The human materno-foetal relationship in malaria. II. Histological, ultrastructural and immunopathological studies of the placenta

Abstract

Histological and ultrastructural studies of four placentae heavily infectd with Plasmodium falciparum revealed large intervillous accumulations of erythrocytes containing parasites together with monocytes which had ingested pigment. These appearances were associated with focal syncytial necrosis, loss of syncytial microvilli and proliferation of cytotrophoblastic cells. In addition, marked irregular thickening of trophoblastic basement membranes and protrusion of tongue-like projections of syncytiotrophoblast into the basement membrane were observed. In six other placentae which contained scanty amounts of pigment but no parasites, representing past or inactive infection, no large collections of monocytes or abnormalities of trophoblast were apparent but basement membrane thickening was evident. Immunohistological studies revealed no significant differences between placentae positive for parasites and those containing pigment only, although the amount of certain immunoproteins and clotting factors was clearly increased above normal. These findings establish that P. falciparum infection in the placenta may result in substantial damage although lesions within the villus are rare. Furthermore, previous infection, although adequately controlled, may leave a heritage of pigment deposition, basement membrane thickening and immunopathological lesions. These results may thus account for both the high frequency of intra-uterine growth retardation and the rarity of congenital malaria in the presence of P. falciparum malaria.

Influence of Malarial Infection on the Maternal‐foetal Relationship in Pregnant Mice

“…The poor development of the foetuses with lower birth weight may be related to the aggravation of anaemia consequent to parasitaemia or to the placental abnormalities demonstrated here. Similar placental abnormalities have been shown to occur in malarial infection in human pregnancy (Galbraith, Fox and Galbraith, 1980). This model of malarial infection in pregnant mice therefore offers a good situation for the study of the course of malarial infection in pregnancy and its effect on foetal development.…”

Murine Malaria Infection Induces Fetal Loss Associated with Accumulation ofPlasmodium chabaudiAS-Infected Erythrocytes in the Placenta

“…These data demonstrate that there is an accumulation of P. chabaudi AS-infected RBCs in the placentae of infected mice, with statistically significantly higher levels than in the peripheral blood being found only in mice undergoing abortion. Contrary to what has been reported in the placentae of malaria-infected pregnant women (22,45,74), preliminary histopathological analysis revealed little accumulation of monocyte/macrophages in the placentae of IP mice (J.…”

Placental Malaria in Colombia: Histopathologic Findings in Plasmodium vivax and P. falciparum Infections

“…The placental intervillous space is the area where most placental malariaassociated injuries occur. In the case of P. falciparum, specific changes in the placenta are evident, 11,[18][19][20][21][22][23][24][25][26] including hemozoin deposition, which might have an interesting role in the pathogenesis of gestational malaria or placental malaria.…”