A case-control study of placental lesions associated with pre-eclampsia

详细信息    查看全文

• 作者：Louise Devisme^a ; Benjamin Merlot^b ; ^{benmerlot@gmail.com} ; Anne Ego^b ; Veronique Houfflin-Debarge^b ; Philippe Deruelle^b ; Damien Subtil^b ; ^c
• 关键词：Hypoxia ; Ischemia ; Placental lesion ; Pre-eclampsia ; Pregnancy
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：120
• 期：2
• 页码：165-168
• 全文大小：128 K

文摘

Objective

To investigate gross and microscopic placental lesions associated with pre-eclampsia and to determine which lesions are most strongly linked to serious pregnancy complications.

Methods

A retrospective case-control study of 173 placentas from women with pre-eclampsia and 173 placentas from healthy normotensive women was conducted.

Results

The mean placental weight in the pre-eclampsia group was lower than that recorded for the control group (280 g vs 360 g; P < 0.001). Infarcts (65.9 % vs 13.2 % ; P < 0.001) and placental abruption (P < 0.001) were most frequent among women with pre-eclampsia. Microscopic findings showed the following lesions to be associated with pre-eclampsia: hypermature villi, defined by absence of intermediate villi (72 % vs 16 % ; P < 0.001), excessive syncytial knots (90 % vs 9 % ; P < 0.001), decidual vasculopathy (51 % vs 8 % ; P < 0.001), villous fibrosis (6 % vs 0 % ; P < 0.001), erythroblastosis (11 % vs 4 % ; P < 0.01), and avascular terminal villi (9 % vs 3 % ; P < 0.05). Increased syncytial knots, infarcts, basal decidual vasculopathy, hypermature villi, and placental erythroblastosis were still associated with pre-eclampsia after logistic regression modeling.

Conclusion

Placental lesions most strongly associated with pre-eclampsia were all causes or expressions of placental hypoxia or ischemia, which appears as the primary mechanism of pre-eclampsia.