Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Sarosh Rana, The University of Chicago, USA
- Second opponent: Associate Professor Elham Baghestan, University of Bergen,
- Third member and chair of the evaluation committee: Professor II Marius Trøseid, University of Oslo
Chair of the Defence
Professor II Rune Svenningsen, University of Oslo
Principal Supervisor
Associate Professor Meryam Sugulle, University of Oslo
Summary
Late- and post-term pregnancies have an increased risk of stillbirth and maternal and fetal morbidity. Placental dysfunction due to progressing placental aging may be a contributing factor. Placental dysfunction is an important factor in the development of placental syndromes such as preeclampsia and fetal growth restriction. In these pregnancies, the maternal circulating “proangiogenic” placental growth factor (PlGF) and “antiangiogenic” soluble fms-like tyrosine kinase-1 (sFlt-1) have been shown to represent useful markers in the prediction of these syndromes.
Reference ranges for PlGF and sFlt-1 in late- and post-term pregnancies and a histo-morphological description of the placenta from healthy late-term pregnancies were lacking at the start of this thesis work. The main aim was therefore to describe the “normal pattern” of PlGF and sFlt-1 as well as the placental histo-morphological characteristics in late- and post-term pregnancies. We also aimed to test the usefulness of PlGF and sFlt-1 to identify placental dysfunction prior to labor onset in term and late-term pregnancies.
426 healthy women with uncomplicated pregnancies contributed to the formation of reference ranges for PlGF and sFlt-1, and 87 placentas from these women were investigated to describe the histo-morphological characteristics of the late- and post term placenta.
We demonstrated that the increased stress burden on the placenta at and after term is reflected in an antiangiogenic shift in PlGF and sFlt-1 indicative of placental dysfunction, and that histo-morphological signs of placental dysfunction corresponded with these findings. At term, pregnancies with placental syndromes had a more rapid antiangiogenic shift in PlGF and sFlt-1 prior to labor onset, and a shorter time to labor onset compared to uncomplicated pregnancies. These findings support the concept of PlGF and sFlt-1 being useful in the evaluation of placental capacity and reserve in term and late-term pregnancies.
Additional information
Contact the research support staff.