Chorangiosis and placental oxygenation

Suzuki, Kazunao; Itoh, Hiroaki; Kimura, Satoshi; Sato, Kazuhiro; Yaguchi, Chizuko; Kobayashi, Yukiko; Hirai, Kyuya; Takeuchi, Kinya; Sugimura, Motoi; Kanayama, Naohiro

doi:10.1111/j.1741-4520.2009.00226.x

Cited by 36 publications

(35 citation statements)

References 16 publications

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“…Chorangiosis has been reported in placentas from infants associated with increased fetal and neonatal morbidity as well as mortality [6,10,34,38] and adverse neurologic outcomes [6,37,39]. Most of the infants require admission to a newborn intensive care unit [4,9,10] and the related pregnancies are usually complicated with umbilical cord abnormalities [40], fetal malformations, maternal diabetes [41,42,43], maternal hypertension, maternal cigarette smoking, preeclampsia [44] and IUGR [6,10].…”

Section: Discussionmentioning

confidence: 99%

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Placental Chorangiosis: The Association with Oxidative Stress and Angiogenesis

Barut¹,

Barut²,

Kandemır³

et al. 2012

Gynecol Obstet Invest

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Background/Aims: Chorangiosis is considered to be strongly associated with fetal, maternal, and placental disorders, and has been found to be correlated with increased fetal morbidity and mortality. In this study, it is aimed to investigate the association of angiogenesis and oxidative stress with the pathogenesis of chorangiosis. Methods: Expressions of heat shock protein 70 (HSP70), vascular endothelial growth factor-A (VEGF-A) and basic fibroblast growth factor (b-FGF), which are investigated with avidin-biotin-peroxidase method in formalin-fixed, paraffin-embedded sections from placental tissues diagnosed as no chorangiosis (n = 18) and chorangiosis (n = 18), have been evaluated in a semiquantitative manner. Results: There were significant differences between chorangiosis and no chorangiosis cases with respect to birth weight, birth length, and Apgar scores (p < 0.001). Statistically significant (p < 0.001), diffuse and strong expressions with HSP70, VEGF-A and b-FGF were observed in the villous tissue of placental chorangiosis cases when compared with no chorangiosis cases. Conclusion: The majority of the chorangiosis cases had an accompanying poor perinatal outcome, and also those with accompanying angiogenesis and increased oxidative stress demonstrated diffuse and strong expressions of HSP70, VEGF-A and b-FGF. The interaction of maternal, placental, and fetal factors with increased oxidative stress and angiogenesis may possibly contribute to this arising pathologic change.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, histological examination of the placenta provides sensitive, specific and scientific information for evaluating the nature, extent and timing of injuries to both the fetus and mother in cases of a poor obstetrical outcome [6,9,11,34]. …”

Section: Discussionmentioning

confidence: 99%

Placental Chorangiosis: The Association with Oxidative Stress and Angiogenesis

Barut¹,

Barut²,

Kandemır³

et al. 2012

Gynecol Obstet Invest

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“…1,17,20,31 The original Altshuler criteria for diagnosis of chorangiosis were adopted, 4,9 although some authors define chorangiosis as occurring only in terminal villi. 8 Terminal villi can usually be distinguished from mature intermediate villi in normal placentas, but in villous hypervascularity, the 2 types of villi are usually considered together, 11 as terminal villi expanded by increased numbers of capillary profiles look like intermediate villi (Figure 1). However, even normally, there is a size overlap, as mature intermediate villi measure 60 to 100 lm whereas terminal villi measure 40 to 80 lm.…”

Section: Methodsmentioning

confidence: 99%

“…6 Although the Altshuler numerical definition looks arbitrary, chorangiosis has been a time-honored placental pattern and has been regarded as a placental response to long-standing low-grade hypoxia. 7,8 It has been related to several chronic obstetric complications and outcomes, 4 to mention only perinatal deaths, maternal diabetes mellitus, chronic infection, in utero asphyxia, umbilical cord problems, congenital anomalies, fetal vascular thrombosis, maternal anemia, smoking, air pollution, and multiple pregnancy. 7,[9][10][11][12][13][14][15][16][17][18][19][20] The incidence of chorangiosis is low in the second trimester and increases in the third trimester, 21 in which it is lower in preterm than in term pregnancies.…”

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confidence: 99%

Chorangiosis of Chorionic Villi: What Does It Really Mean?

Stanek

2016

Archives of Pathology &Amp; Laboratory Medicine

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Chorangiosis has been regarded as a result of low-grade placental hypoxia associated with pregnancy risk factors and abnormal outcomes. It is unknown whether these are a consequence of chorangiosis itself or of associated other placental pathology.Context.— To prove that chorangiosis itself does not portend an increased risk for pregnancy unless associated with other placental pathology.Objective.— This retrospective statistical study analyzes 1231 consecutive placentas with diffuse or focal hypervascularity of chorionic villi: 328 with preuterine pattern of chronic hypoxic placental injury (group 1), 297 with uterine type of chronic hypoxic placental injury (group 2), and 606 cases with chorangiosis (group 3) not fulfilling the inclusion criteria for groups 1 or 2.Design.— Group 2, with 33 cases of chorangiosis (11.1%), featured 10 and 11 statistically significant highest percentages of abnormal clinical and placental variables, respectively; group 3 featured the highest percentages of multiple pregnancy, the heaviest placentas, and the most common acute chorioamnionitis, fetal inflammatory response; and group 1 had the highest proportion of mild erythroblastosis of fetal blood. When comparing groups 1 and 3, 21 of 29 clinical risk factors/outcomes (72.4%) and 30 of 41 placental variables (73.2%) were more common in group 1.Results.— Presence of diffuse hypoxic patterns of placental injury adds prognostically negative significance to increased vascularity of chorionic villi. Chorangiosis without those patterns portends minimal risk for the pregnancy, and is associated with significantly fewer pregnancy risk factors, abnormal outcomes, and other placental abnormalities.Conclusions.—

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“…The increase in syncytial knot number is not the only finding of hypoxia and does not necessarily coexist with the other morphological changes of hypoxia. The morphological findings of hypoxia vary according to the degree and onset of hypoxia (16)(17)(18)(19). For example, TPC may not accompany chorioangiosis that is thought to be formed due to long-lasting low grade hypoxia (3).…”

Section: Dıscussıonmentioning

confidence: 99%

The determination of normal percentages of syncytiotrophoblastic knots in various regions of placenta: where to count the syncytial knots

Cigerciogullari¹,

Filinte²,

Töz³

et al. 2014

TJPATH

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Objective: The marginal, basal and subchorial regions of the placenta are considered to be more hypoxic than other regions. Therefore, it is not recommended to determine the increase in syncytiotrophoblast knots, based on the major morphological change in placental hypoxia, from the samples taken from these regions. However, the normal count of knots at various regions of placenta is not investigated. Material and Method:In this study we have sampled morphologically and clinically normal placenta with eccentric cord insertion from various sites, either close to cord entrance or away from it (marginal, non-marginal basal, non-marginal subchorial, and nonmarginal midparanchymal). The number of knots was calculated on a total of at least 100 villi for each placental sample. The normal amount of knots in different regions and comparison between them were investigated. Twenty-eight placentas with eccentric cord insertion were sampled in the same manner. Hot spots from the above mentioned regions were counted in a total of 100 villi.Results: No significant difference was found between the dual comparison of the mean percentages of different regions (p: 0.148). The variety of hypoxia in different regions of the placenta could not be demonstrated in this study. Conclusion:It is found that there is no difference in perfusion that can be morphologically demonstrated with increase in syncytiotrophoblast knot, between different regions of placenta.

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Chorangiosis and placental oxygenation

Cited by 36 publications

References 16 publications

Placental Chorangiosis: The Association with Oxidative Stress and Angiogenesis

Placental Chorangiosis: The Association with Oxidative Stress and Angiogenesis

Chorangiosis of Chorionic Villi: What Does It Really Mean?

The determination of normal percentages of syncytiotrophoblastic knots in various regions of placenta: where to count the syncytial knots

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