Adult ; Female ; Hemangioma ; pathology ; Humans ; Mesoderm ; pathology ; Placenta ; pathology ; Placenta Diseases ; pathology ; Pregnancy ; Young Adult

Adult ; Chronic Disease ; Female ; Humans ; Placenta ; pathology ; Placenta Diseases ; diagnosis ; pathology ; Pregnancy

The effect of the death or removal of the fetuses at the middle and late stages of pregnancy to the placenta in rats is studied. Either death or removal of the fetuses during pregnancy brought rapid degeneration of all elements of the placenta, first in the yolk sac followed by labyrinth and junctional zone leading into ischemic necrosis secondary to the thrombosis of the maternal blood vessels supplying the placenta. Trophoblasts in the junctional zone survived for a short period of time, but no evidence of abnormal or continuous proliferation of them was noted. Shortly after the death or removal of fetuses cystic degeneration in the junctional zone was observed, but no definite evidence of mole like change was noted. Findings of periodic acid Schiff's reaction, methyl-green pyronine staining and Feulgen reaction in the normal and degenerating placentas are described. The circulatory factors and structural differences between the rat and human placentas are discussed to account for differences observed in the placental changes following the death of fetuses in rats from those of human.
Animals ; Female ; Fetal Death/*pathology ; Placenta/*pathology ; Pregnancy ; Rats

OBJECTIVETo explore the pathologic features and prognosis of early and late onset severe preeclampsia.

METHODSAn observational study was conducted in 178 cases of severe preeclampsia collected during January 2010 to December 2014 from Haidian Maternal and Child Health Hospital.The cases were divided into two groups according to the onset of gestational age of the severe preeclampsia, with 54 cases of namely early onset (onset ≤ 34 weeks) and 124 cases of late onset (onset >34 weeks). Clinical characteristics of the patients, perinatal outcome and the pathologic characteristics of the placentas in each group were evaluated.

RESULTSDecidual vascular disease, placental infarction, abruptio placentae and placental villi dysplasia were seen in both groups. The incidence of placental villi dysplasia was the highest, followed by placental infarction. Incidence of severe decidual vascular disease of early and late onset severe decidual vascular disease were 16.7% (9/54) and 5.6% (7/124), respectively.Incidence of placental infarction of early and late onset severe preeclampsia were 48.1% (26/54) and 61.3% (76/124). Incidence of placental villi dysplasia of early and late onset severe preeclampsia were 79.6% (43/54) and 50.8% (63/124). Incidence of Severe decidual vascular disease, placental infarction and placental villi dysplasia were significantly different between early and late onset severe preeclampsia cases (P<0.05), while there was no difference in decidual vascular disease and placenta thrombi (P>0.05). Fetal survival rate of every group was 81.5% (44/54) and 93.5% (116/124). Incidence of fetal growth retardation was 55.6% (30/54) and 38.7% (48/124). The fetal survival rate and incidence of fetal growth retardation were different between two groups (P<0.05).

CONCLUSIONSThe incidence of decidual vascular disease and placental villi dysplasia in early onset severe preeclampsia is higher than those in late onset severe preeclampsia. Neonatal outcome and prognosis in early onset severe preeclampsia are worse than those in late onset severe preeclampsia.

Chorionic Villi ; pathology ; Female ; Fetus ; Gestational Age ; Humans ; Placenta ; pathology ; Placenta Diseases ; epidemiology ; pathology ; Pre-Eclampsia ; epidemiology ; pathology ; Pregnancy

Humans ; Female ; Pregnancy ; Placenta ; Lung/pathology* ; Tomography, X-Ray Computed

OBJECTIVETo investigate the clinicopathological characteristics, diagnostic criteria and differential diagnosis of placental chorioangioma.

METHODSTwenty-five cases of placental chorioangioma were analyzed for their clinical data, histomorphology and immumohisto chemical staining. Relevant literature was reviewed.

RESULTSThe average age of the 25 patients was 29 years. Fourteen patients had full-term pregnancy, 10 had preterm labor, and 1 had intrauterine fetal death. Nineteen patients had pregnancy complications. The tumors presented as red or dusty pink nodules with clear borders. The tumor size ranged from 1 to 16 cm. Microscopically, the tumors possessed abundant capillaries or cavernous blood spaces lined by hyperplastic endothelial cells. These cells were positive for CD34 and Ki-67 index < 10%.

CONCLUSIONSPlacental chorioangioma is a rare benign tumor of the placenta, and is associated with various pregnancy complications. Misdiagnosis of cell-rich type tumor should be avoided.

Adult ; Diagnosis, Differential ; Endothelial Cells ; pathology ; Female ; Fetal Death ; Hemangioma ; pathology ; Humans ; Infant, Newborn ; Placenta ; pathology ; Placenta Diseases ; pathology ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; Stillbirth

OBJECTIVETo investigate the pathologic features of histologic chorioamnionitis (HCA) and its impact on newborns.

METHODSFrom Jun.2012 to Dec.2014, 5 810 placentas delivered in our hospital were collected. There were 898 HCA cases and positive rate was 18.3%.Cases with complete clinical data were collected, including 308 cases of infected newbon infants (case group), and 120 cases of non-infected infants(control group). The correlation between pathologic results and neonatal outcome was analyzed.

RESULTSThirty nine cases were premature delivery (39/428, 9.1%). Twenty one cases were small for gestational age (21/428, 4.9%). One hundred and eleven cases were delivered by caesarean section (111/428, 25.9%). Three hundred and eight cases of neonatal infection included 104 cases of hematosepsis, 16 cases of purulent meningitis, 78 cases of infectious pneumonia, 34 cases of infective enteritis, 18 cases of urinary tract infection and 58 cases of skin infection.Placental pathological examination found out 40 cases showed mild HCA (18 cases of neonatal infection, and 22 non-neonatal infection cases), 104 cases showed moderate HCA (88 cases of neonatal infection, and 16 non-neonatal infection cases), and 183 cases showed severe HCA (172 cases of neonatal infection and 11 non-neonatal infection cases). Moderate to severe HCA were easily found in premature infants, with higher positive rate of both late pregnancy group B streptococcus (P<0.05) and afterbirth blood culture (P<0.05). Significantly higher serum C reaction protein (P<0.05) and white-cell count(P<0.05) were also found within moderate to severe HCA patients. Moderate to severe HCA, funisitis and syncytial nodular hyperplasia were associated with neonatal infections (P<0.05), while infarction, intervillous thrombosis and villi thrombus were not observed in the inflammation group (P>0.05).

CONCLUSIONSHCA is often of few clinical symptoms and easily misdiagnosed by placental pathological assessment only. HCA is found associated with intrauterine infection and neonatal infection. Pathological assessment of placenta is valuable in diagnosis and treatment of intrauterine infection.

Chorioamnionitis ; pathology ; Female ; Humans ; Infant, Newborn ; Inflammation ; pathology ; Leukocyte Count ; Placenta ; pathology ; Pregnancy

OBJECTIVE: To investigate the invason of trophoblasts in the placenta bed and the change of spiral arteries and microvessels in pre-eclampsia and normal pregnancy. METHODS: Twenty cases of normal pregnancies, mild pre-eclampsia and severe pre-eclampsia were chosen as Group A, Group B, and Group C. HE staining and immunohistochemistry staining (SP method) were used to observe the depth and the density of trophoblasts invading the placenta bed and the change of spiral arteries and microvessels. RESULTS: The significant difference in the degree of invasion was in the superficial myometrial segment. Group C was the most superficial in the 3 groups (P<0.01). The density of trophoblasts which invaded the placenta bed in the lower half of the basal decidual segment and the myometrial segment showed us Group C was the lowest (P<0.01). There was statistical difference among the 3 groups (P<0.01). The average lumen area of the spiral arteries in the decidual segment and the superficial myometrial segment of the placenta bed was the smallest in Group C among the 3 groups(P<0.01) and there was statistical difference among the 3 groups (P<0.01). The spiral arteries were the thickest in Group C with statistical difference among the 3 groups (P<0.01). The physiological and pathological change of the spiral arteries was mainly in the superficial myometrial segment. The incidence rate of physiological changes in the spiral arteries was the lowest in Group C with statistical difference among the 3 groups (P<0.01). The incidence rate of pathological changes was the highest in Group C (P<0.01) and the normal group was the highest. There was significant difference among the 3 groups(P<0.01). There was positive correlation between the physiological change of the spiral arteries and the invaing degree of the trophoblasts (P<0.05), there was negative correlation between the pathological change of the spiral arteries and the invasion depth as well as the invasion density of the trophoblasts(P<0.05). There was negative correlation between the physiological change and the pathogenetic condition of pre-eclampsia(P<0.05)while there was positive correlation between the pathological change and the pathogenetic condition degree of pre-eclampsia(P<0.05). There was negative correlation between the invasion depth as well as density in uteruso superficial myometrial segment by trophoblast and the pathogenetic condition degree of pre-eclampsia(P<0.05). There was invasion trophoblast in 62.50% lumen wall of spiral arteries in uterus superficial myometrial segment of the placental bed in normal pregnancy while 27.5% was seen in severe pre-eclampsia. Microvascular density in the decidual segment and the superficial myometrial segment of the placenta bed in Group C was the lowest among the 3 groups with statistical difference (P<0.01). CONCLUSION The invasion depth of the trophoblasts in pre-eclampsia was more superficial than normal pregnancy.The changes of the invasion of the trophoblasts and the pathological changes of the spiral arteries in the placenta bed mainly existed in the superficial myometrial segment which was closely related to the severity of the illness. That microvascular density in the placental bed of pre-eclampsia started to decrease from the basal decidual segment shows that the microvessel development in the placenta bed is impaired in pre-eclampsia.
Adult ; Arteries ; pathology ; Capillaries ; pathology ; Female ; Humans ; Placenta ; blood supply ; pathology ; Pre-Eclampsia ; pathology ; Pregnancy ; Trophoblasts ; pathology

BackgroundCesarean section (CS) is an independent risk factor for placenta accreta. Some researchers think that the timing of primary cesarean delivery is associated with placenta accreta in subsequent pregnancies. The aim of this study was to investigate the risk of placenta accreta following primary CS without labor, also called primary elective CS, in a pregnancy complicated with placenta previa.

Methods:A retrospective, single-center, case-control study was conducted at Peking University Third Hospital. Relevant clinical data of singleton pregnancies between January 2010 and September 2017 were recorded. The case group included women with placenta accreta who had placenta previa and one previous CS. Control group included women with one previous CS that was complicated with placenta previa. Maternal age, body mass index, gestational age, fetal birth weight, gravity, parity, induced abortion, the rate of women received assisted reproductive technology, other uterine surgery, and primary elective CS were analyzed between the two groups.

Results:The rate of primary elective CS (90.1% vs. 69.9%, P < 0.001) was higher, and maternal age was younger (32.7 ± 4.7 years vs. 34.6 ± 4.0 years, P < 0.001) in case group, compared with control group. Case group also had higher gravity and induced abortions compared with the control group (both P < 0.05). Primary CS without labor was associated with significantly increased risk of placenta accreta in a subsequent pregnancy complicated with placenta previa (odds ratio: 3.32; 95% confidential interval: 1.68-6.58).

Conclusion:Women with a primary elective CS without labor have a higher chance of developing an accreta in a subsequent pregnancy that is complicated with placenta previa.

Adult ; Body Mass Index ; Case-Control Studies ; Cesarean Section ; adverse effects ; Female ; Humans ; Placenta Accreta ; pathology ; Placenta Previa ; pathology ; Pregnancy ; Retrospective Studies

Antigens, CD34 ; metabolism ; Choriocarcinoma ; pathology ; Diagnosis, Differential ; Female ; Hemangioma ; metabolism ; pathology ; Humans ; Keratin-18 ; metabolism ; Mesenchymoma ; pathology ; Placenta ; pathology ; Placenta Diseases ; metabolism ; pathology ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Pregnancy ; Pregnancy Complications, Neoplastic ; metabolism ; pathology ; Young Adult