Clustering of maternal-fetal clinical conditions and outcomes and placental lesions

Am J Obstet Gynecol. 2012 Jun;206(6):493.e1-8. doi: 10.1016/j.ajog.2012.03.025. Epub 2012 Mar 29.


Objective: To identify by an inductive statistical analysis mutually similar and clinically relevant clinicoplacental clusters.

Study design: Twenty-nine maternofetal and 49 placental variables have been retrospectively analyzed in a 3382 case clinicoplacental database using a hierarchical agglomerative Ward dendrogram and multidimensional scaling.

Results: The exploratory cluster analysis identified 9 clinicoplacental (macerated stillbirth, fetal growth restriction, placenta creta, acute fetal distress, uterine hypoxia, severe ascending infection, placental abruption, and mixed etiology [2 clusters]), 5 purely placental (regressive placental changes, excessive extravillous trophoblasts, placental hydrops, fetal thrombotic vasculopathy, stem obliterative endarteritis), and 1 purely clinical (fetal congenital malformations) statistically significant clusters/subclusters. The clusters of such variables like clinical umbilical cord compromise, preuterine and postuterine hypoxia, gross umbilical cord or gross chorionic disk abnormalities did not reveal statistically significant stability.

Conclusion: Although clinical usefulness of several well-established placental lesions has been confirmed, claims about high predictability of others have not.

Publication types

  • Evaluation Study

MeSH terms

  • Cluster Analysis
  • Decision Support Techniques
  • Female
  • Humans
  • Placenta Diseases / diagnosis*
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Outcome
  • Principal Component Analysis
  • Retrospective Studies