Analysis of placenta vascularization in patients with uterine altered artery Doppler flow velocity exams

Gilio, Daniel B.; Corrêa, Rosana Rosa Miranda; Guimarães, Camila Souza de Oliveira; Peres, Luíz César; Salge, Ana Karina Marques; Cavellani, Camila Lourencini; Teixeira, Vicente de Paula Antunes; Castro, Eumênia Costa da Cunha

doi:10.1111/j.1447-0756.2008.00952.x

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…The acute reduction of villous size and perimeter associated with active malaria infection seems unlikely to reflect decreased blood flow in the placenta before delivery (for instance due to the effects of vascular obstruction by sequestered parasites, leukocytes or fibrin deposition) because these processes affect the maternal blood space. Changes in villous vascularity and size in other diseases examined using morphometry developed over a longer period due to poor oxygenation and hypertension, leading to defective stem villous development and hence vascularization of terminal villi [ 16 , 29 , 30 ]. Apart from blood flow, the activity of various growth-promoting hormones, such as insulin-like growth factor or placental growth factor, plays a role in supporting normal placental development [ 31 ], but changes in these growth axes would not explain the acute shrinkage seen in malaria infection.…”

Section: Resultsmentioning

confidence: 99%

A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection

Chaikitgosiyakul

Rijken

Muehlenbachs

et al. 2014

Malar J

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BackgroundMalaria in pregnancy remains a major health problem. Placental malaria infection may cause pathophysiological changes in pregnancy and result in morphological changes to placental villi. Quantitative histomorphological image analysis of placental biopsies was performed to compare placental villous architecture between active or treated placental malaria cases and controls.MethodsA total of 67 placentas were studied from three clinical groups: control patients who did not have malaria (n = 27), active (n = 14) and treated (n=26) malaria cases, including both Plasmodium falciparum and Plasmodium vivax infections. Image analysis of histological placental sections was performed using ImageJ software to measure the number and size (area) of terminal villi, perimeter measurement per villus and total perimeter per unit area, and number of capillaries per villus (vascularity). Histological features of placental malaria were scored and these results were correlated with malaria status and clinical outcomes.ResultsVillous size correlated with vascularity (p <0.0001) but was inversely correlated with observed villi per unit area, (p = 0.0001). Significantly greater villous area and vascularity was observed in UK controls. Indices of histological malaria infection were significantly greater in active versus treated malaria cases. Active placental malaria cases showed significantly smaller villous area (p <0.0084), vascularity (p <0.0139) and perimeter (p <0.0006) than treated malaria cases or controls, but significantly more villi per unit area (p <0.0001). Villous size in treated malaria cases was significantly larger than active placental malaria cases (p <0.001) and similar to controls. There was a significant relationship between villous number and anaemia at the time of infection (p <0.0034), but not placental weight, birth weight or gestational age at delivery. No differences were found between histology or villous morphology comparing infections with P. falciparum or P. vivax.ConclusionsThese results imply that villous size, perimeter and vascularity are acutely decreased during active placental malaria, decreasing the surface area available for gas exchange per villus. However the increased number of villi per unit area offsets this change and persists after treatment. Histopathological and villous architectural changes may be reversed by early detection and appropriate anti-malarial treatment.

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Section: Resultsmentioning

confidence: 99%

A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection

Chaikitgosiyakul

Rijken

Muehlenbachs

et al. 2014

Malar J

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“…This study showed a greater number and width of stem, intermediary, and terminal villi vessels in the placentas of patients with Doppler exam alterations, even without clinically relevant placental pathologies. 39 Additionally, automated image analysis systems have been developed for the evaluation of villous morphology in recurrent miscarriage, 40 delayed or accelerated villous maturation, 41 and distal villous hypoplasia (DVH), achieving respectable and reproducible results. In 2016, fractal dimension (a mathematical calculation of image complexity) was compared to the inter-observer agreement among 5 pathologists regarding DVH, a hallmark of IUGR, demonstrating that artificial intelligence has the potential to increase objectivity in reporting a clinically useful lesion.…”

Section: Discussionmentioning

confidence: 99%

Section: Machine and Deep Learning Algorithmsmentioning

confidence: 99%

Application of Digital Imaging and Artificial Intelligence to Pathology of the Placenta

et al. 2022

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Digital imaging, including the use of artificial intelligence, has been increasingly applied to investigate the placenta and its related pathology. However, there has been no comprehensive review of this body of work to date. The aim of this study was to therefore review the literature regarding digital pathology of the placenta. A systematic literature search was conducted in several electronic databases. Studies involving the application of digital imaging and artificial intelligence techniques to human placental samples were retrieved and analyzed. Relevant articles were categorized by digital image technique and their relevance to studying normal and diseased placenta. Of 2008 retrieved articles, 279 were included. Digital imaging research related to the placenta was often coupled with immunohistochemistry, confocal microscopy, 3D reconstruction, and/or deep learning algorithms. By significantly increasing pathologists’ ability to recognize potentially prognostic relevant features and by lessening inter-observer variability, published data overall indicate that the application of digital pathology to placental and perinatal diseases, along with clinical and radiology correlation, has great potential to improve fetal and maternal health care including the selection of targeted therapy in high-risk pregnancy.

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“…During the second trimester fetal screening, the placenta, and the associated anatomical structures are evaluated, and uterine artery Doppler is performed for the prediction of prenatal complications. Previously, studies were conducted to evaluate the relationship between the placental structure during pregnancy or the postnatal period and Doppler parameters (3,4). Population studies have aimed to determine the average placental thickness (PT) during specific periods of pregnancy (2,5,6).…”

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Evaluation of the Relationship Between Placental Thickness and Obstetric Doppler Parameters During the Second Trimester

Aydın

Bulut

2020

Gynecol Obstet Reprod Med

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OBJECTIVE: To determine whether there is a relationship between placental thickness and the umbilical artery and uterine artery Doppler evaluation in the second trimester. STUDY DESIGN: The placental thickness and the umbilical artery and uterine artery Doppler evaluations were recorded by a single operator for patients who were admitted for an obstetric follow-up or fetal anatomy screening at 18-28 gestational weeks. The relation between these variables was investigated by evaluating the patients only once.RESULTS: In our study, the mean placental thickness was 31.7 (SD±8.01) mm. The umbilical artery Doppler parameters did not correlate with the placental thickness. The uterine artery Doppler systolic/diastolic velocity, Pulsatility index and Resistance index values positively correlated with the placental thickness. However, these correlations were not statistically significant. CONCLUSIONS: Although there was no relationship between the placental thickness and obstetric Doppler parameters in this study, we suggest that they are likely important factors and their significance should be evaluated in future studies

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Analysis of placenta vascularization in patients with uterine altered artery Doppler flow velocity exams

Abstract: The morphological proof that uterine artery Doppler flow velocity exam alterations are associated with placental vascular alterations demonstrates the importance of this exam during prenatal care, even in the absence of maternal-fetal alterations.

Cited by 4 publications

References 13 publications

A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection

A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection

Application of Digital Imaging and Artificial Intelligence to Pathology of the Placenta

Evaluation of the Relationship Between Placental Thickness and Obstetric Doppler Parameters During the Second Trimester

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