Clinical and Histological Associations of Chronic Inflammatory Lesions in Preterm Placentas: Uncovering the Hidden Dangers.

IF 1.3 4区医学 Q3 PATHOLOGY

Pediatric and Developmental Pathology Pub Date : 2024-01-01 Epub Date: 2023-10-06 DOI:10.1177/10935266231194161

Gayatri Ravikumar, Victoria Liza

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引用次数: 0

Abstract

Background: Chronic placental inflammatory lesions (CPIL) include chronic deciduitis (CD), villitis of unknown etiology (VUE), and chronic chorioamnionitis (CCA). The frequency of these lesions and their relationship with various clinicopathological parameters in preterm birth (PTB) is presented.

Material and methods: Preterm placentas from April 2018 to December 2020 were reviewed for presence of CPIL. PTB was classified as spontaneous, indicated, or mixed phenotype. The association of CPIL with clinical parameters like gestational age, birth weight, obstetric complications, and placental parameters like placental dimensions, weight, vascular malperfusion, acute inflammatory lesions, and basal plate myometrial fibers were analyzed.

Results: The study included 538 preterm placentas with 54.3% from indicated PTB. CD was more common (28.4%) than VUE (17.8%) and CCA (12.6%). CD showed significant association with VUE and CCA (both P = .0001) and VUE with CCA (P = .0001). CD was more common in indicated PTB (33.8%, P = .002) and associated with lower birth weight (1591 g vs 1705 g, P = .003), lower placental weight (270.7 g vs 296.9 g, P = .004), length (14.2 cm vs 14.8 cm, P = .006), breadth (11.7 cm vs 12.2 cm, P = .007), maternal vascular malperfusion (P = .004), and basal plate myometrial fibers (P = .02). High-grade and multifocal low-grade VUE was associated with reduced placental length (13.9 cm vs 14.6 cm, P = .02)and breadth (11.5 cm vs 12.1 cm, P = .01). CCA did not show any other association.

Conclusion: CPIL are common in PTB and their coexistence suggested a common pathogenic mechanism. Placental examination is the only definite way to identify as they lack clinical signs and symptoms. The smaller placental size associated with these lesions may suggest alter mechanisms for adverse pregnancy outcomes.

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早产胎盘慢性炎症性病变的临床和组织学相关性：揭开隐患。

背景：慢性胎盘炎性病变（CPIL）包括慢性蜕膜炎（CD）、病因不明的绒毛炎（VUE）和慢性绒毛膜羊膜炎（CCA）。介绍了早产（PTB）中这些病变的频率及其与各种临床病理参数的关系。材料和方法：对2018年4月至2020年12月的早产胎盘进行CPIL检查。PTB分为自发性、指示性或混合表型。分析了CPIL与临床参数（如胎龄、出生体重、产科并发症）以及胎盘参数（如胎盘尺寸、体重、血管灌注不良、急性炎症病变和底板肌层纤维）的相关性。结果：该研究包括538例早产胎盘，其中54.3%来自PTB。CD的发生率（28.4%）高于VUE（17.8%）和CCA（12.6%），CD与VUE和CCA有显著相关性（均P = .0001）和VUE与CCA（P = .0001）。CD在指示PTB中更常见（33.8%，P = .002），并与较低的出生体重有关（1591 g与1705 g、 P = .003），胎盘重量较低（270.7 g与296.9 g、 P = .004），长度（14.2 厘米vs 14.8 cm，P = .006），宽度（11.7 厘米vs 12.2 cm，P = .007）、母体血管灌注不良（P = .004）和基底板肌层纤维（P = .02）。高级别和多灶性低级别VUE与胎盘长度缩短有关（13.9 厘米vs 14.6 cm，P = .02）和宽度（11.5 厘米vs 12.1 cm，P = .01）。CCA没有显示任何其他关联。结论：CPIL在PTB中常见，二者共存提示其共同的致病机制。胎盘检查是唯一确定的识别方法，因为它们缺乏临床体征和症状。与这些病变相关的较小胎盘大小可能表明不良妊娠结局的机制发生了变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric and Developmental Pathology 医学-病理学

CiteScore

3.70

自引率

5.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal covers the spectrum of disorders of early development (including embryology, placentology, and teratology), gestational and perinatal diseases, and all diseases of childhood. Studies may be in any field of experimental, anatomic, or clinical pathology, including molecular pathology. Case reports are published only if they provide new insights into disease mechanisms or new information.