Association of placental chorangiosis with pregnancy complication and prenatal outcome: a case-control study

Abstract

Background Chorangiosis is a vascular change involving the terminal chorionic villi in the placenta. It results from longstanding, low-grade hypoxia in the placental tissue, and is associated with such conditions as intrauterine growth restriction (IUGR), diabetes, and gestational hypertension in pregnancy. Chorangiosis rarely occurs in normal pregnancies. However, its prevalence is 5–7% of all placentas from infants admitted to newborn intensive care units. The present study was aimed at determining the association of chorangiosis with pregnancy complications and perinatal outcomes. Methods In this case-control study, 308 chorangiosis cases were compared with 308 controls (with other diagnoses in pathology) in terms of maternal, placental, prenatal, and neonatal characteristics derived from the medical records of participants retrospectively. R and SPSS version 22 software tools were used, and the statistical significance level was considered 0.05 for all the tests. Results Preeclampsia, diabetes mellitus, maternal hemoglobin, maternal hematocrit, C/S, oligohydramnios, fetal anomaly, dead neonates, NICU admissions were significantly higher in the chorangiosis group OR = 1.6, 3.98, 1.68, 1.92, 2.1, 4.47, 4.22, 2.9, 2.46, respectively (p-value< 0.05 for all). Amniotic fluid index, birth weight, cord PH amount, 1st, and 5th Apgar score was lower in the chorangiosis group OR = 0.31, 1, 0.097, 0.83, 0.85, respectively (p-value< 0.05 for all). Moreover, fundal placenta, retro placental hemorrhage, perivillous fibrin deposition, calcification, and acute chorioamnionitis were higher in the chorangiosis group OR = 2.1, 11.8, 19.96, 4.05, and 6.38 respectively, (p-value< 0.05). There was a high agreement between the two pathologists, and the power of the study was estimated at 99%. Conclusion Although chorangiosis is an uncommon condition, it is associated with a higher incidence of perinatal and neonatal morbidity and mortality. Therefore, it should be considered an important clinical sign of adverse pregnancy outcomes and should be reported in the pathology evaluation.

Stillbirth in the third trimester in a mother with type 1 diabetes mellitus and COVID-19: an autopsy and histopathology case report of the fetus and placenta

“…As seen in our case and reported by other authors, the changes in the placenta do not represent a specific virus-induced pathology in it, but rather a collection of changes that refer to an increased rate of placental aging and fetal hypoxia (9)(10)(11)(15)(16)(17)(18). These changes are also associated with placental diabetes-induced changes as well (19,20).…”

Practice of Placenta Submission for Histopathological Examination, Experience of a Teaching/Tertiary Care Hospital in Saudi Arabia

“…The significance of placenta evaluation has sparked the discussion of several variable studies debating whether proper histopathological examination can predict undesirable perinatal and pregnancy outcomes [12][13][14][15]. This information can be used to enhance patient counseling with regard to future pregnancies and life-long health [16].…”

Gestational age and infection are greater predictors of placental histopathology than maternal prepregnancy BMI

“…We intentionally excluded pregnancies with comorbidities and complications that are associated with obesity and underweight and have known effects on placental development and function [12,31] so that we could more accurately gain insight into the effects of suboptimal BMI alone on placental pathology and morphometry. A systemic pro-inflammatory state is present in women with pre-eclampsia and gestational diabetes mellitus [32,33], and placental pathologies, such as villous immaturity or chorangiosis, have been reported in women with these complications [11,12,34], irrespective of maternal BMI. Hypertension and gestational diabetes mellitus are highly prevalent in mothers who are overweight or have obesity [35] and could be driving the placental histopathological changes previously reported in pregnancies complicated by suboptimal maternal BMI.…”