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The frequency and type of placental histologic lesions in term pregnancies with normal outcome

Authors
  • Romero, Roberto
  • Kim, Yeon Mee
  • Pacora, Percy
  • Kim, Chong Jai
  • Benshalom-Tirosh, Neta
  • Jaiman, Sunil
  • Bhatti, Gaurav
  • Kim, Jung-Sun
  • Qureshi, Faisal
  • Jacques, Suzanne M.
  • Jung, Eun Jung
  • Yeo, Lami
  • Panaitescu, Bogdan
  • Maymon, Eli
  • Hassan, Sonia S.
  • Hsu, Chaur-Dong
  • Erez, Offer
Type
Published Article
Journal
Journal of Perinatal Medicine
Publisher
Walter de Gruyter GmbH
Publication Date
Jul 25, 2018
Volume
46
Issue
6
Pages
613–630
Identifiers
DOI: 10.1515/jpm-2018-0055
Source
De Gruyter
Keywords
License
Yellow

Abstract

Objective To determine the frequency and type of histopathologic lesions in placentas delivered by women with a normal pregnancy outcome. Methods This retrospective cohort study included placental samples from 944 women with a singleton gestation who delivered at term without obstetrical complications. Placental lesions were classified into the following four categories as defined by the Society for Pediatric Pathology and by our unit: (1) acute placental inflammation, (2) chronic placental inflammation, (3) maternal vascular malperfusion and (4) fetal vascular malperfusion. Results (1) Seventy-eight percent of the placentas had lesions consistent with inflammatory or vascular lesions; (2) acute inflammatory lesions were the most prevalent, observed in 42.3% of the placentas, but only 1.0% of the lesions were severe; (3) acute inflammatory lesions were more common in the placentas of women with labor than in those without labor; (4) chronic inflammatory lesions of the placenta were present in 29.9%; and (5) maternal and fetal vascular lesions of malperfusion were detected in 35.7% and 19.7%, respectively. Two or more lesions with maternal or fetal vascular features consistent with malperfusion (high-burden lesions) were present in 7.4% and 0.7%, respectively. Conclusion Most placentas had lesions consistent with inflammatory or vascular lesions, but severe and/or high-burden lesions were infrequent. Mild placental lesions may be interpreted either as acute changes associated with parturition or as representative of a subclinical pathological process (intra-amniotic infection or sterile intra-amniotic inflammation) that did not affect the clinical course of pregnancy.

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