Vascular Changes in the Decidua Associated With Eclamptogenic Toxemia of Pregnancy

Zeek, Pearl M.; Assali, N.S.

doi:10.1097/00006254-195104000-00019

Cited by 22 publications

(24 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…19 It is proposed that in these large placentas there is a relative reduction in placental perfusion. Another alteration of the spiral arteries in preeclampsia, atherosis, results in occlusion of the decidual vessels 20 reminiscent of the vascular findings of allograft rejection. This finding further supports an immunologic component of preeclampsia.…”

Section: Stagementioning

confidence: 96%

See 1 more Smart Citation

Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy

et al. 2003

View full text Add to dashboard Cite

Abstract-A Working Group on Research in Hypertension in Pregnancy was recently convened by the National Heart, Lung, and Blood Institute to determine the state of knowledge in this area and suggest appropriate directions for research. Hypertensive disorders in pregnancy, especially preeclampsia, are a leading cause of maternal death worldwide and even in developed countries increase perinatal mortality rates 5-fold. Much has been learned about preeclampsia, but gaps in the knowledge necessary to direct therapeutic strategies remain. Oxidative stress is a biologically plausible contributor to the disorder that may be amenable to intervention. Hypertension that antedates pregnancy (chronic hypertension) bears many similarities to hypertension in nonpregnant women, but the special setting of pregnancy demands information to guide evidence-based therapy. The recommendations of the Working Group are to attempt a clinical trial of antioxidant therapy to prevent preeclampsia that is be complemented by mechanistic research to increase understanding of the genetics and pathogenesis of the disorder. For chronic hypertension, clinical trials are recommended to direct choice of drugs, evaluate degree of control, and assess implications to the mother and fetus.Recommendations to increase participation in this research are also presented.

show abstract

Section: Stagementioning

confidence: 96%

“…Lipid oxidation products 38 Antibodies to oxidized LDL 62 In systemic maternal tissues Increased nitrotyrosine residues in blood vessels 65 Activated neutrophils and monocytes 66 In decidua Atherosis with lipid-laden macrophages 20 Increased lipid peroxides 67 Increased isoprostanes (8 iso PGF2␣) 68 Protein carbonyls 69 In placenta…”

Section: Lipid Markersmentioning

confidence: 99%

Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy

et al. 2003

View full text Add to dashboard Cite

show abstract

“…Placental infarction is also more frequently observed in hypertensive cases due to thrombotic occlusion of maternal uteroplacental vessels. 15,16 Presence of syncytial knots increases with increasing gestational age, and with conditions of uteroplacental mal-perfusion and are important in placental examination. 17 In our study, increased syncytial knots in placenta were observed in 70% cases with severe hypertension whereas placenta of only 10% of normotensive mothers showed syncytial knots which was also reported by Rohini Motwani et al 13 , Heazella AEP et al 18 and Kristina L et al 19 They also hypothesized that the formation of syncytial knots may be induced by exposure to hypoxia.…”

Section: 12mentioning

confidence: 99%

Comparative Study of Histology of Placenta in Normotensive and Hypertensive Cases

Rana¹

2017

jmscr

View full text Add to dashboard Cite

“…Acute atherosis has been dem- onstrated in both decidual and myometrial portions of spiral arteries in preeclampsia (Figure 2A through 2D). 66,83 However, typical lesions were confined to nontransformed spiral arteries that have not undergone the trophoblast-associated physiological change. 84 Acute atherosis is characterized by subendothelial lipid-filled foam cells, vascular (fibrinoid) necrosis, and perivascular lymphocytic infiltration.…”

Section: Acute Atherosis Of Spiral Arteries Clinical Associations Amentioning

confidence: 99%

“…89 The phenomenon of acute atherosis seems not to be a unique feature to preeclampsia, because not all of the preeclamptic placentas have developed acute atherosis. 83,89 Pregnancies without preeclampsia also have shown features of acute atherosis, including pregnancies complicated by intrauterine growth restriction, 116 systemic lupus erythematosus, and antiphospholipid syndrome. 117 Meekins et al 86 found lipoprotein (a) in atherotic lesions of physiologically transformed spiral arteries of the placental bed in some normotensive pregnant women, quantitatively less than in the spiral arteries of preeclamptic pregnancies, concluding that acute atherosis follows physiological tissue destruction and incorporation of lipoprotein.…”

Section: Acute Atherosis Of Spiral Arteries Clinical Associations Amentioning

confidence: 99%

Learning From the Placenta

2010

View full text Add to dashboard Cite

Abstract-Preeclampsia is a common and potentially lethal pregnancy complication for women and offspring. Women who develop preeclampsia also run a long-term augmented risk of cardiovascular disease and premature death, and two theories are discussed. Women developing preeclampsia and persons developing cardiovascular disease may have common risk factors, which are unmasked by the "stress" of pregnancy. Alternatively, a new risk factor might occur de novo during the preeclamptic pregnancy. In preeclampsia, lipid deposition in walls of the maternal uterine arteries leading to the placenta, named spiral arteries, regularly occurs. These vascular lesions resemble early stages of atherosclerosis and are named "acute atherosis" and is thought to regress after delivery. The mechanisms that contribute to acute atherosis in preeclampsia are largely unknown, but are related to the impaired vascular remodeling of the spiral arteries in the first half of pregnancy. One striking feature is that the development of these "atherosclerosis-like" lesions requires a few months in pregnancy and may be partly linked to invasion of trophoblasts (specialized fetally derived placenta cells). We summarize normal and pathological vessel remodeling in pregnancy and discuss similarities and differences between preeclampsia and arteriosclerosis. The transient appearance of acute atherosis of uterine wall spiral arteries seen in pregnancy complications and the molecular interaction between trophoblast, smooth muscle and vascular cells could add important elements to explain arteriosclerosis and stenosis in cardiovascular disease. Preeclampsia affects 5% to 7% of all pregnancies and is a major health problem, 1 being responsible for Ϸ50 000 maternal deaths annually. 2 Children and mothers who have undergone a preeclamptic pregnancy experience an increased long-term cardiovascular risk. 3 The diagnosis is based on increased blood pressure in normally normotensive women and the development of proteinuria at Ͼ20 weeks of pregnancy. 4 Although the pathogenesis is still unclear, factors such as oxidative stress, circulating placenta-derived factors, immunologic defects, and genetic variance may all be important.

show abstract

Vascular Changes in the Decidua Associated With Eclamptogenic Toxemia of Pregnancy

Cited by 22 publications

References 0 publications

Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy

Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy

Comparative Study of Histology of Placenta in Normotensive and Hypertensive Cases

Learning From the Placenta

Contact Info

Product

Resources

About