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A., Ashoka, Manjunatha Sarthi, Basavraj A. C., and Mahesh T. K. "Placental pathology and its correlation with immediate feto neonatal outcome." International Journal of Contemporary Pediatrics 6, no. 3 (April 30, 2019): 1108. http://dx.doi.org/10.18203/2349-3291.ijcp20191999.
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Background: Placenta plays a major role in growth and development of the fetus as it helps in both exchange of nutrients and removal of waste. Even though it yields a valuable information of prognostic significance for the newborn, majority of the time it will be discarded after the gross examination. Hence the present study was conducted to determine the placental pathology and its correlation with fetal outcome.Methods: The present study was carried out in Davangere for a period of 2 years. The placenta of 100 parturients, more than 28 weeks of gestation were included for the present study. The data was collected after detailed review of the obstetric case records. Placentas were examined soon after delivery. After the gross examination was complete, the placentas were put in a labelled plastic container. The placentas were re-examined macroscopically again by the pathologist. Cut-section examination was done. Then, at least 4 appropriate blocks were taken for each placenta. They were stained with hematoxylin-eosin stain and examined under the microscope. The histopathological examination was conducted as per proforma.Results: One hundred placentae belonging to one hundred babies were studied among which 80% of the maternal cases had anaemia, 68% were term infant, 37% had IUGR. Eccentric insertion of the cord was observed to be the commonest (51). Marginally inserted membranes were seen most frequently (97).Conclusions: In the present study we conclude that placental reserve is large and small alteration do not affect the pregnancy outcome. The placental changes are not specific to a particular condition affecting the pregnancy.
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Dhawle, Manjusha S., Ashwini R. Tangde, Bhagyashree P. Mundhe, Santosh G. Rathod, and Rajan S. Bindu. "Department of Pathology, Government Medical College and Cancer Hospital, Aurangabad, Maharashtra, India." International Journal of Research in Medical Sciences 5, no. 7 (June 24, 2017): 3214. http://dx.doi.org/10.18203/2320-6012.ijrms20173015.
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Background: The intrauterine existence of fetus is dependent on one vital organ 'the placenta’. The placenta reflects the status of maternal hypertension as it is the mirror of maternal and fetal health. The hypertensive disorders complicate 5-10% of all pregnancies and form a dangerous triad with haemorrhage and infection that contributes greatly to maternal morbidity and mortality. The fetus is dependent on placenta for growth and development. Many disorders of pregnancy like hypertension are accompanied by gross and histological changes in placenta. Aim of the study was to study the various morphological lesions of placenta in pregnancy induced hypertension and compare them with normal pregnanciesMethods: Gross and microscopic examination was conducted on 70 placentas. These included 15 normal placentas and 55 placentas from pregnancy induced hypertension.Results: In PIH, on gross the placenta showed areas of infarction, perivillous fibrin deposition and basal decidual haematoma, while microscopically showed increased syncytial knotting, cytotrophoblasitc proliferation, basement membrane thickening, vasculosyncytial membrane deficiency, infarction and fibrinoid necrosis.Conclusions: Maternal disorders affect the placental histology and can be detected by morphological examination of such placentae. The placenta from hypertensive pregnant women show significant morphological changes as compared to control, which may alter the perinatal outcome.
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Sarode, Ashwini, Anil R. Joshi, and Anjali S. Kulkarni. "The Association of Various Placental Lesions with Perinatal Outcome in Preterm Births." International Journal of Research and Review 8, no. 5 (June 2, 2021): 357–64. http://dx.doi.org/10.52403/ijrr.20210545.
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Objective: Present study was designed to identify various lesions in placenta and investigate their impact on neonatal and perinatal outcome and also to determine the frequency of various inflammatory lesions in placenta. Materials and Methods: Placentae of 60 singleton nonanomalous preterm births were examined at Department of pathology at Tertiary care centre. Complete placental examination including both macroscopic and microscopic examination with the help of Haematoxylin and Eosin staining done. Thereafter placental lesions were classified according to Redline criteria for classification of placental pathology. Thereafter placental lesions were correlated with perinatal mortality and neonatal morbidity in early neonatal period. The relevant clinical details were collected from the obstetric clinical records and neonatal clinical records. Result: We found placental vascular processes as most frequent (73.33%) pathological lesion in our study. Most common inflammatory lesion in our study was chorioamnionitis (15%). Also among placentae of stillbirths, placental vascular lesions were predominant finding present in 85.7% of placentae of stillbirths. Other lesions found in placentae of stillbirths were Immune inflammatory lesions, maternal floor infarction and placenta accreta. Out of total placentae with vasculopathy, 19.2% cases developed neonatal sepsis, in chorioamnionitis group 66.6% live births were having sepsis. In present study we observed higher frequency of resuscitation in babies with placentae having chorioamnionitis. Discussion: This study revealed that the placental pathological findings appear to be correlated with perinatal mortality and early neonatal morbidity. So, examination of the preterm placentae gains importance in early determination of morbidity in infants. Placental findings can help neonatologist in routine diagnosis and management. Keywords: Placenta, Placental pathology, Preterm births, Perinatal outcome.
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Nanda J. Patil, Jyoti S. Tele, Rohit S. Kadam, Pawar S. J, and Sujata M. Kumbar. "Placental pathology in intrauterine fetal death." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (December 21, 2020): 2376–80. http://dx.doi.org/10.26452/ijrps.v11ispl4.4480.
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Placenta is the most accessible and readily evaluable specimen which is mirror image of pregnancy. The objective here is to study the histomorphological changes in placenta in cases of intrauterine fetal deaths and to study correlation of placental findings with causes of fetal death which is significant to understand. The present cross sectional study was carried out in Department of Pathology of a tertiary care hospital from June 2015 to May 2017. Study of Placental Pathology in Intrauterine Fetal Death cases comprised of 99 placentas. The present study was undertaken to study the placental pathology in cases of intrauterine fetal death. IUFD was found to be more common in primigravida 50/99 (50.50%) mothers. Placental study gives useful morphological information regarding the abnormality of pregnancy. Gross and microscopic examination of the placenta plays an important role in identifying the underlying causes of fetal death and helps prevent further recurrence by making appropriate interventions during the next pregnancy. Study of placental pathology gives clues to events occurring throughout gestation and can potentially help to answer, questions concerning pregnancy management and risk assessment of future pregnancies. It will help the researchers who are doing the research in the field of placental pathology in the days to come.
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Shanes, Elisheva D., Leena B. Mithal, Sebastian Otero, Hooman A. Azad, Emily S. Miller, and Jeffery A. Goldstein. "Placental Pathology in COVID-19." American Journal of Clinical Pathology 154, no. 1 (May 22, 2020): 23–32. http://dx.doi.org/10.1093/ajcp/aqaa089.
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Abstract Objectives To describe histopathologic findings in the placentas of women with coronavirus disease 2019 (COVID-19) during pregnancy. Methods Pregnant women with COVID-19 delivering between March 18, 2020, and May 5, 2020, were identified. Placentas were examined and compared to historical controls and women with placental evaluation for a history of melanoma. Results Sixteen placentas from patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were examined (15 with live birth in the third trimester, 1 delivered in the second trimester after intrauterine fetal demise). Compared to controls, third trimester placentas were significantly more likely to show at least one feature of maternal vascular malperfusion (MVM), particularly abnormal or injured maternal vessels, and intervillous thrombi. Rates of acute and chronic inflammation were not increased. The placenta from the patient with intrauterine fetal demise showed villous edema and a retroplacental hematoma. Conclusions Relative to controls, COVID-19 placentas show increased prevalence of decidual arteriopathy and other features of MVM, a pattern of placental injury reflecting abnormalities in oxygenation within the intervillous space associated with adverse perinatal outcomes. Only 1 COVID-19 patient was hypertensive despite the association of MVM with hypertensive disorders and preeclampsia. These changes may reflect a systemic inflammatory or hypercoagulable state influencing placental physiology.
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Ojha, Kamala, Suniti Rawal, and Abhimanyu Jha. "Placental Pathology in Severe Pre-eclampsia and Eclampsia." Nepalese Medical Journal 1, no. 1 (June 22, 2018): 32–35. http://dx.doi.org/10.3126/nmj.v1i1.20397.
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Introduction: Hypertensive disorders complicating pregnancy contribute significantly to maternal and perinatal morbidity and mortality. Since placenta is the functional unit between the mother and fetus examination of placenta can give an idea about prenatal experience of fetus. The aim is to observe the morphology and histopathology of placenta in pregnancy with severe preeclampsia / eclampsia between 20-42 weeks of gestation.Materials and Methods: This was a prospective, descriptive study carried out in the Department of Obstetrics and Gynaecology and Department of Pathology at Institute of Medicine, Tribhuwan University Teaching Hospital, TUTH for one year, starting from 15th May 2015 - 14th May 2016. A total 55 placentas, 48 of severe preeclampsia and 7 of eclampsia were collected and placental morphometric parameters, gross and histopathological features were examined.Results: It was found that placental morphometric parameters were significantly reduced. Histopathological study showed significant number of syncytial knots, areas of fibrinoid necrosis, hyalinization and calcification. These placental findings were associated with significantly decreased weight of fetus at birth.Conclusions: Preeclampsia and eclampsia cause significant placental morphometric and histological changes which in turn adversely affects neonatal birth weight.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 32-35
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Ernst, Linda M., and Vinita Parkash. "Placental Pathology in Fetal Bartter Syndrome." Pediatric and Developmental Pathology 5, no. 1 (January 2002): 76–79. http://dx.doi.org/10.1007/s10024-001-0092-4.
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Bartter syndrome, which presents clinically with polyuria, urinary potassium loss, hypokalemia, hypercalciuria, and alkalosis, is an autosomal recessive disorder with mutations in genes encoding the Na-K-2Cl cotransporter, the chloride channel CLC-NKB, and the potassium channel ROMK. Prenatal diagnosis of Bartter syndrome is now possible; however, there are no reports of the placental pathology associated with fetal Bartter syndrome. We present the placental pathologic findings in two siblings with fetal Bartter syndrome. Both pregnancies were complicated by polyhydramnios and preterm delivery. The first pregnancy delivered at 30 weeks, and Bartter syndrome was diagnosed in the perinatal period. The subsequent pregnancy required periodic therapeutic amniocentesis secondary to massive polyhydramnios and delivered at 32 weeks gestation. The suspicion of fetal Bartter syndrome was very high in this second pregnancy, and the infant was confirmed to have Bartter syndrome subsequently. Both placentas were large for gestational age, weighing greater than the 95th percentile. Microscopic examination showed extensive subtrophoblastic basement membrane mineralization (special stains positive for iron and calcium) in the chorionic villi. This striking finding was present in both placentas. Subtrophoblastic mineralization has been described in the literature in placentas of fetuses with abnormalities including anencephaly, trisomy 21, and other congenital abnormalities; however, it has also been described in normal pregnancies. Mechanisms of calcification in the placenta are not well understood, but these striking cases suggest that defects in fetal renal excretion of ions can lead to dystrophic calcification within the placenta, particularly in a subtrophoblastic pattern.
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Bockoven, Crystal, Roland D. Gastfield, Thomas Victor, Palamadai N. Venkatasubramanian, Alice M. Wyrwicz, and Linda M. Ernst. "Correlation of Placental Magnetic Resonance Imaging With Histopathologic Diagnosis: Detection of Aberrations in Structure and Water Diffusivity." Pediatric and Developmental Pathology 23, no. 4 (December 23, 2019): 260–66. http://dx.doi.org/10.1177/1093526619895438.
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Objective Noninvasive methods to identify placental pathologic conditions are being sought in order to recognize these conditions at an earlier stage leading to improved clinical interventions and perinatal outcomes. The objective of this study was to examine fixed tissue slices of placenta by T2- and diffusion-weighted magnetic resonance imaging (MRI) and correlate the images with placental pathologic findings defined by routine gross and histologic examination. Methods Four formalin-fixed placentas with significant placental pathology (maternal vascular malperfusion, chronic villitis of unknown etiology, and massive perivillous fibrin deposition) and 2 histologically normal placentas were evaluated by high-resolution MRI. Representative placental slices were selected (2 cm long and 10 mm wide) and rehydrated. Imaging was performed on a Bruker Avance 14.1 T microimager. Diffusion-weighted images were acquired from 16 slices using slice thickness 0.5 mm and in-plane resolution approximately 100 µm × 100 µm. T2 maps were obtained from the same slices. T2 relaxation time and apparent diffusion coefficient (ADC) were acquired from representative regions of interest and compared between normal and diseased placentas. Results In T2- and diffusion-weighted images, the placental microstructure differed subjectively between diseased and normal placentas. Furthermore, diseased placentas showed statistically significantly longer mean T2 relaxation times and generally higher mean ADC. Conclusion Diffusion- and T2-weighted MRI can potentially be used to detect significant placental pathology by using T2 relaxation time and ADC as markers of altered placental microstructure.
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Ramachandran, Amrutha. "Analysis of placental pathology and fetal outcome." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 4 (March 27, 2018): 1322. http://dx.doi.org/10.18203/2320-1770.ijrcog20180996.
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Background: A careful examination of placenta along with microscopic study may frequently point to the cause of perinatal death. The American College of Pathologists has provided guidelines for the examination of placenta. Aim of this study was to illustrate the gross and histopathological changes in placenta in certain normal and abnormal pregnancies and to analyse the relationship of placental pathology with fetal outcome.Methods: A prospective study of 120 deliveries at a tertiary teaching centre in India. Each placenta was studied macroscopically and sent to the pathology department for histological examination. The study included placentas of normal pregnancies and those with maternal high-risk features. The placenta was fixed in formalin and 6 sections were taken. The paraffin sections were studied for vessel wall thickening, infarction, villitis, chorioangiosis, calcification and intervillous hemorrhage. The primary outcome variables were fetal and neonatal morbidity. Abnormal fetal /neonatal events in each histological group were compared with the normal group using Ψ2 test for homogeneity. For cell frequencies less than 5, Fischer exact test was used.Results: Vessel wall thickening was demonstrated in 54/120 patients (45%). 7 out of 54 (12.96%) fetuses were still born in this group compared to 2/30 (6.67%) with normal histology (p value <0.05). Infarcts were demonstrated in 15/120 (12.5%). The occurrence of abnormal neonatal events in this group was significant p <0.01.Conclusions: Placental histological features of vessel wall thickening, and infarction is associated with abnormal fetal and neonatal outcome. Larger studies are required to establish the inference.
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Levy, RA, E. Avvad, J. Oliveira, and LC Porto. "Placental pathology in antiphospholipid syndrome." Lupus 7, no. 2_suppl (February 1998): 81–85. http://dx.doi.org/10.1177/096120339800700218.
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One of the major targets of antiphospholipid antibodies (aPL) is the placenta, the evolution of which during pregnancy has been well documented. Histopathological findings are related to gestational age, and several physiologic and pathologic alterations that occur during its development. The major findings in placentae from aPL positive patients are thrombosis, acute atherosis, a decreased number of syncytio-vascular membranes, increased number of syncytial knots and obliterative arteriopathy. These findings are not specific to the antiphospholipid syndrome (APS) and sometimes do not correlate with the fetal outcome. Histopathological study of placentae may elucidate mechanisms of action of aPL in fetal loss and other obstetric complications. In addition, it may assist in the investigation of the differential diagnosis between APS and pregnancy-induced hypertension. Immunohistochemical studies of local placental proteins contribute to this differential diagnosis.
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Leal, Caio Ribeiro Vieira, Rayra Amana Macêdo Maciel, and Mário Dias Corrêa Júnior. "SARS-CoV-2 Infection and Placental Pathology." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 43, no. 06 (June 2021): 474–79. http://dx.doi.org/10.1055/s-0041-1730291.
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AbstractPlacental pathophysiology in SARS-CoV-2 infection can help researchers understand more about the infection and its impact on the maternal/neonatal outcomes. This brief review provides an overview about some aspects of the placental pathology in SARS-CoV-2 infection. In total, 11 papers were included. The current literature suggests that there are no specific histopathological characteristics in the placenta related to SARS-CoV-2 infection, but placentas from infected women are more likely to show findings of maternal and/or fetal malperfusion. The most common findings in placentas from infected women were fibrin deposition and intense recruitment of inflammatory infiltrates. The transplacental transmission of this virus is unlikely to occur, probably due to low expression of the receptor for SARS-CoV-2 in placental cell types. Further studies are needed to improve our knowledge about the interaction between the virus and the mother-fetus dyad and the impact on maternal and neonatal/fetal outcomes.
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Khajuria, Ruchi, and Megha Sharma. "Histopathology of placenta in intrauterine growth restriction (IUGR)." International Journal of Research in Medical Sciences 7, no. 3 (February 27, 2019): 889. http://dx.doi.org/10.18203/2320-6012.ijrms20190943.
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Background: Birth of healthy term baby depends on normal placenta. IUGR is a condition associated with placental insufficiency. There is a close relationship between IUGR and placental qualitative changes. The aim of the present study was to evaluate the morphological and histological changes in placentas of IUGR fetuses and in placentas of normal uncomplicated pregnancies and to determine the relationship that exists between morphological change and frequency of IUGR.Methods: In a cross sectional study conducted in the department of Pathology, GMC Jammu, a total of 60 placenta were received, 30 placenta of IUGR fetus (group 1-case) and 30 placenta of uncomplicated pregnancy with normal single fetus (group 2-control). Exclusion criteria: Twin pregnancy, gestational hypertension, diabetes, congenital anomaly, antepartum hemorrhage and systemic disorder.Results: Placental weights in IUGR group were significantly lower than control group. Average placental weight in IUGR group was 425 gms while in the control group (normal placenta) it was 550 gms. Infarction, intervillous thrombosis, chorionic villitis, hemorrhagic endovasculitis, placental intravascular thrombi, perivillous fibrin deposition, fibrinoid necrosis and villous edema were found to be more common in IUGR group (Group 1-case group) than Normal (Group 2- control group).Conclusions: This study highlightened that significant pathological differences were found between the placentas of IUGR fetus and normal fetus. The gross and microscopic measurement of a placenta is a good way to get proper information about IUGR and helps in management of the pregnancy.
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Hansen, Anne R., Margaret H. Collins, David Genest, Debra Heller, Susan Schwarz, Petra Banagon, Elizabeth N. Allred, and Alan Leviton. "Very Low Birthweight Infant's Placenta and Its Relation to Pregnancy and Fetal Characteristics." Pediatric and Developmental Pathology 3, no. 5 (September 2000): 419–30. http://dx.doi.org/10.1007/s100240010043.
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Our objective was to relate pathology of the very low birthweight (VLBW) infant's placenta to pregnancy and fetal characteristics. We correlated the pathologic features of 1146 placentas from infants with birth weights of 500–1500 g who were born between 1/1/91 and 12/ 31/93 to the number of gestations per pregnancy, initiator of preterm delivery, gestational age, birth weight Z score, and duration of rupture of membrane (ROM). Placental correlates of acute inflammation and villous edema were associated with preterm labor (PTL), pre-labor premature rupture of membranes (PROM), lower gestational age, and higher birth weight Z score. In PTL pregnancies delivered within 1 h of membrane rupture, 61% of placentas already had membrane inflammation. Placental correlates of pregnancy-induced hypertension (PIH) were seen more commonly with PIH pregnancies, older gestational age, and lower birth weight Z score. We found a more prominent histopathologic signature for singleton than for multiple gestation placentas. The placental pathologic findings associated with the clinical diagnoses of infection, PIH, and low–birth weight Z scores in our VLBW/preterm population are similar to those in the literature regarding term pregnancies. The presence of multiple histologic findings consistent with inflammation in placentas of PTL pregnancies with duration of ROM lasting < 1 h suggests that some cases of PTL are precipitated by a more long-standing infection than that previously suspected. Morphologic placental features appear to be correlates of the phenomena leading to premature delivery. Examination of the VLBW infant's placenta provides insight into the etiology and management of VLBW/preterm deliveries.
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Benz, Laura D., Peter K. Bode, Simone Brandt, Beate Grass, Cornelia Hagmann, Rabia Liamlahi, Bernhard Frey, Ulrike Held, and Barbara Brotschi. "Placental findings are not associated with neurodevelopmental outcome in neonates with hypoxic-ischemic encephalopathy – an 11-year single-center experience." Journal of Perinatal Medicine 50, no. 3 (October 21, 2021): 343–50. http://dx.doi.org/10.1515/jpm-2020-0583.
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Abstract Objectives Although neonates with moderate to severe hypoxic ischemic encephalopathy (HIE) receive therapeutic hypothermia (TH), 40–50% die or have significant neurological disability. The aim of this study is to analyse the association of placental pathology and neurodevelopmental outcome in cooled neonates with HIE at 18–24 months of age. Methods Retrospective analysis of prospectively collected data on 120 neonates registered in the Swiss National Asphyxia and Cooling Register born between 2007 and 2017. This descriptive study examines the frequency and range of pathologic findings in placentas of neonates with HIE. Placenta pathology was available of 69/120 neonates, whose results are summarized as placental findings. As neonates with HIE staged Sarnat score 1 (21/69) did not routinely undergo follow-up assessments and of six neonates staged Sarnat Score 2/3 no follow-up assessments were available, 42/48 (88%) neonates remain to assess the association between placental findings and outcome. Results Of the 42/48 (88%) neonates with available follow up 29% (12/42) neonates died. Major placenta abnormalities occurred in 48% (20/42). Major placenta abnormality was neither associated with outcome at 18–24 months of age (OR 1.75 [95% CI 0.50–6.36, p=0.381]), nor with death by 2 years of age (OR 1.96 [95% CI 0.53–7.78, p=0.320]). Conclusions In this study cohort there could not be shown an association between the placenta findings and the neurodevelopmental outcome at 18–24 months of age.
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Ma, Lucy X., Daniel Levitan, and Rebecca N. Baergen. "Weights of Fetal Membranes and Umbilical Cords: Correlation With Placental Pathology." Pediatric and Developmental Pathology 23, no. 4 (November 18, 2019): 249–52. http://dx.doi.org/10.1177/1093526619889460.
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Introduction Proper placental gross examination requires weighing the placental disc trimmed of fetal membranes and the umbilical cord. However, untrimmed placental weights are often reported, both in cases submitted for consultation and in publications. Thus, determining the contribution of membranes and cords to untrimmed placental weights would be helpful in estimating the true trimmed weight of placentas. We sought to report the average weights of membranes and cord in term placentas and to correlate these weights with common placental pathologies. Methods A total of 500 consecutive placentas delivered between 36 and 42 weeks gestational age were subjected to a modified grossing protocol, in which the weight of the trimmed and untrimmed placentas, fetal membranes, and umbilical cords were recorded. Acute chorioamnionitis, meconium, maternal vascular malperfusion, and fetal vascular malperfusion were included as pathologic correlates. Clinical data such as the presence of fetal hydrops, intrauterine growth restriction, intrauterine fetal demise, and maternal diabetes were also recorded. Results The mean weights of the trimmed placenta, fetal membranes, and umbilical cords were 442 g (180–805 g), 47.2 g (16–108 g), and 37.9 g (9–126 g), respectively. The fetal membranes and umbilical cord weights contributed a mean of 16% to the total untrimmed placental weight. Meconium was associated with heavier fetal membranes. Fetal vascular malperfusion was associated with longer umbilical cord and thus also with heavier umbilical cords. Maternal vascular malperfusion and intrauterine growth restriction were associated with lighter placentas. Discussion The trimmed placental disc weight may be estimated by subtracting 16% (ie, weight of the fetal membranes and umbilical cord) from the untrimmed placental weight, or alternatively by subtracting the mean weight of the membranes and umbilical cord. It is important to consider the effects of meconium, fetal and maternal vascular malperfusion, and intrauterine growth restriction on membrane and cord weights when estimating the trimmed placental disc weight.
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Malango, A. E. "Pathological Study of Stillbirths Placentas at Muhimbili National Hospital, Tanzania." American Journal of Clinical Pathology 154, Supplement_1 (October 2020): S22—S23. http://dx.doi.org/10.1093/ajcp/aqaa161.041.
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Abstract Introduction/Objective Stillbirth is defined as fetal death that occurs at gestational age of ≥28 weeks. In our setting clinical assessment is the only method used to determine cause of stillbirths, with no reported proportion of unknown clinical diagnosis. Studies showed that unknown cause of stillbirths can be reduced by examination of placenta. Causal identification aids in the mourning process and identifying recurrence risks. The study aimed to describe pathological changes in the placentas of stillbirths which have risk to cause fetal death Methods A descriptive cross-sectional study done for the period of 6 months, it involved examination of 80 placentas of stillbirths born at gestational age of ≥ 28 weeks, placentas were fixed in 10% neutral buffered formalin for 8–12 hours. Grossing and interpretation of placenta pathology was according to Amsterdam Placental Workshop Group Consensus Statement. Results Out of 80 stillbirths, 32(40%) had unknown clinical diagnosis. Majority of stillbirth placentas 71(91%) found with either one or combined pathologies with the risk to cause stillbirth. Maternal vascular malperfusion was the commonest pathology and was significantly associated with preterm stillbirths. Maternal floor infarction, a placenta pathology with risk to cause fetal death and high risk of recurrence was among the pathologies found, was seen in 4(5%) of stillbirth placentas. Conclusion Findings in this study clearly indicated the importance of pathological examination of placenta in determining cause of stillbirth. Placenta examination in stillbirths can identify more pathology related to stillbirths than clinical assessment alone.
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Tambouret, Rosemary, William R. Jeck, and Drucilla J. Roberts. "The Difference Between Unfixed and Postfixation Placental Weight." American Journal of Clinical Pathology 152, no. 2 (May 22, 2019): 217–20. http://dx.doi.org/10.1093/ajcp/aqz033.
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ABSTRACT Objectives Reference values for placental weights correlated with gestational age are used in surgical pathology. Most reference values were established for fresh placentas. Some laboratories routinely fix all placentas, bringing into question the accuracy of the reference weight values. We wanted to determine the impact of fixation on placental weight. Methods One hundred placentas from uncomplicated pregnancies were weighed in the fresh state, after removal of the cord and membranes. After fixation in formalin for 1 day and 5 days, the placentas were reweighed. The change in weight for each placenta was analyzed by a two-tailed paired t test. Results Statistically, a small but significant gain in weight occurred after 24 hours (3.7%, P << .001), and there was no significant change identified in the additional 4 days (P = .51). Nine placentas lost weight with fixation; the weight of four was unchanged. Conclusions We consider formalin fixation to add a statistically significant but clinically negligible amount of weight to the placenta.
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Sosnina, Aleksandra K., Tatyana G. Tral, and Julia S. Krylova. "Functional morphology of the placental villous tree at term singleton pregnancies, achieved by methods of assisted reproductive technology." Journal of obstetrics and women's diseases 65, no. 3 (June 15, 2016): 43–51. http://dx.doi.org/10.17816/jowd65343-51.
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Introduction. Of special interest in the use of assisted reproductive technology techniques (ART) is the placenta as the main authority responsible for the formation and growth of the fetus. Purpose and objectives. The aim of our research is to study the morpho-functional state of placenta after pregnancy achieved by means of ART. Research objectives: histological and immunohistochemical study using the CD34, NOS-3 and HIF in these placentas. Methods. Total 98 placentas from full-term singleton pregnancies with gestational age were examined. Two study groups were formed: a basic group - the placenta from pregnancy induced methods of ART (n = 60) was divided into I subgroup, which included 30 placentas from women with primary infertility and II subgroup - 30 placentas from women with secondary infertility comparison group consisted of the placenta from the naturally ensuing pregnancy (12 placentas from primigravidae and 26 placentas from multiparous patients). Results. Histological examination of the morphological structure of the placenta was found that the incidence of chronic placental insufficiency was 1.4 times higher than in the subgroup with secondary infertility. Immunohistochemical study of placentas in the basic group, there was a significant decrease in the expression of cell adhesion marker (CD34) in the vascular epithelium chorionic villi, decreased expression of vascular tone marker (NOS-3) and increase the expression of hypoxia-inducible factor (HIF-1α) in the basic group compared to placenta s from children born naturally. Changes in the expression of the studied markers are most pronounced in the placentas from children born with secondary infertility, which is likely due to the high incidence of inflammatory diseases of the pelvic organs in this subgroup. Conclusions. Endometrial pathology in primary and secondary infertility, can cause the formation of functional disorders and morphological structure of placental complex and occurrence in the future placental insufficiency.
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Seryogina, Darya S., Alexandra K. Sosnina, Tatyana G. Tral, Gulrukhsor Kh Tolibova, and Elena V. Mozgovaya. "Morphological features of the placenta in obese women." Journal of obstetrics and women's diseases 69, no. 6 (January 25, 2021): 91–98. http://dx.doi.org/10.17816/jowd69691-98.
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Hypothesis/Aims of study. Obesity and severe chronic somatic pathology in a woman leads to a rapid depletion of compensatory and adaptive reserves of the placenta and to the progression of circulatory and dystrophic changes, which causes intrauterine growth retardation and reduces the likelihood of a favorable course of pregnancy and childbirth. The aim of this study was to assess the morphological features of the vascular component of placental villi in obese women.
Study design, materials and methods. Histological and immunohistochemical studies were conducted on 41 placentas from obese patients with and without gestational diabetes mellitus and from healthy patients, endothelial marker CD34+ expression being assessed in chorionic villi.
Results. In obese patients, chronic placental insufficiency is presented in most cases as a dissociated form with persistence of not only mature but also immature villi, which indicates early structural pathology of the placenta.
Conclusion. Obesity in women contributes to more frequent chronic placental insufficiency with severe circulatory disorders and varying degrees of severity of compensatory and adaptive changes.
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Roberts, Drucilla J. "Placental Pathology, a Survival Guide." Archives of Pathology & Laboratory Medicine 132, no. 4 (April 1, 2008): 641–51. http://dx.doi.org/10.5858/2008-132-641-ppasg.
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Abstract Placental pathology continues to be an underutilized, undertaught, and inadequately handled surgical subspecialty. The requests for placental pathology are soaring, due partly to demands from obstetricians and to the litigious environment in which they practice, and to improved obstetrical care leading to pregnancies in medically challenging situations. Evaluation of the placenta requires a good understanding of the questions and issues concerning both the fetus/infant and the mother. Information from placental pathology can be critical in early neonatal care and in reproductive planning for the family, and it can provide risk assessment for neurologic outcome of the infant. A comfortable interaction among the obstetric staff, mothers, and pathologists often obviates need for legal intervention in unexpected pregnancy outcomes. Some critical pathologic features that involve maternal and fetal management are illustrated herein. A template for gross examination and a few critical histopathologic diagnostic features with clincopathologic correlation are included.
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Shannon, Patrick, Courtney Hum, Tony Parks, GM Schauer, David Chitayat, Karen Chong, Shiri Shinar, Susan Blaser, Gaea Moore, and Tim Van Mieghem. "Brain and Placental Pathology in Fetal COL4A1 Related Disease." Pediatric and Developmental Pathology 24, no. 3 (January 21, 2021): 175–86. http://dx.doi.org/10.1177/1093526620984083.
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Introduction Although fetal brain injury due to COL4A1 gene mutation is well documented, fetal central nervous system (CNS) and placental histopathology lack description. We report CNS and placental pathology in fetal cases with symptomatic COL4A1 mutation. Methods We retrieved four autopsy cases of COL4A1 related disease, confirmed by genetic sequencing after fetal brain injury was detected. Results One case was a midgestation fetus with residua of ventricular zone hemorrhage and normal placental villi. Three cases were 30-32 week gestation fetuses: two demonstrated CNS small vessel thrombosis, with CNS injury. Both demonstrated high grade placental fetal vascular malperfusion (FVM). One additionally showed villous dysmorphism, the other demonstrated mild villous immaturity. The fetus whose placenta demonstrated high grade FVM was growth restricted. A fourth fetus demonstrated schizencephaly with a CNS arteriopathy with smooth muscle cell degeneration and cerebral infarcts; the placenta demonstrated severe villous dysmorphism and low grade FVM. Discussion These cases confirm that small vessel disease is important in producing intracranial pathology in COL4A1mutation. We report an arteriopathy distinct from microvascular thrombosis and demonstrate that placental pathology is common in fetal COL4A1 related disease. This tentatively suggests that placental pathology may contribute to CNS abnormalities by affecting circulatory sufficiency.
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Nikkels, Peter GJ, Annemieke CC Evers, Ewoud Schuit, Hens AA Brouwers, Hein W. Bruinse, Louis Bont, Michiel L. Houben, and Anneke Kwee. "Placenta Pathology From Term Born Neonates With Normal or Adverse Outcome." Pediatric and Developmental Pathology 24, no. 2 (January 20, 2021): 121–30. http://dx.doi.org/10.1177/1093526620980608.
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Background The incidence of umbilical cord or placental parenchyma abnormalities associated with mortality or morbidity of term infants is lacking. Methods Placentas of 55 antepartum stillbirths (APD), 21 intrapartum stillbirths (IPD), 12 neonatal deaths (ND), and 80 admissions to a level 3 neonatal intensive care unit (NS) were studied and compared with 439 placentas from neonates from normal term pregnancies and normal outcome after vaginal delivery (NPVD) and with 105 placentas after an elective caesarian sections (NPEC). Results NPVD and NPEC placentas showed no or one abnormality in 70% and placentas from stillbirth showed two or more abnormalities in 80% of cases. APD placentas more frequently had a low weight and less formation of terminal villi. Hypercoiling was more often present in all study groups. Severe chronic villitis was almost exclusively present in APD placentas. Chorioamnionitis was significantly more frequent in APD, IPD and NS placentas and funisitis was more often observed in IPD and NS placentas. Conclusion Multiple placental abnormalities are significantly more frequent in placentas from term neonates with severe perinatal morbidity and mortality. These placental abnormalities are thought to be associated with disturbed oxygen transfer or with inflammation.
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Kornete, Anna, Natalija Vedmedovska, and Solvita Blazuka. "Correlation between placental pathology and neonatal morbidity: a case-control study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 2 (January 31, 2017): 599. http://dx.doi.org/10.18203/2320-1770.ijrcog20170390.
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Background: Preterm births occur in approximately 12% of pregnancies worldwide and in 5.6% of pregnancies in Latvia, and the incidence has increased. Prematurity poses the major challenge in perinatology and pediatrics, accounting for 75% of perinatal mortalities and 50% of long-term complication. The placenta is a unique organ in explaining the incomprehensible pathogenesis of prematurity.Methods: The retrospective case-control study was conducted to determine placental histological and microbiological findings associated with gestational age and neonatal morbidity.Results: Histological chorioamnionitis was the most prevalent lesion in extremely preterm and very preterm birth groups compared with moderate to late preterm and term birth groups (P=0.027). A higher rate of funisitis was detected among extremely preterm and very preterm birth cases (P=0.001). Microbiological examination of placentas in preterm birth cases most commonly revealed Streptococcus agalactiae, Staphylococcus epidermidis, Staphylococcus haemolyticus. Umbilical cord vessels thrombosis and placental thrombotic vasculopathy were found mostly in moderate to late preterm birth category (P=0.032; P=0.008, respectively). Intrauterine growth restriction was linked to chorionic villous edema (P=0.007) and chorionic villous fibrinoid necrosis (P=0.014). Chorion-decidual hemorrhage and deciduitis were significantly associated with respiratory distress syndrome (P=0.036; P=0.022, respectively). Chorion-decidual hemorrhage was the main predisposing factor for hypoxic-ischemic encephalopathy (P=0.058).Conclusions: Comprehension of the pathogenic mechanisms of prematurity of the placenta and preterm births, and the impact of placental prematurity on neonatal morbidity may lead to improved prenatal diagnostic and enhanced preventive care for both the mother and the child.
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Jung, Eun Jung, Hwa Jin Cho, Ha Young Park, Jung Mi Byun, Dae Hoon Jeong, Kyung Bok Lee, Moon Su Sung, Ki Tae Kim, Hyo Jung An, and Young Nam Kim. "Placental pathology and neonatal outcomes in placenta previa." Placenta 57 (September 2017): 281. http://dx.doi.org/10.1016/j.placenta.2017.07.187.
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Zhyvetska-Denysova, A. A., I. I. Vorobiova, N. Ya Skrypchenko, T. D. Zadorozhna, V. B. Tkachenko, Yu M. Bondarenko, and S. K. Stryzhak. "MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL FEATURES OF PLACENTAL DAMAGE DUE TO THE INCORPORATION OF 137Cs." Проблеми радіаційної медицини та радіобіології = Problems of Radiation Medicine and Radiobiology 27 (2022): 474–94. http://dx.doi.org/10.33145/2304-8336-2022-27-474-494.
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Objective: to investigate the morphological and immunohistochemical features of placental damage due to the incorporation of 137Cs depending on the scenario of pregnancy completion. Materials and methods. The study material consisted of placentas from 60 women with reproductive losses in anamnesis and signs of termination of the current pregnancy (first group) and placental samples from 30 women with an uncomplicated gestation and an unencumbered anamnesis (control group). The detailed study required the distribution of placental samples from the first group into subgroups. Subgroup 1a included 38 placentas from women who gave birth at 37–40 weeks, despite signs of termination of the current pregnancy. Subgroup 1b – placentas of 13 women who gave birth at a gestation period of 28–36 weeks + 6 days. Subgroup 1c – 9 placental samples from women who gave birth at a gestation period of 22–27 weeks + 6 days. The volumetric activity of the 137Cs in the placentas was measured using β-spectrometer. The histology of the placenta was studied using a standard technique. The following expressions were studied in placenta: CD31 / PECAM-1, CD45 / T200 / LCA, CD56 / NCAM-1, CEA / CD66e Ab-2, Vimentin, using indirect streptavidin peroxidase detection method. Results. Placentas accumulate 137Cs. The different volumetric activity of the isotope correlates with scenarios of pregnancy. Due to the action of incorporated 137Cs with a specific mass of more than 1.1 Bq/kg, placental dysfunction develops. The consequences of placental dysfunction depend on the volumetric activity of the 137Cs and the preservation of adaptive and compensatory reactions in the placenta. Morphological and immunohistochemical features of placental damage to incorporated 137Cs were established, depending on the scenario of completion of pregnancy. A marker of unfavorable completion of pregnancy is the expression of a carcinoembryonic antigen (CEA) in the placenta. Conclusions. Premature termination of pregnancy (PTP) is a multifactorial pathology associated with pathological changes in immune and neuroendocrine regulation and hereditary, infectious, and environmental factors that disrupt the adaptation mechanisms in the mother-placenta-fetus system. Intraplacental irradiation of 137Cs is one of the factors in the multifactorial nature of reproductive losses. As a result of intraplacental irradiation of 137Cs, the architecture of the placenta is disturbed, the activity of pro-inflammatory cytokines CD45 and CD56 increases, and the coagulation cascade is activated. Extreme effects depend on the volumetric activity of the isotope incorporated in the placenta and the organ’s compensatory capacity. Accumulation of up to 1.0 Bq/kg 137Cs does not affect the course of gestation. Internal irradiation with an activity of 4.5–10.4 Bq/kg 137Cs triggers late preterm labor. The nature of the damages corresponds to the category of «lesion of the maternal stroma» of the placenta. The volumetric activity of 137Cs over 10.4 Bq/kg is a probable cause of early preterm labor and antenatal fetal death. At the same time, the maternal and fetal structures of the placenta suffer damage. Expression of vimentin is a marker of placental destruction due to internal irradiation of 137Cs with a specific gravity of more than 4.5 Bq/kg. Expression of CEA in the structures of the placenta of women with PTP is a unique find and marker of premature birth and antenatal fetal death with intraplacental irradiation of 137Cs with an activity of more than 4.5 Bq/kg. Key words: pregnancy, placenta, reproductive losses, 137Cs, CD45 / T200 / LCA, CD56 / NCAM-1, CD31 / PECAM-1, Vimentin, CEA / CD66e Ab-2.
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Kedziora, Sarah M., Benedikt Obermayer, Meryam Sugulle, Florian Herse, Kristin Kräker, Nadine Haase, Immaculate M. Langmia, et al. "Placental Transcriptome Profiling in Subtypes of Diabetic Pregnancies Is Strongly Confounded by Fetal Sex." International Journal of Molecular Sciences 23, no. 23 (December 6, 2022): 15388. http://dx.doi.org/10.3390/ijms232315388.
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The placenta is a temporary organ with a unique structure and function to ensure healthy fetal development. Placental dysfunction is involved in pre-eclampsia (PE), fetal growth restriction, preterm birth, and gestational diabetes mellitus (GDM). A diabetic state affects maternal and fetal health and may lead to functional alterations of placental metabolism, inflammation, hypoxia, and weight, amplifying the fetal stress. The placental molecular adaptations to the diabetic environment and the adaptive spatio–temporal consequences to elevated glucose or insulin are largely unknown (2). We aimed to identify gene expression signatures related to the diabetic placental pathology of placentas from women with diabetes mellitus. Human placenta samples (n = 77) consisting of healthy controls, women with either gestational diabetes mellitus (GDM), type 1 or type 2 diabetes, and women with GDM, type 1 or type 2 diabetes and superimposed PE were collected. Interestingly, gene expression differences quantified by total RNA sequencing were mainly driven by fetal sex rather than clinical diagnosis. Association of the principal components with a full set of clinical patient data identified fetal sex as the single main explanatory variable. Accordingly, placentas complicated by type 1 and type 2 diabetes showed only few differentially expressed genes, while possible effects of GDM and diabetic pregnancy complicated by PE were not identifiable in this cohort. We conclude that fetal sex has a prominent effect on the placental transcriptome, dominating and confounding gene expression signatures resulting from diabetes mellitus in settings of well-controlled diabetic disease. Our results support the notion of placenta as a sexual dimorphic organ.
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Charest, Phanie L., Vanessa Vrolyk, Pauline Herst, Maryse Lessard, Deborah M. Sloboda, Mathieu Dalvai, Julius Haruna, Janice L. Bailey, and Marie-Odile Benoit-Biancamano. "Histomorphologic Analysis of the Late-term Rat Fetus and Placenta." Toxicologic Pathology 46, no. 2 (February 2018): 158–68. http://dx.doi.org/10.1177/0192623318755135.
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Histological examination of the rat placenta and fetus is uncommon. Toxicological studies mainly rely on gross examination of the fetus and on fetal and placental weights. These are often insufficient to assess the fetal and placental toxicity of xenobiotics. The small size of the fetus makes its dissection labor-intensive. Thus, our objective was to develop a simple and accurate technique to evaluate the rat fetus and placenta. Sprague-Dawley rat fetuses at gestational day 19.5 ( n = 18) and their placentas ( n = 32) were fixed in formalin. Placentas were cut transversally in the center. Fetuses were cut following a freehand whole-body serial sectioning diagram adapted from Wilson’s method. Sections were stained with hematoxylin–eosin–phloxine–saffron, and histomorphometry was used to measure the area of the fetal placental region (27.2 ± 1.7 mm2), including the labyrinth (22.2 ± 1.0 mm2) and the basal zone (4.8 ± 0.8 mm2). Our whole-fetus serial sectioning technique resulted in 12 precise cutting planes that fit on 3 histological slides, enabling the examination of most organs without labor-intensive dissection. Quantitative analysis of placental areas improves the understanding of the pathogenesis of treatment-related changes. This technique provides a standardized method for future research in pertinent fields such as developmental biology and toxicology.
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Tertyshnyk, D. Yu, О. S. Prokopiuk, V. Yu Prokopiuk, V. V. Lazurenko, I. V. Borzenkova, and O. L. Chernyak. "Morphological Features of Placenta from Pregnant Women with Placental Dysfunction due to Diabetes Mellitus." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 7, no. 1 (March 22, 2022): 79–85. http://dx.doi.org/10.26693/jmbs07.01.079.
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The purpose of the study was to conduct a comparative analysis of morphological examination of the placenta depending on the type of diabetes in pregnant women with placental dysfunction. Materials and methods. To analyze the morphological changes of the placenta in pregnant women with various forms of diabetes, 50 placentas were studied. The age of patients ranged from 22 to 39 years. All placentas were divided into three groups according to the objectives of the study: group I – 20 placentas, after childbirth in women with pre-gestational diabetes; group II – 20 placentas, after childbirth in women with gestational diabetes; group III (control) – 10 placentas, after childbirth in women with physiological course of pregnancy. The presence of placental dysfunction in pregnant women was determined using ultrasound and Doppler examination of the fetoplacental complex, the data of hormonal and immunological studies. After delivery, the placentas were weighed, thickness and diameter were measured, an external evaluation was carried out, attention was paid to the presence of infarctions, the development of connective tissue, the number of cotyledons, and the features of umbilical cord attachment. In histological preparations, the diameter of villi, the number of capillaries, syncytial nodules, the number of capillaries in villi were calculated, focusing on the methods described for assessing the placentas in diabetes mellitus. Results and discussion. Macroscopic examination in the control group showed that 90% of placentas did not have pathological changes, cotyledons were clearly separated, umbilical cord discharge in 7 placentas was central; infarctions and thinning of some cotyledons were visualized in 1 (10%) placenta. Macroscopic examination of the placentas of women with pre-gestational diabetes showed increased weight compared to the control group (748.8±48.5 g versus 643.2±57.0 g, p <0.05) and diameter (25.5±2.3 cm versus 22.8±2.1, p> 0.05) of placentas, which is a characteristic manifestation of diabetic pathology. The average number of cotyledons also differed significantly from the indicators of the control group (12.8±3.2 and 9.3±1.2, respectively, p <0.05). The number of visible infarctions and thinning of individual cotyledons of the placentas did not exceed 20%. Macroscopic examination of the placentas after childbirth in women with gestational diabetes revealed changes similar to group I, but less pronounced: the weight of the placenta was significantly higher compared to the control group (720.2±20.5 and 643.2±57.0, respectively, p <0.05), the number of cotyledons exceeded the control indicators, but this difference was not significant, and the number of infarctions and thickenings did not differ from the control group. Conclusion. Morphological examination of the placentas revealed typical changes for diabetes, which are the result of hypoxia and prolonged dyscirculation: an increase in weight, placenta size, the number of cotyledons at the macroscopic level. Microscopic examination revealed an increase in villi, vessels in villi, thinning of the placental barrier, fibrinoid deposition. The changes were more pronounced in placentas obtained after childbirth in women with pre-gestational diabetes, which is a more severe pathology. Stimulation of childbirth led to minor dyscirculatory disorders in some placentas (vasodilation and plethora)
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Maliar, Volodymyr, Tunzala Ibadova, Vitalii Maliar, and Vasyl Maliar. "MORPHOFUNCTIONAL PECULIARITIES OF THE PLACENTA IN WOMEN WITH UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA SYNDROME." Wiadomości Lekarskie 75, no. 10 (2022): 2467–70. http://dx.doi.org/10.36740/wlek202210128.
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The aim: The impact of undifferentiated connective tissue dysplasia on the formation of the placenta. Materials and methods: The morphostructure of 50 placentas with the undifferentiated connective tissue syndrome and 50 placentas of women with physiological pregnancy and absence of connective tissue pathology was studied. Results: The results of morphological studies have shown that the main pathogenetic link of placental dysfunction with highly resistant blood flow in the umbilical arteries in pregnant women with undifferentiated connective tissue dysplasia syndrome is a disorder of functional differentiation of the villous tree.In these cases the dominats were large and medium-sized villi with narrowed lumen in arterial, venular and capillary vessels and arterial spasm and venous plethora, as well as with numerous chaotically sclerosed villi, indicating stage I and II of placental. There is a large amount of fibrins in intervillous space which narrows it and leads to violation of microcirculation and placenta tissue hypoxia. Conclusions: The morphological basis of high flow resistance in the umbilical artery with the undifferentiated connective tissue dysplasia syndrome in pregnant women is a pathological immaturity of the placental villous tree. Morphological study of the architecture of the stem and intermediate placental villi revealed a violation of the structure of collagen fibers in the form of lack of crosslinks of bundles of collagen fibers.
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Jang, Won-Kyu, Su-Yeon Lee, Sunggyun Park, Nam Hee Ryoo, Ilseon Hwang, Ji Min Park, and Jin-Gon Bae. "Pregnancy Outcome, Antibodies, and Placental Pathology in SARS-CoV-2 Infection during Early Pregnancy." International Journal of Environmental Research and Public Health 18, no. 11 (May 26, 2021): 5709. http://dx.doi.org/10.3390/ijerph18115709.
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There are reports that pregnant women infected with SARS-CoV-2 not only have increased morbidity but also increased complications and evidence of maternal and fetal vascular malperfusion on placental pathology. This was a retrospective study of pregnant women diagnosed with SARS-CoV-2 infection after March 2020. The results of reverse transcription polymerase chain reaction testing and IgM and IgG antibody testing of the amniotic fluid, cord blood, placenta, and maternal blood were confirmed at delivery. Placentas were evaluated histopathologically. The study included seven pregnant women diagnosed with SARS-CoV-2 infection during pregnancy at a mean gestational age of 14.5 weeks. Out of the seven women, five were infected during the first trimester. The mean gestational age at delivery was 38.4 weeks. The reverse transcription polymerase chain reaction results for maternal plasma, cord blood, placenta, and amniotic fluid were negative and IgG antibodies were detected in maternal plasma and cord blood. On placental pathology, maternal vascular malperfusion was found in only one case, fetal vascular malperfusion in four cases, and inflammatory changes were found in two cases. Pregnancy outcomes for women diagnosed with SARS-CoV-2 infection during early pregnancy are positive and it is likely that maternal antibodies are passed to the fetus, which results in a period of immunity.
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Shirishkar, Varun, and Kiran Patole. "Study of Placental Insufficiencies in IUGR Babies in Term Pregnancies." MVP Journal of Medical Sciences 1, no. 2 (July 1, 2014): 80. http://dx.doi.org/10.18311/mvpjms/2014/v1/i2/821.
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<p><strong>Introduction:</strong> In intrauterine growth restricted babies, at term, the placenta might hold the key to the etiology. This present study is aimed at comparison of data of gross and pathological study of placentae from normal weight (control) and IUGR groups and attempted to establish a relationship between placenta pathology and intrauterine growth retardation in term pregnancy.</p><p><strong> Aims and Objectives:</strong> 1. To study placental factors associated with IUGR. 2. To study prevalence of placental factors in details. Material and Methods: A study of 100 patients, with more 37 and less 42 weeks of gestation wasconducted for 2yrs in a tertiary care hospital. A thorough general examination&amp;Systemic examination which included per abdominal examination including uterine height, abdominal girth, symphysio fundal height, estimated fetal weight, abdominal grips, fetal heart auscultation, and per vaginal examination. Routine and specific investigations will be sent for clinical correlation. Placenta obtained after delivery was send for macroscopic and microscopic examination to pathologist. The reports obtained will be used to study placental causes in IUGR and placenta in detail.</p><p><strong>Result:</strong> Average placental weight of term pregnancy is 400 gms and placental coefficient is 0.18. decidual surface area is 254 cm2 and its thickness is 2.72cm. Retroplacental haemorrhage is closely associated with PIH. Microscopic infarction is found with high frequency (p<0.005). Placenta of IUGR fetus, gross pathological changes like severe infarction with or without retroplacental haematoma can obviously be noted but they are not found to be statistically significant. Placental coefficient is increased in cases of anemia. Syncytial knot formation in excess and thickening of basement membrane is well correlated.</p>
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Schwartz, David A. "Stillbirth after COVID-19 in Unvaccinated Mothers Can Result from SARS-CoV-2 Placentitis, Placental Insufficiency, and Hypoxic Ischemic Fetal Demise, Not Direct Fetal Infection: Potential Role of Maternal Vaccination in Pregnancy." Viruses 14, no. 3 (February 23, 2022): 458. http://dx.doi.org/10.3390/v14030458.
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Stillbirth is a recently recognized complication of COVID-19 in pregnant women. Other congenitally transmitted infections from viruses, bacteria and parasites can cause stillbirth by infecting fetal organs following transplacental transmission of the agent from the maternal bloodstream. However, recent research on pregnant women with COVID-19 having stillbirths indicates that there is another mechanism of stillbirth that can occur in placentas infected with SARS-CoV-2. In these cases, viral infection of the placenta results in SARS-CoV-2 placentitis, a combination of concurrent destructive findings that include increased fibrin deposition which typically reaches the level of massive perivillous fibrin deposition, chronic histiocytic intervillositis and trophoblast necrosis. These three pathological lesions, in some cases together with placental hemorrhage, thrombohematomas and villitis, result in severe and diffuse placental parenchymal destruction. This pathology can involve greater than one-half of the placental volume, averaging 77% in the largest study of 68 cases, effectively rendering the placenta incapable of performing its function of oxygenating the fetus. This destructive placental process can lead to stillbirth and neonatal death via malperfusion and placental insufficiency which is independent of fetal infection. Fetal autopsies show no evidence that direct infection of fetal organs is contributory. Because all mothers examined have been unvaccinated, maternal vaccination may prevent viremia and consequent placental infection.
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Thomas, Jeffrey, Yu Sun, and Larisa Debelenko. "Infrequent Placental and Fetal Involvement in SARS-CoV-2 Infection: Pathology Data from a Large Medical Center." Journal of Developmental Biology 9, no. 4 (October 16, 2021): 45. http://dx.doi.org/10.3390/jdb9040045.
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In order to determine the frequency of SARS-CoV-2 placental and fetal involvements, we analyzed placentas of 197 women positive for infection at delivery and fetal tissues in cases of pregnancy loss in women positive by SARS-CoV-2 PCR (N = 2) and COVID-19 serology (N = 4), using in situ hybridization (ISH), immunohistochemistry (IHC) and, in selected cases, RT-PCR of tissue homogenates. The virus was identified in situ, accompanied by intervillositis, in 2 of 197 placentas (1.02%). In three more cases, SARS-CoV-2 was detected by tissue PCR without in situ localization and placental inflammation. There were no maternal mortality or association of placental infection with the clinical severity of COVID-19. All tested neonates born to SARS-CoV-2-positive women (N = 172) were negative for the virus. There were three pregnancy losses among 197 infected women and in two cases available fetal tissues were negative for SARS-CoV-2. In one of four fetal autopsies performed in women with positive COVID-19 serology, the mother-to-child transmission (MTCT) could be inferred based on positive SARS-CoV-2 nucleocapsid IHC in fetal pulmonary endothelium. Placental involvement by SARS-CoV-2 is rare, but may be underestimated due to its transient nature. MTCT is even rarer, supporting the protective role of placenta in SARS-CoV-2 infection.
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Benton, Samantha J., Erika E. Mery, David Grynspan, Laura M. Gaudet, Graeme N. Smith, and Shannon A. Bainbridge. "Placental Pathology as a Tool to Identify Women for Postpartum Cardiovascular Risk Screening following Preeclampsia: A Preliminary Investigation." Journal of Clinical Medicine 11, no. 6 (March 13, 2022): 1576. http://dx.doi.org/10.3390/jcm11061576.
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Preeclampsia (PE) is associated with an increased risk of cardiovascular disease (CVD) in later life. Postpartum cardiovascular risk screening could identify patients who would benefit most from early intervention and lifestyle modification. However, there are no readily available methods to identify these high-risk women. We propose that placental lesions may be useful in this regard. Here, we determine the association between placental lesions and lifetime CVD risk assessed 6 months following PE. Placentas from 85 PE women were evaluated for histopathological lesions. At 6 months postpartum, a lifetime cardiovascular risk score was calculated. Placental lesions were compared between CVD risk groups and the association was assessed using odds ratios. Multivariable logistic regression was used to develop prediction models for CVD risk with placental pathology. Placentas from high-risk women had more severe lesions of maternal vascular malperfusion (MVM) and resulted in a 3-fold increased risk of screening as high-risk for CVD (OR 3.10 (1.20–7.92)) compared to women without these lesions. MVM lesion severity was moderately predictive of high-risk screening (AUC 0.63 (0.51, 0.75); sensitivity 71.8% (54.6, 84.4); specificity 54.7% (41.5, 67.3)). When clinical parameters were added, the model’s predictive performance improved (AUC 0.73 (0.62, 0.84); sensitivity 78.4% (65.4, 87.5); specificity 51.6% (34.8, 68.0)). The results suggest that placenta pathology may provide a unique modality to identify women for cardiovascular screening.
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Voronova, O. V., A. P. Milovanov, and L. M. Mikhaleva. "Integration approach to study placental vessels in preeclampsia." CLINICAL AND EXPERIMENTAL MORPHOLOGY 11, no. 3 (2022): 30–44. http://dx.doi.org/10.31088/cem2022.11.3.30-44.
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Introduction. Preeclampsia is key in obstetric pathology, which is one of the causes of maternal and perinatal morbidity and mortality. It is due to the difficulties of diagnosis, variable clinical picture, severity, and high risk of an unfavorable outcome. This problem requires special attention not only from obstetricians and gynecologists, but also from pathologists who make intravital morphological diagnosis ofplacenta in women with preeclampsia. The purpose of the study was to perform amorphological, morphometric, and immunohistochemical analysis of obliterative angiopathy in the vessels of placental stem villi with preeclampsia of varying severity. Materials and methods.We studied 60 placentas, 40 of which were from women having preeclampsia of varying severity, as well as 20 healthy placentas (the comparison group). For morphometric studies, an automated histological analysis system Leica Application Suite hardware and software module based on a Leica DM4000B microscope was used. The immunohistochemical study was carried out with markers CD34, VEGF-A, and endothelial NOS. Results. We established a directly proportional relationship between the degree of preeclampsia and the severity of arteriole lumen obliteration of the stem villi, and accordingly the degree of placental insufficiency. The most pronounced disorders of fetoplacental circulation were observed in combined severe preeclampsia and extragenital pathology. Conclusion. The data obtained allow us to confirm the significance of obliterative angiopathy in preeclamptic placentas as an integral component. Prevention of ischemic changes in the placenta, where obliterative angiopathy of the villus vessels plays a leading role, is an urgent medical problem that requires an objective approach to predict the condition of the newborn. Keywords: preeclampsia, placenta, obliterative angiopathy, morphometric, immunohistochemical study
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Stanek, Jerzy, and Zarius Drummond. "Occult Placenta Accreta: The Missing Link in the Diagnosis of Abnormal Placentation." Pediatric and Developmental Pathology 10, no. 4 (August 2007): 266–73. http://dx.doi.org/10.2350/06-10-0174.1.
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Placenta creta (accreta, increta, or percreta) is a clinically symptomatic condition, usually diagnosed histologically on hysterectomy specimens. At a minimum, focal absence of decidua is the histological finding for this condition; however, excessive amounts of extravillous trophoblasts were recently documented on hysterectomy specimens. The histological finding of basal plate myometrial fibers (BPMF) without intervening decidua in spontaneously delivered placentas, which we term occult placenta accreta (OPA), is not infrequent, even in clinically asymptomatic cases. To prove that OPA is a missing link between normal placental implantation and clinical placenta accreta, CD146 immunohistochemical stains were performed on 25 sections of OPA (study group) and 25 placental sections without BPMF (control group). Implantation-site intermediate trophoblast (ISIT) cell number, thickness, and density were compared between the study and control groups. The ISIT micrometry thickness and cell number at BPMF sites were statistically significantly higher in OPA than in control group and same OPA placentas away from BPMF. There were no statistically significant differences in ISIT density. Therefore, although asymptomatic, OPA features the same histopathology as clinical placenta accreta and may share same pathogenesis, which may include decidual deficiency, abnormal trophoblast/ decidua interaction, and/or hypoxia.
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Roy, Bithi, Susan Arbuckle, Karen Walker, Catherine Morgan, Claire Galea, Nadia Badawi, and Iona Novak. "The Role of the Placenta in Perinatal Stroke: A Systematic Review." Journal of Child Neurology 35, no. 11 (June 9, 2020): 773–83. http://dx.doi.org/10.1177/0883073820929214.
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Context: Placental pathology may be an important missing link in the causal pathway of perinatal stroke. The study aim was to systematically review the literature regarding the role of the placenta in perinatal stroke. MEDLINE, Embase, Scopus, and Web of Science electronic databases were searched from 2000 to 2019. Studies were selected based on predefined criteria. To enable comparisons, placental abnormalities were coded using Redline’s classification. Results: Ten studies met the inclusion criteria. Less than a quarter of stroke cases had placental pathology reported. Placental abnormalities were more common among children with perinatal stroke than in the control group. The most frequent placental abnormality was Redline’s category 2 (thrombo-inflammatory process). Conclusions: Placental abnormalities appear to be associated with perinatal stroke, supporting additional indirect evidence and biological plausibility of a causative role. However, the results should be interpreted cautiously considering the low frequency of placental examination and lack of uniformity in placental pathology reporting. Clinical Trial Registration: PROSPERO Registration no: CRD42017081256.
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Zalud, Ivica, Jennifer Holzman, and Marguerite Lisa Bartholomew. "Ultrasound of the Placenta." Donald School Journal of Ultrasound in Obstetrics and Gynecology 1, no. 4 (2007): 47–60. http://dx.doi.org/10.5005/jp-journals-10009-1119.
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Abstract This review covers ultrasound evaluation of the normal and abnormal placenta with clinical correlation. Normal placental function is essential for a healthy pregnancy outcome as well as for maternal, fetal, childhood, and adult health. Abnormal placental function may result in a compromised pregnancy, creating pathology for the fetus and mother alike. Despite the fact that placental anatomy, function, and location has far-reaching effects for the parents and the developing offspring, ultrasound examination of the placenta is often considered secondary to the fetus by expectant parents and sonographers as well. Location, size, shape, and architecture are easily ascertained with two-dimensional techniques. Three-dimensional ultrasound and Doppler techniques have opened up the frontier of placental function and have set the stage to make placental evaluation as fascinating as that of the fetus. Learning objectives To assess normal placenta by ultrasound. To discuss abnormal placenta and umbilical cord. To understand placentation in multiple gestation.
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Nuovo, Gerard. "The Utility of Immunohistochemistry and In Situ Hybridization in Placental Pathology." Archives of Pathology & Laboratory Medicine 130, no. 7 (July 1, 2006): 979–83. http://dx.doi.org/10.5858/2006-130-979-tuoiai.
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Abstract It has long been recognized that routine histologic examination of the placenta has limitations, especially with regard to the diagnosis of infectious diseases and the concomitant cytokine response that may cause severe in utero fetal damage. Immunohistochemical testing of the placenta in such situations can be very useful in terms of identifying the infectious agent as well as in demonstrating a marked increase in cytokines such as tumor necrosis factor α and interleukin 8, produced primarily by cells native to the villi and fetal membranes. One hundred placentas (20 normal childbirths, 20 with severe neonatal morbidity of known cause, 25 idiopathic stillbirths where autopsy material was available, 35 with severe idiopathic neonatal morbidity) were examined for a wide variety of infectious diseases and cytokine production. An infectious agent was evident in 19 (76%) of 25 placentas from stillbirths and 28 (80%) of 35 placentas associated with idiopathic severe neonatal morbidity. No infectious agent was noted in the placentas from normal childbirths or cases of known neonatal morbidity. The most common infectious agent was coxsackie virus (51% of infections) followed by bacterial infections (24% of infections). The same infectious agent found in the placenta was found in the corresponding autopsy material from the stillbirths, with the spleen containing the greatest number of infected cells. There was a strong correlation between the number of cells demonstrating cytokine expression (tumor necrosis factor α and interleukin 8) and the presence of an infectious disease in the placenta and stillborn. No histologic feature was associated with an in utero infection. Immunohistochemical testing of placentas gives much insight into their structure and function, including, besides infectious disease detection, the marked diversity of function of trophoblasts, the rarity of committed B cell response, and the strong potential of contractility of villi.
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Siddheshware, Ratnamala, Sunil S. Patil, and Pradip W. Sambarey. "Clinical correlation with pathology of placenta in medical disorders of pregnancy and its comparison in normal pregnancy." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 1 (December 20, 2016): 127. http://dx.doi.org/10.18203/2320-1770.ijrcog20164645.
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Background: Healthy placenta is responsible for maintaining pregnancy and promoting normal foetal development. It reflects the intrauterine status of the foetus.Methods: In the present prospective study, total 50 Placentae from Medical Disorders of Pregnancies were studied and compared with equal number of Placentae from normal Pregnancies.Results: The significant macroscopic changes were calcification and infarction seen in Hypertensive Disorder. Extensive placental infarction was associated with high incidence of low APGAR (82%) and perinatal deaths (66.67%). No significant gross macroscopic changes were seen in Anaemia, Diabetes Mellitus and Heart Disease. Increased syncytial knots, fibrinoid degeneration, vasculo-syncytial membrane paucity were significant microscopic changes in Hypertensive Disorder. In Anaemia stromal fibrosis, increased syncytial knots were seen, whereas in Diabetes Mellitus villous edema was the most significant microscopic finding. No significant microscopic change was found in Heart Disease. Increased syncytial knots, fibrinoid degeneration, vasculo-syncytial membrane paucity, stromal fibrosis were associated with increased perinatal mortality.Conclusions: Gross and microscopic examination of placenta is strongly recommended in cases where maternal co-morbid conditions is likely to have an adverse perinatal outcome.
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Ailamazyan, E. K., I. I. Evsukova, and I. I. Koroleva. "To the question of pathogenesis of perinatal pathology in pregnant women with genital chlamydiosis." Journal of obstetrics and women's diseases 49, no. 1 (February 15, 2000): 9–14. http://dx.doi.org/10.17816/jowd88928.
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The aim of the investigation was the assessment of humoral immunity in neonates and their mothers, who had genital chlamydiosis during pregnancy in correlation with results of immunomorphological and histological investigation of placenta with the significance of these disturbances for the development of perinatal pathology. 48 tern neonates and their mothers, who had genital chlamydiosis during pregnancy composed the main group, 16 healthy neonates and their mothers composed a control group. Decreasing in adaptation and. immunoresistive processes were found in 60,4% neonates from mothers with chlamydiosis. It was shown that the condition of neonates correlates with placental changes. In placentas of sick neonates, the highest level of fixed immune complex with excessive contents of C3b fraction of complement and IgM were seen. Our investigation showed that perinatal pathology in neonates from mothers with chlamydiosis could be a result of intrauterine C. trachomatis infection, and a consequence, of immunity disturbances in the system mother-placenta-fetus.
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Spencer, Michael K., and T. Yee Khong. "Conformity to Guidelines for Pathologic Examination of the Placenta." Archives of Pathology & Laboratory Medicine 127, no. 2 (February 1, 2003): 205–7. http://dx.doi.org/10.5858/2003-127-205-ctgfpe.
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Abstract Context.—The College of American Pathologists developed a consensual guideline for placental examination that included indications for the submission of placentas for pathologic examination. The adherence to this guideline is not known. Objectives.—To identify the number of placentas that were and that should have been examined by a tertiary-care hospital according to the College of American Pathologists' practice guideline and to compare the indications listed by medical staff on their pathology request forms with the clinical events recorded on the hospital's databases. Design.—Data from the hospital computer databases and from pathology request forms were collected for all 987 deliveries occurring at a tertiary-level maternity hospital from April through June 2000. Results.—Fewer than 20% of placentas were examined, but about 50% should have been. Maternal fever and suspected neonatal infection were the indications with the lowest examination rates. Neonatal indications were infrequently listed. Conclusions.—This hospital examined approximately one third of the placentas that should have been examined. When the placentas were examined, the medical staff often failed to appropriately list the indications on their pathology request forms.
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Caspe, Sergio Gaston, Morag Livingstone, David Frew, Kevin Aitchison, Sean Ranjan Wattegedera, Gary Entrican, Javier Palarea-Albaladejo, et al. "The 1B vaccine strain of Chlamydia abortus produces placental pathology indistinguishable from a wild type infection." PLOS ONE 15, no. 11 (November 16, 2020): e0242526. http://dx.doi.org/10.1371/journal.pone.0242526.
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Chlamydia abortus is one of the most commonly diagnosed causes of infectious abortion in small ruminants worldwide. Control of the disease (Enzootic Abortion of Ewes or EAE) is achieved using the commercial live, attenuated C. abortus 1B vaccine strain, which can be distinguished from virulent wild-type (wt) strains by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Published studies applying this typing method and whole-genome sequence analyses to cases of EAE in vaccinated and non-vaccinated animals have provided strong evidence that the 1B strain is not attenuated and can infect the placenta causing disease in some ewes. Therefore, the objective of this study was to characterise the lesions found in the placentas of ewes vaccinated with the 1B strain and to compare these to those resulting from a wt infection. A C. abortus-free flock of multiparous adult ewes was vaccinated twice, over three breeding seasons, each before mating, with the commercial C. abortus 1B vaccine strain (Cevac® Chlamydia, Ceva Animal Health Ltd.). In the second lambing season following vaccination, placentas (n = 117) were collected at parturition and analysed by C. abortus-specific real-time quantitative PCR (qPCR). Two placentas, from a single ewe, which gave birth to live twin lambs, were found to be positive by qPCR and viable organisms were recovered and identified as vaccine type (vt) by PCR-RFLP, with no evidence of any wt strain being present. All cotyledons from the vt-infected placentas were analysed by histopathology and immunohistochemistry and compared to those from wt-infected placentas. Both vt-infected placentas showed lesions typical of those found in a wt infection in terms of their severity, distribution, and associated intensity of antigen labelling. These results conclusively demonstrate that the 1B strain can infect the placenta, producing typical EAE placental lesions that are indistinguishable from those found in wt infected animals.
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Romero, Roberto, Yeon Mee Kim, Percy Pacora, Chong Jai Kim, Neta Benshalom-Tirosh, Sunil Jaiman, Gaurav Bhatti, et al. "The frequency and type of placental histologic lesions in term pregnancies with normal outcome." Journal of Perinatal Medicine 46, no. 6 (August 28, 2018): 613–30. http://dx.doi.org/10.1515/jpm-2018-0055.
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AbstractObjectiveTo determine the frequency and type of histopathologic lesions in placentas delivered by women with a normal pregnancy outcome.MethodsThis retrospective cohort study included placental samples from 944 women with a singleton gestation who delivered at term without obstetrical complications. Placental lesions were classified into the following four categories as defined by the Society for Pediatric Pathology and by our unit: (1) acute placental inflammation, (2) chronic placental inflammation, (3) maternal vascular malperfusion and (4) fetal vascular malperfusion.Results(1) Seventy-eight percent of the placentas had lesions consistent with inflammatory or vascular lesions; (2) acute inflammatory lesions were the most prevalent, observed in 42.3% of the placentas, but only 1.0% of the lesions were severe; (3) acute inflammatory lesions were more common in the placentas of women with labor than in those without labor; (4) chronic inflammatory lesions of the placenta were present in 29.9%; and (5) maternal and fetal vascular lesions of malperfusion were detected in 35.7% and 19.7%, respectively. Two or more lesions with maternal or fetal vascular features consistent with malperfusion (high-burden lesions) were present in 7.4% and 0.7%, respectively.ConclusionMost placentas had lesions consistent with inflammatory or vascular lesions, but severe and/or high-burden lesions were infrequent. Mild placental lesions may be interpreted either as acute changes associated with parturition or as representative of a subclinical pathological process (intra-amniotic infection or sterile intra-amniotic inflammation) that did not affect the clinical course of pregnancy.
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Khong, T. Yee, and Sanne J. Gordijn. "Quality of Placental Pathology Reports." Pediatric and Developmental Pathology 6, no. 1 (January 2003): 54–58. http://dx.doi.org/10.1007/s10024-001-0263-3.
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The surgical report is an important means of documenting normal and abnormal findings, and for distilling such information into a meaningful clinico-pathologic correlation. An audit of the quality of placental reports from four laboratories was performed using an arbitrary numerical scoring scheme that examined the gross, histologic, and commentary components of each report. The mean scores from the four laboratories were not statistically different from each other. Three (2%) and 48 (33%) of the 147 singleton placentas scored less than 50 and 75%, respectively, on this scoring scheme. None and 14 (41%) of the placentas from 34 multiple pregnancies scored less than 50 and 75%, respectively. Different aspects of the gross and histologic examination were reported variably by the laboratories. Commentaries on gross or histologic abnormalities, and in relation to clinical indications, were inconsistently reported. The standards of placental surgical reporting can be improved. The use of templates and checklists for reporting of placentas may be considered.
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Zhou, Yi Yuan, Sanjita Ravishankar, Guangju Luo, and Raymond W. Redline. "Predictors of High Grade and Other Clinically Significant Placental Findings by Indication for Submission in Singleton Placentas From Term Births." Pediatric and Developmental Pathology 23, no. 4 (March 8, 2020): 274–84. http://dx.doi.org/10.1177/1093526620904801.
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Indications for placental submission are variable. Established guidelines are largely based on expert opinion, and there is a need for more evidence-based criteria. A 10-year database of term placentas was used to evaluate indications significantly associated with placental pathology. Lesions in 5 categories were separated into high- and low-grade subgroups. Two additional high-grade lesions were also evaluated. Indications associated with high-grade placental lesions were chronic monitoring abnormalities, severe preeclampsia, pregestational diabetes, maternal signs of infection, postdates pregnancy, artificial reproductive technology, drug abuse, umbilical cord entanglements, selected gross placental abnormalities, stillbirth, Apgar 5 minutes <6, small-for-gestational age infant, and macrosomia. Indications for which placental findings did not differ from the population as a whole were acute monitoring abnormalities, chronic hypertension, maternal obesity, vaginal bleeding, accessory lobe/multilobed placenta, meconium-stained fluid, single umbilical artery, and borderline large-for-gestational age infant. Other indications for submission were intermediate showing significant or borderline elevations in the prevalence of low- and high-grade lesions combined. We suggest on the basis of this study that guidelines for the submission of singleton term placentas could be modified to exclude cases with clinical indications that lack a significant association with placental lesions.
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Stabayeva, L. M., I. Mukhammad, Maida Tussupbekova, Olga Kostyleva, Raihan Nygyzbaeva, G. N. Imanbayeva, Yasminur Turdybekova, et al. "Vascular Malperfusion – As a Morphological Pattern of Preeclampsia." Open Access Macedonian Journal of Medical Sciences 10, B (August 4, 2022): 1973–78. http://dx.doi.org/10.3889/oamjms.2022.9668.
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Introduction. The system « mother-placenta-fetus » is in a complex functional balance, and dysfunction of any of the components can compromise others. The placenta plays an important role in the development of preeclampsia, since preeclampsia can occur in the absence of a fetus, but in the presence of a trophoblast. In this regard, the study of morphological placental patterns in preeclampsia can give an idea of preeclampsia as a pathology in general, as well as its relationship with hypoxic damage to the fetus.
Aim. Identification of morphological patterns of placental lesions associated with preeclampsia.
Materials and methods. A retrospective morphological study of 355 placentas sent for histological examination in the period from 2015 to 2020 was carried out. During the analyzed period, 184 placentas from pregnancies with an established diagnosis of preeclampsia and 171 placentas from pregnancies with a physiological course were studied.
Results. It has been established that preeclampsia is associated with a smaller mass, size and height of the placenta. As morphological patterns associated with preeclampsia, such histological signs of maternal vascular malperfusion, such as infarcts, arterial atherosclerosis, etc., were identified.
Conclusions. The heterogeneity of clinical and histological signs associated with both the physiological and pathological course of pregnancy reflects the different gestational age of the onset of the disease and the stage of development of the adaptive capabilities of the placenta. Identification of morphological patterns associated with hypoxic damage to the fetus allows us to identify a group of newborns with a high risk of chronic hypoxic damage in the perinatal period and to stratify the risk group in the postnatal period in order to reduce infant morbidity and mortality.
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Tiulienieva, Olena, Igor Davydenko, Viallanta Tiulienieva, Olena Marchuk, Tetiana Shelest, and Oleksandr Volkov. "Histological criteria of maturity of the uterine-placental area of manure." Journal of Education, Health and Sport 11, no. 5 (May 28, 2021): 275–80. http://dx.doi.org/10.12775/jehs.2021.11.05.028.
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In order to improve the procedure of morphological diagnosis of the degree of maturity of the uterine-placental area of the placenta, the authors conducted special studies of the structures of the placental bed of the uterus at different stages of gestation during physiological pregnancy and under various pathologies of the mother or placenta. Criteria for maturity of the uterine-placental area of manure in gestational segments 13-27, 28-36 and 37-40 weeks based on the percentage of spiral arteries with complete gestational remodeling of the walls due to the destructive effect of invasive trophoblast and the first parameters of the norm for the number of veins per unit area in the uterine-placental area. To morphologically determine the degree of maturity of the uteroplacental area, a table of the percentage of spiral arteries with complete gestational adjustment and the number of venous vessels per 1 mm2 area of histological section according to gestational age. For morphological diagnosis of the degree of maturity of the placenta at different stages of gestation during physiological pregnancy and under conditions of different pathology of the mother or placenta, it is recommended to conduct a comprehensive morphological assessment of placental structures using maturity criteria of placental chorionic tree and maturity criteria of placental placenta.
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Åmark, Hanna, Magnus Westgren, Meeli Sirotkina, Ingela Hulthén Varli, Martina Persson, and Nikos Papadogiannakis. "Maternal obesity and stillbirth at term; placental pathology—A case control study." PLOS ONE 16, no. 4 (April 30, 2021): e0250983. http://dx.doi.org/10.1371/journal.pone.0250983.
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Objective The aim was to explore the potential role of the placenta for the risk of stillbirth at term in pregnancies of obese women. Methods This was a case-control study comparing placental findings from term stillbirths with placental findings from live born infants. Cases were singleton term stillbirths to normal weight or obese women, identified in the Stockholm stillbirth database, n = 264 and n = 87, respectively. Controls were term singletons born alive to normal weight or obese women, delivered between 2002–2005 and between 2018–2019. Placentas were compared between women with stillborn and live-born infants, using logistic regression analyses. Results A long and hyper coiled cord, cord thrombosis and velamentous cord insertion were stronger risk factors for stillbirth in obese women compared to normal weight women. When these variables were adjusted for in the logistic regression analysis, also adjusted for potential confounders, the odds ratio for stillbirth in obese women decreased from 1.89 (CI 1.24–2.89) to 1.63 (CI 1.04–2.56). Conclusion Approximately one fourth of the effect of obesity on the risk of stillbirth in term pregnancies is explained by umbilical cord associated pathology.
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Tapilskaya, N. I., K. N. Mel’nikov, I. A. Kuznetsova, and R. I. Glushakov. "Placental insufficiency and fetal growth restriction: etiology, prevention, and treatment." Medical alphabet, no. 4 (June 12, 2020): 6–10. http://dx.doi.org/10.33667/2078-5631-2020-4-6-10.
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The review presents modern aspects of the etiology of placental insufficiency (uteroplacental vascular insufficiency), fetal growth restriction and preeclampsia, which arises primarily due to deficient remodeling of the uterine spiral arteries supplying the placenta during early pregnancy. The embryonic, maternal and placental factors of the occurrence of placental insufficiency and placental-related pathology considered. The issues of prevention and treatment of placental insufficiency are considered taking into account the common pathogenesis of this pathological condition.