Histomorphometric study of placental villi vascular volume in toxemia and diabetes

Maly, Alexander; Goshen, Gal; Sela, J.; Pinelis, Alexander; Stark, Michael; Maly, Bella

doi:10.1016/j.humpath.2005.07.021

Cited by 35 publications

(22 citation statements)

References 26 publications

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“…Poor glycemic control in the periconception period and first trimester of pregnancy has been linked to a number of maternal adverse outcomes, such as hypertension, preeclampsia, Cesarean section, and hypoglycemia, as well as numerous fetal adverse outcomes, including fetal and neonatal loss, fetal growth acceleration, macrosomia, stillbirth, and respiratory distress syndrome (67). Moreover, the correction of hyperglycemia might not prevent the development of placental abnormalities since several studies have shown that placental histopathologic changes persisted even in pregnancies with well-controlled diabetes (4, 6, 7, 9, 10, 30-33, 38, 39, 43, 46). Consequently, additional research on placental histopathology in maternal diabetes should include a consideration of the glycemic control of diabetic populations in order to maximally characterize the impact of dysglycemia on placental histopathology.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of placental pathology in maternal diabetes mellitus

et al. 2015

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During a pregnancy complicated by diabetes, the human placenta undergoes a number of functional and structural pathologic changes, such as increased placental weight and increased incidence of placental lesions including villous maturational defects and fibrinoid necrosis. The pathologic findings reported have differed among studies, potentially reflecting differences in type of diabetes, study methodology, or glycemic control of study participants. Alternatively, these discrepancies may represent different biologic adaptations to distinct metabolic diseases. In order to clarify these distinctions, we conducted a comprehensive review of English language citations in Pubmed and Embase using the keywords “diabetes”, “placenta”, AND “pathology”. Abstracts were reviewed for relevance then full-text articles were reviewed in order to extract a comprehensive summary of current pathological findings associated with pregestational and gestational diabetes mellitus, as well as an understanding of the impact of glycemic control on placental pathology. Placental abnormalities most consistently associated with maternal diabetes are an increased incidence of villous immaturity, increased measures of angiogenesis, and increased placental weight. The literature suggests that, despite similarities in placental abnormalities, differences in placental pathology may reflect differences in pathophysiology among different types of diabetes. Consequently, standardization of terminology used to define placental lesions is warranted. Moreover, further research is needed to investigate the impact of pathophysiology, glycemic control and clinical factors, such as infant sex, weight and race, on placental structure and function.

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Section: Discussionmentioning

confidence: 99%

A systematic review of placental pathology in maternal diabetes mellitus

et al. 2015

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“…Entretanto, verifica-se redução na capacidade de difusão específica da membrana vilosa nos casos com diabetes quando comparados com o grupo controle, indicando que o desenvolvimento placentário na gestante diabética insulino-dependente é afetado, principalmente, quando se acompanha da macrossomia fetal. Alterações na vascularização vilosa também são observadas na placenta da gestante diabética com redução no volume vascular dos vilos placentários 29 . Esses aspectos tornam o concepto mais susceptível à hipoxia fetal e devem interferir nos mecanismos de troca de fluidos e produção de líquido amniótico.…”

Section: Resultsunclassified

Associação entre perfil glicêmico materno e o índice de líquido amniótico em gestações complicadas pelo Diabetes mellituspré-gestacional

Maganha¹,

Nomura²,

Zugaib³

2009

Rev. Assoc. Med. Bras.

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ASSOCIAÇÃO ENTRE PERFIL GLICÊMICO MATERNO E O ÍNDICE DE LÍQUIDO AMNIÓTICO EM GESTAÇÕES COMPLICADAS PELO DIABETES MELLITUS. As complicações decorrentes do Diabetes mellitus na gravidez tem relação direta com o controle metabólico materno 4,5 . Com o advento da insulina e sua utilização em mulheres grávidas, foi possível obter melhor controle metabólico e houve importante redução na mortalidade perinatal.A hiperglicemia materna eleva as taxas de complicações em gestantes diabéticas. 6,7 O desenvolvimento tecnológico do final do século XX concentrou-se na busca de métodos que possibilitassem a predição dessas complicações com o objetivo de atenuá-las. Dentre essas técnicas, destaca-se a ultrassonografia obstétrica.A elevação do volume de líquido amniótico em gestações complicadas por diabetes tem fisiopatologia complexa, não totalmente conhecida. As principais hipóteses dessa associação consideram a hiperglicemia materna como ponto de partida desse processo. A glicose, em excesso no sangue materno, atravessaria mais a placenta levando à hiperglicemia fetal. Esta, por sua vez, desencadearia a diurese osmótica fetal resultando em excesso de líquido amniótico 8 . A relação positiva da hiperglicemia materna com o aumento da diurese fetal é verificada inicialmente em estudos com

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“…For frozen sections, separate samples from the same placentas were fixed in paraformaldehyde followed by cryopreservation by immersion in sucrose and PBS and then frozen, sectioned (5 m), and stained (21). The selected samples were embedded in paraffin or frozen with the cut face down to meet the requirements for vertical sections, which is necessary for design-based estimation of the surface area (24,25).…”

Section: Animals and Tissuesmentioning

confidence: 99%

“…Randomly selected sections of the paraffin-embedded material were stained with H&E. The following morphometric placental parameters were evaluated: mean number of villous cross-sections per mm 2 of paraffin section, percentage of total number of the various villous classes (examined under ϫ4 objective), length of stem villi, diameter of villi, the thickness of the villous trophoblast, villous surface area, villous stromal area, the number of vessel cross-sections per villus (examined under ϫ10 objective), maximal luminal diameter of villous vessels, and vessel surface area (examined under ϫ20 objective) (25)(26)(27)(28)(29). Stromal/epithelial surface and vessel/villous surface ratios were calculated.…”

Section: Histological and Morphometric Analysismentioning

confidence: 99%

“…Contours of the structurally intact villi and their stroma and vessels were traced manually on the computer monitor with a mouse-controlled cursor at on-screen magnification to calculate the areas of these components (28). The results from five images were averaged to give one value for each specimen (25). All measurements were analyzed blind (without knowledge of the treatment group) by the same person.…”

Section: Histological and Morphometric Analysismentioning

confidence: 99%

See 1 more Smart Citation

Passive Immunization against the MHC Class I Molecule Mamu-AG Disrupts Rhesus Placental Development and Endometrial Responses

Bondarenko

Burleigh

Durning

et al. 2007

The Journal of Immunology

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The unique MHC phenotype of the human and nonhuman primate placenta has suggested a potential role in maternal-fetal immune tolerance, pregnancy success, and maternal as well as fetal well-being. In the rhesus monkey (Macaca mulatta) a nonclassical MHC class I molecule, Mamu-AG, is a putative homologue of HLA-G and is hypothesized to play a role in maternal-fetal immune interactions during pregnancy. Rhesus monkeys were passively immunized during the second week after implantation with a mAb against Mamu-AG. Passive immunization altered the growth and vascularization of the fetal placenta, the placental modification of maternal endometrial vessels, the maternal leukocyte response to implantation, and the differentiation of epithelial and stromal cells in the endometrium. These data are the first to demonstrate in vivo the importance of MHC class I molecules expressed on primate trophoblasts in establishing an important environment for pregnancy success through coordinated interactions between endometrial and fetal tissues.

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Histomorphometric study of placental villi vascular volume in toxemia and diabetes

Cited by 35 publications

References 26 publications

A systematic review of placental pathology in maternal diabetes mellitus

A systematic review of placental pathology in maternal diabetes mellitus

Associação entre perfil glicêmico materno e o índice de líquido amniótico em gestações complicadas pelo Diabetes mellituspré-gestacional

Passive Immunization against the MHC Class I Molecule Mamu-AG Disrupts Rhesus Placental Development and Endometrial Responses

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