The severity of clinical manifestations in preeclampsia correlates with the amount of placental infarction

Abstract

In pregnancies with mild or severe preeclampsia, a large proportion of the placentas had histological signs of pathology, in particular signs of ischemia. The pathology was similar, but more pronounced in severe compared to mild preeclampsia, suggesting mild and severe preeclampsia to have similar underlying etiology.

Placental histopathology associated with pre‐eclampsia: systematic review and meta‐analysis

“…This study meta-analyzes data from publications using this classification, and demonstrates a higher prevalence of both villous and vascular histopathological lesions in the placentae of PE pregnancies than in the placentae of normal pregnancies. The latter finding is in keeping with those of previous studies conducted prior to agreed Ruiz-Quiñonez (2014) 11 Devisme (2013) 7 Maloney (2012) 6 Pathak (2011) 10 Ogge (2011) 5 van Der Merwe (2010) 9 Vinnars (2010) 8 Kos (2005) 4 Devisme (2013) 7 Maloney (2012) 6 Ogge (2011) 5 Kos (2005) Ruiz-Quiñonez (2014) 11 Pathak (2011) 10 van Der Merwe (2010) 9 Vinnars (2010) classifications or when using different histopathological classifications for placental lesions.…”

“…Devisme (2013) 7 Maloney (2012) 6 Ogge (2011) 5 van Der Merwe (2010) 9 Vinnars (2010) 8 Devisme (2013) 7 Maloney (2012) 6 Ogge (2011) Figure 4 Forest plots of odds ratios (ORs) (random-effects model) for vascular lesions in pregnancies complicated by pre-eclampsia and normotensive pregnancies, for all studies (a) and for blinded (b) and unblinded (c) studies. Only first author given for each study.…”

“…This results in placental hypoxia and/or stress and the typical villous and vascular placental lesions associated with PE [1][2][3] . However, the literature on the prevalence, nature and severity of the placental histopathological lesions in PE is conflicting [4][5][6][7][8][9][10][11] . The lack of agreement between studies may result from differences in their design, with retrospective studies being prone to selection bias 8 and unblinded studies being susceptible to operator bias [4][5][6][7] .…”

“…However, the literature on the prevalence, nature and severity of the placental histopathological lesions in PE is conflicting [4][5][6][7][8][9][10][11] . The lack of agreement between studies may result from differences in their design, with retrospective studies being prone to selection bias 8 and unblinded studies being susceptible to operator bias [4][5][6][7] . Furthermore, prior to the recommendations of the Society for Pediatric Pathology for the classification of placental pathology, many of the original investigations were prone to a lack or variation of criteria for defining placental histological features, thereby making the assessment subjective 12 .…”

Placental Component and Pregnancy Outcome in Singleton versus Twin Pregnancies Complicated by Preeclampsia

“…The placental component in singleton pregnancies complicated by PE has been studied thoroughly in different clinical manifestations, such as in term versus preterm PE [20,21], PE with and without early fetal growth restriction [22], in relation to neonatal composite morbidity in cases of late-onset fetal growth restriction [23], and with correlation to the severity of the disease [24,25]. However, to the best of our knowledge, studies investigating the placental vascular component in twin pregnancies complicated by PE are scarce.…”