A Prospective Study of Villous Capillary Lesions in Complicated Pregnancies

Abstract

The vascularity of placental tissue is dependent on various factors of which fetomaternal hypoxia plays a major role. Hypoxia can be of different types and each type influences the vascularity of the villi, especially terminal villi, in its own way. In this study, we attempted to identify villous vascular changes in a group of term placentae from mothers with diseases complicating pregnancy. Chorangiosis was the most frequently identified lesion while chorangioma was found in only 2 cases. There were no cases of chorangiomatosis. A few cases had normal villous vasculature. Maternal diseases have a major role in disrupting the placental vasculogenesis and angiogenesis by creating a hypoxic environment that may affect the fetus adversely. Hence, such conditions need to be identified early in pregnancy and managed appropriately as it is possible to maintain a normal vasculature and prevent neonatal mortality and morbidity if prompt intervention is done.

Villous Capillary Lesions OfPlacentaA Ten-Year Experience With Brief Review Of Literature

“…Placental lesions -abruption placenta, placenta previa, amnion nodosum, villitis (due to rubella,syphilis, Bortenella, CMV infection), umblical cord anomalies, placentomegaly Table 3 shows clinico-pathological profile of CH in various recent studies. [1,3,[6][7][8][9][10][11][12][13] Many feto-maternal factors in the present study correlate with the literature. Rare associations include Tuberculosis, hypothyroidism, oligohydramnios and PROM.…”

“…[2] Normally terminal villus has 2 to 6 capillary vessels even when represented twice in the section. [3,4] CM is characterized by increase in villous capillaries that permeates normal villous structure. CA is a neoplastic proliferation of capillaries and stroma within a villous forming an expansile nodular lesion.…”

“…Any factor that affects angiogenesis of placenta whether maternal or fetal will affect the number of capillaries per villi resulting in VC lesions. [3] In other words, VC lesions are thought to be an adaptive response to injury caused by various associated pre and post-placental risk factors.…”

“…[1] Chorangosis should be differentiated from congestion where the number of capillaries remains normal. [3,8] Risk factors associated with Chorangiosis: There are many maternal, fetal and placental factors associated with chorangiosis that are documented in literature. [1,6,[8][9][10] They are:…”

Histopathological Study of Villous Hypervascularity and Chorangiosis at Different Maternal Hemoglobin Levels

“…Therefore, such conditions need to be recognized early in pregnancy and treated properly as it is possible to maintain a normal circulation and prevent fetal abnormalities if quick intervention is done. 19…”