Novel 3D light microscopic analysis of IUGR placentas points to a morphological correlate of compensated ischemic placental disease in humans

Abstract

The villous tree of the human placenta is a complex three-dimensional (3D) structure with branches and nodes at the feto-maternal border in the key area of gas and nutrient exchange. Recently we introduced a novel, computer-assisted 3D light microscopic method that enables 3D topological analysis of branching patterns of the human placental villous tree. In the present study we applied this novel method to the 3D architecture of peripheral villous trees of placentas from patients with intrauterine growth retardation (IUGR placentas), a severe obstetric syndrome. We found that the mean branching angle of branches in terminal positions of the villous trees was significantly different statistically between IUGR placentas and clinically normal placentas. Furthermore, the mean tortuosity of branches of villous trees in directly preterminal positions was significantly different statistically between IUGR placentas and clinically normal placentas. We show that these differences can be interpreted as consequences of morphological adaptation of villous trees between IUGR placentas and clinically normal placentas, and may have important consequences for the understanding of the morphological correlates of the efficiency of the placental villous tree and their influence on fetal development.

Placental Morphology Is Associated with Maternal Depressive Symptoms during Pregnancy and Toddler Psychiatric Problems

“…On the other hand, we circumvented the weakness of conventional histologic villous classifications (differentiation in stem, intermediate, and terminal villi) in the recognition of peripheral villous arborizations 48 – 50 by detecting SMA as a criterion of more central (stem villus like, SMA-positive) or peripheral (SMA-negative) villi. However, care should be taken since many SMA-positive villi did not have a larger calibre than many SMA-negative villi, making them histologically indiscernible.…”

“…By 2D section histology, recognizing differences in arborization topology is impossible; nodes cannot be recognized. The recently introduced 3D microscopy of peripheral villous trees 48 – 50 can potentially provide this information in further studies. Yet, our study has a novel focus, and its strengths include the longitudinal design, the use of validated questionnaires on maternal and toddler psychopathology 39 , 51 – 54 , and the repeated, fortnightly assessments of maternal antenatal depressive symptoms.…”

Dynamic modeling of uteroplacental blood flow in IUGR indicates vortices and elevated pressure in the intervillous space – a pilot study

“…While pressure dropped more steeply at the arterial opening in the pathological cases than in the clinically normal situation, the end pressure in the proximal IVS of the IUGR and IUGR/PE conditions was higher than in the proximal IVS of the clinically normal situation. Increased blood pressure in the IVS, as indicated for the first time in the models of the present study, is unexpected in current pathogenetic concepts and could have a substantial impact on villous topology30 and placental function. These circumstances can lead to blood retention in the IVS next to the opening of the uterine spiral arteries.…”

Advances in Human Placental Biomechanics

“…Additionally, a more in-depth look at the structural differences between healthy and pathological placentae has been possible [14,18,23,26,28]. …”