer pregnancy. Instead, researchers observed that preterm placentae had greater concentrations of microplastics and nanoplastics despite the shorter gestational period.

“The finding of higher placental concentrations among preterm births was surprising because it was counterintuitive to what you might expect if it was merely a byproduct of the length of time of the pregnancy,” said lead author Enrico R. Barrozo, PhD, an assistant professor in the Department of Obstetrics and Gynecology at Baylor College of Medicine and Texas Children’s Hospital in Houston.

“In other words, a preterm delivery not only accumulated more microplastics and nanoplastics in its placenta relative to term, but did so at an earlier time point in the pregnancy,” added Aagaard. “This hints at the possibility that the accumulation of plastics could be contributing to the risk and occurrence of preterm birth. When combined with other recent research, this study adds to the growing body of evidence, ranging from heart disease to potentially stroke, that demonstrates a real risk of exposure to plastics on human health and disease.”

The findings highlight the need for further research into the potential impact of plastic exposure on pregnancy and fetal development.

SMFM. New study finds high concentrations of plastics in the placentae of infants born prematurely. Eurekalert. January 30, 2025. Accessed January 30, 2025. https://www.eurekalert.org/news-releases/1071500

Researchers have identified higher concentrations of microplastics and nanoplastics in the placentae of infants born prematurely compared to those born at term, a new study finds.

Clinical

Microplastics and nanoplastics found in higher concentrations in preterm placentas

First trimester hemorrhage and anemia: new insights into placenta accreta spectrum risk

A recent study led by researchers at Mount Sinai sheds light on a potential link between first-trimester hemorrhage, anemia, and placenta accreta spectrum (PAS) development. This research aims to refine risk stratification in obstetric care, potentially leading to earlier and more targeted surveillance for high-risk pregnancies.

"The motivation for this study was born out of a parental study that's currently unpublished, ongoing with our main goal of identifying non-traditional risk factors for PAS," said Henri M. Rosenberg, MD, a third-year fellow in maternal-fetal medicine at the Icahn School of Medicine at Mount Sinai in New York. "What the ultimate goal of being able at a preconception visit, or at a first OB, initial OB appointment, is being able to really scrutinize and risk stratify who needs more surveillance in this pregnancy."

The study’s findings revealed a significantly higher association between concurrent first-trimester hemorrhage and anemia with PAS. Rosenberg emphasized that while association does not imply causation, biological mechanisms could help explain the connection. "When we have hemorrhage and when we have anemia at a placental local level, there could be some local hypoxia going on, disruption of the placenta from the decidua. And in those cases, it's possible that at least so pro-inflammatory state, abnormal vascular remodeling of the arterials, and could ultimately lead to an abnormal attachment of the placenta to any prior uterine defect."

One of the most significant findings in the study was the strength of this association. "I don't think we expected to find the degree of association as high as it is, being 16 times higher for the development of PAS or diagnosis of PAS, if you have a concurrent hemorrhage and anemia," Rosenberg noted. "We think of all these traditional risk factors being prior C-sections, with or without prior previa, assisted reproductive technology, myomectomies, anything that can lead to uterine defect. But when we looked at when we compared our risk of association with the concurrent hemorrhage, it was much higher than these traditional risk factors."

Given these findings, Rosenberg reccomended heightened vigilance in obstetric care. "I think given these findings, any patient with a traditional risk factor, or non-traditional risk factors, as we're finding throughout our parent study and this secondary analysis, these patients should probably have earlier screening, possibly at a center that has experience looking and diagnosing placenta accreta spectrum."

Future research aims to further explore non-traditional risk factors and improve early diagnostic techniques. "It's important to continue to identify these non-traditional risk factors, to really risk stratify these patients and get them into earlier ultrasounds in the first trimester, possibly transvaginal if possible," Rosenberg concluded.

A new study links first-trimester hemorrhage and anemia to a higher placenta accreta spectrum risk, emphasizing early screening and non-traditional risk factors.

First trimester hemorrhage and anemia: New insights into placenta accreta spectrum risk

A 27-year-old woman presents with an 18-month history of vulvar irritation. She is otherwise healthy except for episodes of depression. She has tried multiple agents for her condition including topical steroids, Vagisil, antibiotics, and fluconazole. She used oral steroids but developed knee pain. Tacrolimus has not helped. A biopsy revealed lichen simplex chronicus. Immunofluorescent studies were negative.

A 27-year-old woman presents with an 18-month history of vulvar irritation. She has tried multiple agents for her condition including topical steroids, Vagisil, antibiotics, and fluconazole without relief. What's your diagnosis?

Vulvar irritation in a 27-year-old woman

In a recent interview ObGyn.net conducted for 

 on comprehensive care and cancer screenings at well-woman visits, the topic of stethoscopes came up. Ilene S. Gewirtz, MD, the interviewee, mentioned that she still carries a stethoscope and listens to her patients' heart and lungs at well-woman visits. She also said that she believes she's in the minority regarding this practice. We want to know if she's right.

POLL: Many women consider their OB/GYN their primary care provider. But like your primary care counterpart, do you carry a stethoscope?

Do OB/GYNs Carry Stethoscopes?

Saying "obstetrician-gynecologist" is a mouthful for most people, and it's probably the most abbreviated specialty in medicine, both spoken and written. However, there doesn't seem to be a consensus on how to pronounce OB-GYN. First, is it the two-syllable "O-B" or the monosyllabic "Ob"? Second, is it "gin" or "gyne" (like "Lyme")? I wonder if you have a preference. I know I do.

Almost nobody says "obstetrician-gynecologist" when speaking about these specialist physicians. But what's the "correct" way to pronounce OB/GYN?

Is It Ob-Gin or Ob-Gyne?

These are 3D ultrasound images of a 14-week fetus. What is your diagnosis?

occipital meningocele and umbilical hernia

Deepa Jacob

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