Re‐view and view on maturation disorders in the placenta

Turowski, G; Vogel, Martin

doi:10.1111/apm.12858

Cited by 35 publications

(18 citation statements)

References 37 publications

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“…In our study we found a significantly higher proportion of cases with RPH. Malperfusion can lead to changes such as AVM and subsequent DVH due to a poorly developed distal villous tree [8]. Both these findings were significantly higher in cases.…”

Section: Discussionmentioning

confidence: 91%

COVID-19 as an independent risk factor for subclinical placental dysfunction

Jaiswal

Puri

Agarwal

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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Background: The pandemic of the severe acute respiratory distress syndrome-associated Coronavirus-2 (SARS-CoV-2) has affected millions around the world. In pregnancy the dangers to the mother and fetus are still being explored. SARS-CoV2 can potentially compromise maternal and neonatal outcomes and this may be dependent on the pregnancy stage during which the infection occurs. Objective: The present study was done to find the histopathological alterations in the placenta of SARS-CoV-2 positive pregnancies with either no symptoms or mild coronavirus disease (COVID)-19 related symptoms and its association with neonatal outcomes. Study design: This was a prospective analytical study. Twenty seven asymptomatic or mildly symptomatic SARS-CoV-2 positive pregnant women with a singleton pregnancy delivered between 1 st July 2020 and 15 th September 2020, were included as cases. An equal number of SARS-CoV-2 negative singleton pregnancies matched for maternal and gestational age during the same period were included as controls. After delivery the histopathological examination of the placenta of these women was done and the findings recorded on a predesigned proforma based on the Amsterdam consensus criteria for evidence of maternal and fetal vascular malperfusion changes. Results: The baseline characteristics were comparable between the cases and controls. The following features of maternal vascular malperfusion (MVM) were significantly higher in the placentae of COVID-19 positive pregnancies: retroplacental hematomas (RPH), accelerated villous maturation (AVM), distal villous hyperplasia (DVH), atherosis, fibrinoid necrosis, mural hypertrophy of membrane arterioles (MHMA), vessel ectasia and persistence of intramural endovascular trophoblast (PIEVT). Fetal vascular malperfusion (FVM) significantly associated with the positive pregnancies were chorioangiosis, thrombosis of the fetal chorionic plate (TFCP), intramural fibrin deposition (IMFD) and vascular ectasia. Additionally, perivillous fibrin deposition was also significantly higher in the placentae of cases. The percentage of spontaneously delivered women was comparable in the two groups. The sex and weight of the newborn and the number of live births were comparable between the two groups. Conclusions: Asymptomatic or mildly symptomatic SARS-CoV-2 positive pregnant women, with otherwise uncomplicated pregnancies, show evidence of placental injury at a microscopic level. Similar findings have been demonstrated in other studies too. This placental injury apparently does not lead to poor pregnancy outcomes. The extent of this injury in symptomatic cases of COVID-19 pregnancies and its consequences on the outcomes need to be analysed.

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Section: Discussionmentioning

confidence: 91%

COVID-19 as an independent risk factor for subclinical placental dysfunction

Jaiswal

Puri

Agarwal

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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“…), blind to case or control status, gestational age and maternal characteristics. The classification of any histological features was performed according to previous agreed and standardized criteria (Table 3) (Redline, 2015; Turowski & Vogel, 2018). Pathological features were recorded qualitatively (present or absent).…”

Section: Methodsmentioning

confidence: 99%

Abnormal placental CD8⁺ T‐cell infiltration is a feature of fetal growth restriction and pre‐eclampsia

Lager

Sovio

Eddershaw

et al. 2020

The Journal of Physiology

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Placental pathological abnormalities are more frequently observed in complicated pregnancies than in healthy pregnancies. r Infiltration of CD8 + T-cells into the placental villous tissue occurred in both fetal growth restriction and pre-eclampsia, whereas CD79α + B-cell infiltration was only apparent with reduced fetal growth. r Vascularization, fibrin depositions, macrophage and neutrophil infiltration in the placenta did not differ between healthy and complicated pregnancies.

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“…This is a placental histopathologic finding that can be found near the end of pregnancy and rarely before 34 weeks of gestation [24]. It is clinically associated with FGR as well as intrauterine hypoxia, maternal metabolic disorder, and obesity [68]. It is characterized by a monotonous unvaried villous population, with increased villous diameter, with centrally placed capillaries, cellular stroma, a continuous cytotrophoblast l ayer, and reduced numbers of vasculosyncytial membranes [24].…”

Section: Placenta In Late Fgrmentioning

confidence: 99%

Fetal Growth Restriction: Does an Integrated Maternal Hemodynamic-Placental Model Fit Better?

et al. 2020

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In recent years, a growing interest has arisen regarding the possible relationship between adverse pregnancy outcomes (APOs) and inadequate maternal hemodynamic adaptations to the pregnancy. A possible association between “placental syndromes,” such as preeclampsia (PE) and fetal growth restriction (FGR), and subsequent maternal cardiovascular diseases (CVD) later in life has been reported. The two subtypes of FGR show different pathogenetic and clinical features. Defective placentation, due to a poor trophoblastic invasion of the maternal spiral arteries, is believed to play a central role in the pathogenesis of early-onset PE and FGR. Since placental functioning is dependent on the maternal cardiovascular system, a pre-existent or subsequent cardiovascular impairment may play a key role in the pathogenesis of early-onset FGR. Late FGR does not seem to be determined by a primary abnormal placentation in the first trimester. The pathological pathway of late-onset FGR may be due to a primary maternal cardiovascular maladaptation: CV system shows a flat profile and remains similar to those of non-pregnant women. Since the second trimester, when the placenta is already developed and increases its functional request, a hypovolemic state could lead to placental hypoperfusion and to an altered maturation of the placental villous tree and therefore to an altered fetal growth. Thus, this review focalizes on the possible relationship between maternal cardiac function and placentation in the development of both early and late-onset FGR. A better understanding of maternal hemodynamics in pregnancies complicated by FGR could bring various benefits in clinical practice, improving screening and therapeutic tools.

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Re‐view and view on maturation disorders in the placenta

Cited by 35 publications

References 37 publications

COVID-19 as an independent risk factor for subclinical placental dysfunction

COVID-19 as an independent risk factor for subclinical placental dysfunction

Abnormal placental CD8⁺ T‐cell infiltration is a feature of fetal growth restriction and pre‐eclampsia

Fetal Growth Restriction: Does an Integrated Maternal Hemodynamic-Placental Model Fit Better?

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Re‐view and view on maturation disorders in the placenta

Cited by 35 publications

References 37 publications

COVID-19 as an independent risk factor for subclinical placental dysfunction

COVID-19 as an independent risk factor for subclinical placental dysfunction

Abnormal placental CD8+ T‐cell infiltration is a feature of fetal growth restriction and pre‐eclampsia

Fetal Growth Restriction: Does an Integrated Maternal Hemodynamic-Placental Model Fit Better?

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Product

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Abnormal placental CD8⁺ T‐cell infiltration is a feature of fetal growth restriction and pre‐eclampsia