Placental pathology in early-onset fetal growth restriction: insights into fetal growth restriction mechanisms.

IF 1.2 4区 医学 Q4 DEVELOPMENTAL BIOLOGY
Daniela Loredana Bujorescu, Adrian Claudiu Raţiu, Andrei Gheorghe Marius Motoc, Ioan Cosmin Cîtu, Ioan Sas, Ion Florin Gorun, Oana Maria Gorun, Roxana Folescu, Daniela Gurguş
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引用次数: 1

Abstract

Background: Early-onset fetal growth restriction (FGR), an identifiable variant of FGR, exhibits divergences in its severity, management, and placental pathologies when juxtaposed with late-onset FGR. The objective of this cross-sectional investigation was to scrutinize placental pathologies in pregnancies afflicted by early-onset FGR, emphasizing a comparative analysis between cohorts with and without preeclampsia (PE).

Patients, materials and methods: The study encompassed a cohort of 85 expectant mothers who received a diagnosis of early-onset FGR. Rigorous histopathological (HP) and immunohistochemical (IHC) assessments were conducted on the placentas. Comparative analyses were performed, distinguishing between individuals diagnosed with both PE and early-onset FGR, and those presenting normotensive early-onset FGR.

Results: HP analysis unveiled a multitude of shared placental lesions, encompassing retroplacental hemorrhage, expedited villous maturation, infarctions, and calcification-associated fibrin deposits. IHC investigations displayed affirmative immunoreactivity for anti-hypoxia-inducible factor (HIF) and anti-vascular endothelial growth factor (VEGF) antibodies within the placental infarcted villitis. Moreover, noteworthy variances in placental measurements and distinctive lesions were discerned when comparing the PE and early-onset FGR cohort with the normotensive group.

Conclusions: Maternal malperfusion emerged as a pivotal determinant linked to placental lesions in pregnancies affected by early-onset FGR. Remarkably, the occurrence of infarctions, specifically delayed infarctions, exhibited a noteworthy correlation with PE. These findings accentuate the significance of pursuing additional research endeavors aimed at unraveling the intricate mechanisms governing maternal malperfusion and its consequential influence on placental health in the context of early-onset FGR, with particular attention to the interplay with PE.

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Abstract Image

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早发性胎儿生长受限的胎盘病理学:对胎儿生长受限机制的见解。
背景:早发性胎儿生长受限(FGR)是一种可识别的FGR变体,当与晚发性FGR并列时,其严重程度、处理和胎盘病理表现出差异。这项横断面调查的目的是仔细检查患有早发性FGR的妊娠中的胎盘病理,强调有先兆子痫(PE)和无先兆子痫(PE)的队列之间的比较分析。患者、材料和方法:该研究包括85名被诊断为早发性FGR的准妈妈。对胎盘进行严格的组织病理学(HP)和免疫组织化学(IHC)评估。进行比较分析,区分诊断为PE和早发性FGR的个体,以及表现为血压正常的早发性FGR的个体。结果:HP分析揭示了许多共同的胎盘病变,包括胎盘后出血、绒毛加速成熟、梗死和钙化相关的纤维蛋白沉积。IHC研究显示,抗缺氧诱导因子(HIF)和抗血管内皮生长因子(VEGF)抗体在胎盘梗死绒毛炎中具有肯定的免疫反应性。此外,在比较PE和早发性FGR队列与血压正常组时,发现胎盘测量值和明显病变存在显著差异。结论:在早发性FGR影响的妊娠中,母体不当灌注是与胎盘病变相关的关键决定因素。值得注意的是,梗死的发生,特别是延迟性梗死,与PE表现出显著的相关性。这些发现强调了进行额外研究的重要性,旨在揭示在早发性FGR的背景下,母亲不当灌注的复杂机制及其对胎盘健康的影响,特别注意与PE的相互作用。
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来源期刊
CiteScore
1.70
自引率
20.00%
发文量
221
审稿时长
3-8 weeks
期刊介绍: Romanian Journal of Morphology and Embryology (Rom J Morphol Embryol) publishes studies on all aspects of normal morphology and human comparative and experimental pathology. The Journal accepts only researches that utilize modern investigation methods (studies of anatomy, pathology, cytopathology, immunohistochemistry, histochemistry, immunology, morphometry, molecular and cellular biology, electronic microscopy, etc.).
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