Rebecca N. Baergen

New York Presbyterian Hospital, New York City, New York, United States

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Publications (12)15.01 Total impact

  • Rebecca N. Baergen
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    ABSTRACT: Problems and abnormalities of the umbilical cord play a significant role in perinatal morbidity and mortality. Because the umbilical cord is the lifeline of the fetus, any disruption of blood flow through the umbilical vessels can lead to severe fetal consequences.
    Surgical Pathology Clinics 03/2013; 6(1):61–85. DOI:10.1016/j.path.2012.11.003
  • Rebecca N. Baergen
    Surgical Pathology Clinics 03/2013; 6(1):ix. DOI:10.1016/j.path.2012.11.008
  • Joanna Sue Yee Chan, Rebecca N. Baergen
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    ABSTRACT: Abstract Umbilical cord complications (CC) such as true knots (TK), velamentous insertion (VEL), entanglement (CE), excessive cord length (ELUC), or excessive coiling (ETUC) can lead to decreased umbilical blood flow and have been associated with adverse fetal outcome and demise (IUFD). Few large series exist correlating CC with specific pathologic findings of the placenta. We present the largest series of CC at this time. 841 third trimester placentas with umbilical cord complications were identified, as well as 858 randomly selected gestational age matched placentas with grossly unremarkable umbilical cords. Lesions associated with circulatory stasis and thrombosis (CST) including villous congestion (VC), umbilical vessel distension (UVD), chorionic plate vessel distension (CPD), umbilical vessel thrombosis (UVT), fetal vascular thrombosis (FVT), and avascular villi (AV) were noted as well as any other pathologic lesions. Data was analyzed by ANOVA and Fisher's exact tests, with p<.05 statistically significant. Umbilical cord complications as a group was associated with a significant increase in placental circulatory stasis lesions. Lesions associated with hypoxia, namely nucleated red blood cells (RBC) and chorangiosis (CHS), were also increased. Finally, the presence of any CC was significantly associated with IUFD. We also found that multiple cord abnormalities are associated with non-reassuring fetal heart rate and chorangiosis, but the presence of a single cord abnormality was not. This indicates that cord complications may lead to intrauterine hypoxia and subsequent adverse fetal outcome, and multiple cord abnormalities may be cumulative in effect. Keywords: Fetal death, fetal hypoxia, placental circulation, placenta, umbilical cord.
    Pediatric and Developmental Pathology 09/2012; 15(6). DOI:10.2350/12-06-1211-OA.1 · 0.86 Impact Factor
  • Katherine F Maloney, Debra Heller, Rebecca N Baergen
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    ABSTRACT: Hypertensive disease (HD) during pregnancy includes chronic hypertension (HTN), gestational hypertension (GH), and preeclampsia/eclampsia (PEC). Differences between types of HD have not been well studied. Clinicopathologic features were compared between the HD groups and controls. HD was associated with lower Apgar scores, intrauterine growth restriction, IUGR, and delivery at an earlier gestational age (GA). IUGR was less common in the GH group, gestational age was lowest in the PEC. As expected, HD is associated with placental lesions of malperfusion, younger GA, and increased incidence of IUGR and controls showed less chronic and more "acute" lesions (ACA, MEC). Finally, comparisons of the HD groups showed differences only in GA and IUGR in the GH group as compared to the HTN and PEC groups. This suggests that GH may be associated with less severe clinical disease while showing similar pathologic features.
    Fetal and pediatric pathology 03/2012; 31(5):319-23. DOI:10.3109/15513815.2012.659391 · 0.40 Impact Factor
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    ABSTRACT: Animal models have demonstrated the critical role of bone marrow-derived VEGFR1(+) hematopoietic progenitor cells (HPCs) and VEGFR2(+) endothelial progenitor cells (EPCs) in metastatic progression. We explored whether these cells could predict relapse and response in breast cancer (BC) patients. One hundred and thirty-two patients with stages 1-4 BC were enrolled on 2 studies. Circulating CD45(+)/CD34(+)/VEGFR1(+) HPCs and CD45(dim)/CD133(+)/VEGFR2(+) EPCs were assessed from peripheral blood mononuclear cells using flow cytometry. Changes in HPCs and EPCs were analyzed in (1) patients without overt disease that relapsed and (2) metastatic patients according to response by RECIST. At study entry, 102 patients were without evidence of disease and 30 patients had metastatic BC. Seven patients without evidence of BC by exam, labs, and imaging developed recurrence while on study. Median HPC/ml (range) increased from 645.8 (23.5-1,914) to 2,899 (1,176-37,336), P = 0.016, followed by an increase in median EPC/ml from 21.3 (4.7-42.5) to 94.7 (28.2-201.3), P = 0.016, prior to clinical relapse. In metastatic patients with progressive disease, median HPC/ml increased from 1,696 (10-16,470) to 5,124 (374-77,605), P = 0.0009, and median EPC/ml increased from 26 (0-560) to 71 (0-615) prior to progression, P = 0.10. In patients with responding disease, median HPC/ml decreased from 6,147 (912-85,070) to 633 (47-18,065), P = 0.05, and EPC/ml decreased from 46 (0-197) to 23 (0-105), P = 0.41, at response. There were no significant changes in these cells over time in patients with stable disease. Circulating bone marrow-derived HPCs and EPCs predict relapse and disease progression in BC patients.
    Breast Cancer Research and Treatment 12/2011; 132(1):235-42. DOI:10.1007/s10549-011-1906-3 · 4.47 Impact Factor
  • Cancer Research 07/2011; 71(8 Supplement):4720-4720. DOI:10.1158/1538-7445.AM2011-4720 · 9.28 Impact Factor
  • Rebecca N. Baergen
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    ABSTRACT: In general, tissue removed or spontaneously passed from the body must be sent for pathologic examination. Placentas are the notable exception in that they are the only specimens for which routine examination is not required. The Joint Commission on the Accreditation of Hospitals states that “normal placentas” from “normal deliveries” are not required to be examined or submitted to pathology. However, a definition of what is normal is not forthcoming. Although there are a number of options for placental selection, this task is frequently left to obstetricians or other health care workers involved in the delivery, and thus selection is seldom based on specific criteria. This is the least desirable of the possible options discussed below.
    12/2010: pages 23-42;
  • Rebecca N. Baergen
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    ABSTRACT: The umbilical vessels insert onto the placental surface, branch, run within the chorionic plate, and then, at the periphery, turn abruptly toward the maternal surface, branching repeatedly to finally become villous capillaries. Blood is returned from the villous capillary loops to the umbilical cord by veins that merge into the umbilical vein. In the overwhelming majority of cotyledons, there is a 1:1 relation between artery and vein at the periphery, and each artery “supplies” a single cotyledon (placentone). It is remarkable that at least the larger arteries always cross over the veins on the placental surface. They can thus be readily identified by macroscopic examination, while histologically it is nearly impossible to make this distinction. It is interesting to note that the circumferential architecture of the placental surface vessels is asymmetrical. This is due to hemodynamic thinning where pressure in the vessels buckle and thin the superficial portions of the vessels, whereas the “fixed” portions resist this pressure. This phenomenon of thinning of the superficial aspect of chorionic vessels is also shared with cord vessels.
    12/2010: pages 401-412;
  • Rebecca N. Baergen
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    ABSTRACT: The allantoic duct arises at about the 16th day postconception, as a rudimentary outpouching of the caudal portion of the yolk sac (see Fig. 5.4 in Chap.  5). Normally, there is complete obliteration of the allantoic duct at 15 weeks’ gestation. A remnant, which connects the umbilicus to the bladder, persists as the median umbilical ligament. Occasionally, the duct persists as a minute connection to the fetal bladder. Allantoic duct remnants may be found in estimated 15% of umbilical cords and for unknown reasons; they are more common in males. In most cases they do not have connections with the fetal bladder.
    12/2010: pages 247-277;
  • Rebecca N. Baergen
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    ABSTRACT: Hydrops fetalis is defined as severe, diffuse edema of the fetus. It has an overall incidence of 0.02–0.07% and is usually divided into immune and nonimmune hydrops. The majority of cases are nonimmune hydrops, the etiology of which is extremely varied. Nonimmune hydrops may be separated into the general categories of congenital anomalies, infections, genetic disorders, hematologic disorders, fetomaternal hemorrhage, trauma, and miscellaneous. Cardiac abnormalities are the most common, comprising approximately 40% of cases of nonimmune hydrops. About 35% of cases can be ascribed to genetic diseases; chromosomal anomalies make up 10–15%, hematologic disorders about 10%, and miscellaneous causes make up the remaining cases (Table 20.1).
    12/2010: pages 379-400;
  • Joanna Chan, Rebecca N. Baergen
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    ABSTRACT: Abnormalities of the umbilical cord are associated with poor perinatal outcome and fetal demise. These abnormalities include excessively long or short cord, over and under-coiled cord, true knots, nuchal and body entanglements, velamentous insertion, meconium staining, and cord rupture. These abnormalities in umbilical cord lead to decreased perfusion of the fetus, which is believed to be the mechanism for the poor outcome. Cord abnormalities may help explain some histologic findings in the placentas of infants with poor perinatal outcome or fetal demise.
    Pathology Case Reviews 02/2010; 15(2):40-44. DOI:10.1097/PCR.0b013e3181dcdf0f
  • Katherine F. Maloney, Rebecca N. Baergen
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    ABSTRACT: Maternal floor infarction, also known as massive diffuse perivillous fibrin deposition, is an uncommon, idiopathic placental disorder with characteristic macroscopic and histologic findings. It is an important cause of adverse outcome in the fetus, including intrauterine growth restriction, premature delivery, fetal death, and neurologic injury. Recognition of this entity is important clinically due to its significant perinatal morbidity and its tendency to recur in subsequent pregnancies.
    Pathology Case Reviews 02/2010; 15(2):58-61. DOI:10.1097/PCR.0b013e3181dce239

Publication Stats

16 Citations
15.01 Total Impact Points

Institutions

  • 2013
    • New York Presbyterian Hospital
      New York City, New York, United States
  • 2010–2012
    • Weill Cornell Medical College
      • • Department of Pathology and Laboratory Medicine
      • • Department of Medicine
      New York, New York, United States