Maternal vasculopathy and histologic diagnosis of preeclampsia: Poor correlation of histologic changes and clinical manifestation

Zhang, Peilin; Schmidt, Matthew; Cook, Linda

doi:10.1016/j.ajog.2005.10.196

Cited by 50 publications

(28 citation statements)

References 19 publications

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“…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]. We observed similar results supporting these studies in the evaluation of our clinical data.…”

Section: Discussionsupporting

confidence: 81%

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: Discussionsupporting

confidence: 81%

Placental Chorangiosis: The Association with Oxidative Stress and Angiogenesis

Barut¹,

Barut²,

Kandemır³

et al. 2012

Gynecol Obstet Invest

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“…Aberrantly many abruptions and multiple infarcts ( Figure 22) were seen in pre-eclamptic specimens which is consistent with the hypoxia theory. Our results were in harmony with Zhang et al [24] who performed a placental examination for changes with preeclampsia, and reported poor correlation between these changes with the clinical manifestations of pregnancy induced hypertension. The histological changes and clinical manifestation were also reported in a review article by Guller Seth [20] who explained how hypoxia/ reperfusion injury disrupts the syncytial architecture and results in the previously mentioned changes.…”

Section: Disscussionsupporting

confidence: 79%

Electron and Scanning Microscopic Observations on the Syncytiotrophoblast Microvillous Membrane Contribution to Preeclampsia in Early Placental Rats

Selim¹,

Elshmry²,

Rashed³

2013

J Blood Disord Transfus

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“…This might be related to random sampling error, because the true frequency of decidual arteriopathy is optimally demonstrated in placental bed biopsies. Zhang et al 16 showed recently that there is poor correlation between the histological diagnosis of maternal vasculopathy and the clinical manifestations of PE.…”

Section: Vinnars Et Al Severe Preeclampsia With and Without Hellpmentioning

confidence: 99%

Severe Preeclampsia With and Without HELLP Differ With Regard to Placental Pathology

et al. 2008

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Abstract-The aim of the present study was to evaluate the histopathology in placentas from patients with severe preeclampsia with and without hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. An additional aim was to compare the prevalence of infants born small for gestational age in the 2 groups. The study is retrospective and includes 178 women who have been diagnosed at the Karolinska University Hospital Huddinge or at the Free University Medical Center between 2000 and 2005 with severe preeclampsia. A total of 96 women had severe preeclampsia without signs of HELLP (preeclampsia group), whereas 82 fulfilled the criteria for having HELLP syndrome (HELLP group). Infarction (Pϭ0.014), intervillous thrombosis (PϽ0.001), and abruption (Pϭ0.002) were more common in the preeclampsia group than in the HELLP group. There was no statistically significant difference in the frequency of accelerated villous maturation (Pϭ0.61), decidual arteriopathy (Pϭ0.27), or chorioamnionitis (Pϭ0.61). Furthermore, there was a higher mean placental weight, adjusted for gestational age, in the Swedish HELLP material than in the preeclampsia group (PϽ0.001). Finally, mothers in the preeclampsia group gave birth significantly more often to small for gestational age babies than mothers suffering from HELLP syndrome (PϽ0.001). The histopathologic profile and the range of placental lesions were partly different in the preeclampsia and HELLP patients. Considering the central role that placenta seems to have in preeclampsia, the present result might suggest that different underlying pathogenetic mechanisms and courses can be in play in patients with preeclampsia and HELLP syndrome. Key Words: eclampsia Ⅲ gestational hypertension Ⅲ pregnancy hypertension Ⅲ preeclampsia Ⅲ pregnancy Ⅲ proteinuria Ⅲ women P reeclampsia (PE) affects 2% to 7% of healthy nulliparous women and is a major cause of maternal and fetal morbidity and mortality. 1 It is further subclassified into late-onset and early onset PE, severe and mild PE, and into a maternal and fetal syndrome. 2,3 The syndrome is characterized by hypertension and proteinuria, and a common fetal feature is intrauterine growth restriction. 2 Common pathological features in PE include small placentas with decidual arteriopathy, infarcts in central portions of the placenta, abruption placentae, and intervillous thrombosis. Arteriopathy is commonly found in PE, as well as intrauterine growth restriction, whereas the other findings are nonspecific. 4 -6 Hemolysis, elevated liver enzymes, and low platelets (HELLP) occurs in 20% of severe PE. The pathogenesis of this complication is not clear. Involvement of the coagulation system is seen in HELLP patients, which is not present in PE patients without HELLP. Symptoms include malaise, right upper quadrant tenderness, nausea, vomiting, edema, relative or absolute hypertension, and a varying degree of proteinuria. 7 Although the classical severe PE with manifest hypertension is more common in an African population, the HELLP syndrome is...

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Maternal vasculopathy and histologic diagnosis of preeclampsia: Poor correlation of histologic changes and clinical manifestation

Cited by 50 publications

References 19 publications

Placental Chorangiosis: The Association with Oxidative Stress and Angiogenesis

Placental Chorangiosis: The Association with Oxidative Stress and Angiogenesis

Electron and Scanning Microscopic Observations on the Syncytiotrophoblast Microvillous Membrane Contribution to Preeclampsia in Early Placental Rats

Severe Preeclampsia With and Without HELLP Differ With Regard to Placental Pathology

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