Placental pathological findings and their association with maternal and fetal clinical outcomes: A cross-sectional study

Background: Placental pathological changes can occur in both normal and high-risk pregnancies, leading to adverse maternal and neonatal outcomes.

Objective: This study aimed to investigate the relationship between placental histopathological findings and maternal and fetal clinical outcomes, as well as to determine if there is an association between maternal comorbidities and placental pathologies. Materials and Methods: In this study, 250 placenta samples were evaluated. The slides and paraffin blocks were retrieved from the archive of the pathology department of Shariati and Yas hospitals, Tehran, Iran. The placental histopathological findings were analyzed in relation to maternal and fetal clinical data.

Results: The average age of pregnant women was 31.84 yr. The average gestational age at birth was 28 wk. The most prevalent pathological finding was maternal vascular malperfusion, observed in 59.6% of cases. The presence of nucleated red blood cells (NRBC) in umbilical cord blood vessels was observed in 16.4% of cases. Fetal vascular malperfusion was significantly associated with intrauterine fetal demise. Maternal inflammatory response was associated with premature rupture of membranes. Maternal vascular malperfusion and the presence of NRBC in umbilical cord blood vessels was significantly associated with pre-eclampsia and preterm labor. Furthermore, a history of maternal malignancy was associated with placental infarction and the presence of NRBC in umbilical cord blood vessels.

Conclusion: The findings of this study underscore the importance of evaluating placental histopathological findings in relation to maternal and fetal clinical outcomes. Therefore, understanding these placental pathological changes will be crucial in predicting and preventing complications in subsequent pregnancies.

 

Keywords: Placenta, Histopathology, Pregnancy complications, Maternal health, Fetal outcome.

[1] Gude NM, Roberts CT, Kalionis B, King RG. Growth and function of the normal human placenta. Thrombosis Research 2004; 114: 397–407.

[2] Lakshmi Devi CK, Raghupathy NS. The histological findings in human placenta at different gestational ages. IOSR J Dental Med Sci 2013; 6: 29–31.

[3] Redline RW. Placental pathology: A systematic approach with clinical correlations. Placenta 2008; 29: 86–91.

[4] Benton SJ, Lafreniere AJ, Grynspan D, Bainbridge SA. A synoptic framework and future directions for placental pathology reporting. Placenta 2019; 77: 46–57.

[5] Khong TY, Mooney EE, Ariel I, Balmus NC, Boyd TK, Brundler M-A, et al. Sampling and definitions of placental lesions: Amsterdam Placental Workshop Group consensus statement. Arch Pathol Lab Med 2016; 140: 698–713.

[6] Lawn JE, Blencowe H, Pattinson R, Cousens S, Kumar R, Ibiebele I, et al. Stillbirths: Where? When? Why? How to make the data count? Lancet 2011; 377: 1448–1463.

[7] Roberts DJ, Baergen RN, Boyd TK, Carreon CK, Duncan VE, Ernst LM, et al. Criteria for placental examination for obstetrical and neonatal providers. Am J Obstet Gynecol 2023; 228: 497–508.

[8] Redline RW, Roberts DJ, Parast MM, Ernst LM, Morgan TK, Greene MF, et al. Placental pathology is necessary to understand common pregnancy complications and achieve an improved taxonomy of obstetrical disease. Am J Obstet Gynecol 2023; 228: 187–202.

[9] Freedman AA, Keenan-Devlin LS, Borders A, Miller GE, Ernst LM. Formulating a meaningful and comprehensive placental phenotypic classification. Pediatr Dev Pathol 2021; 24: 337–350.

[10] Ernst LM. Maternal vascular malperfusion of the placental bed. APMIS 2018; 126: 551–560.

[11] Heider A. Fetal vascular malperfusion. Arch Pathol Lab Med 2017; 141: 1484–1489.

[12] Parast MM, Crum CP, Boyd TK. Placental histologic criteria for umbilical blood flow restriction in unexplained stillbirth. Hum Pathol 2008; 39: 948–953.

[13] Suresh SC, Freedman AA, Hirsch E, Ernst LM. A comprehensive analysis of the association between placental pathology and recurrent preterm birth. Am J Obstet Gynecol 2022; 227: 887.

[14] Loverro MT, Damiani GR, Di Naro E, Schonauer LM, Laforgia N, Loverro M, et al. Analysis of relation between placental lesions and perinatal outcome according to Amsterdam criteria: A comparative study. Acta Biomed 2020; 91: e2020061.

[15] Siddheshware R, Patil SS, Sambarey PW. Clinical correlation with pathology of placenta in medical disorders of pregnancy and its comparison in normal pregnancy. Int J Reprod Contracept Obstet Gynecol 2017; 6: 127–133.

[16] Saragade P, Chaudhari R, Chakravarti A. Study of histopathological findings of placenta in cases of deliveries at Tertiary Health Care Institute. MVP J Med Sci 2017; 4: 165–171.

[17] Altuncu E, Akman I, KOTiloglu E, Basgül A, Yurdakul Z, Demir F, et al. The relationship of placental histology to pregnancy and neonatal characteristics in preterm infants. J Turkish-German Gynecol Assoc 2008; 9: 1–7.

[18] Moscuzza F, Belcari F, Nardini V, Bartoli A, Domenici C, Cuttano A, et al. Correlation between placental histopathology and fetal/neonatal outcome: Chorioamnionitis and funisitis are associated to intraventricular haemorrage and retinopathy of prematurity in preterm newborns. Gynecol Endocrinol 2011; 27: 319–323.

[19] Kumar S, Sudarshan V. The correlation of placental histopathology with neonatal outcome. Tropical J Pathol Microbiol 2018; 4: 336–343.

[20] Azizi M, Rejaei M, Pezeshkpour Z, Alipour MR, Kazemi E, Zare S, et al. Correlation between pathology of placenta and preterm labor: A case-control study. J Biol Todays World 2014; 3: 238–241.

[21] Khong TY, Mooney EE, Nikkels PGJ, Morgan TK, Gordijn SJ. Pathology of the placenta: A practical guide. Switzerland: Springer Cham; 2019.

[22] Langston C, Kaplan C, Macpherson T, Manci E, Peevy K, Clark B, et al. Practice guideline for examination of the placenta: Developed by the placental pathology practice guideline development task force of the college of American pathologists. Arch Pathol Lab Med 1997; 121: 449–476.

留言 (0)

沒有登入
gif