Abstract
PURPOSE: to analyze the histopathological patterns of the placental bed arteries in pregnancies complicated by abruptio placentae (AP) and compare them with the normal vascular histology of the placental bed. METHODS: placental bed biopsy was performed in 23 pregnant women with a diagnosis of abruptio placentae associated with high blood pressure (G/HBP) disorders, with gestational age of 28 weeks or more, submitted to cesarean section. The control group (CG) consisted of 30 patients without disease, submitted to cesarean section for obstetric reasons. The selected histological variables were: unaltered pattern, physiological changes, medial layer disorganization, hyperplastic changes, acute necrosis and atherosis. RESULTS: in patients with AP associated with HBP there was a significant predominance of medial layer disorganization and hyperplastic changes, compared to CG, while physiological changes in spiral arteries were statistically more common in CG. Findings of acute necrosis and atherosis were observed in a low number of G/HBP, with no statistical significance. CONCLUSIONS: in pregnant women with AP associated with HBP the predominant vascular histological findings were medial layer disorganization and hyperplastic changes. The presence of histopathological features was significantly higher in G/HBP, with prevalence of medial layer disorganization. Normal histological pattern, i.e., physiological changes, were more prevalent in CG.
Highlights
11.Robertson WB, Khong TY, Brosens I, De Wolf F, Sheppard BL, Bonnar J
Purpose: to analyze the histopathological patterns of the placental bed arteries in pregnancies complicated by abruptio placentae (AP) and compare them with the normal vascular histology of the placental bed
Methods: placental bed biopsy was performed in 23 pregnant women with a diagnosis of abruptio placentae associated with high blood pressure (G/HBP) disorders, with gestational age of 28 weeks or more, submitted to cesarean section
Summary
Maria Rita de Souza Mesquita[1], Nelson Sass[1], João Norberto Stavalle[2], Luiz Camano[1]. Objetivo: análise histopatológica das artérias espiraladas do leito placentário em gestações complicadas pelo descolamento prematuro da placenta (DPP) associado à hipertensão, comparando-as com a estrutura vascular dos leitos placentários normais. Método: a biópsia do leito placentário foi realizada em 23 gestantes com diagnóstico de descolamento prematuro de placenta associado à hipertensão (G/HA) e idade gestacional maior ou igual a 28 semanas, submetidas ao parto cesáreo. Resultados: nas pacientes com DPP associado à hipertensão ocorreu uma predominância significativa de desorganização da camada média, detectada em 50% das pacientes, e de alterações hiperplásicas, em comparação ao GC, ao passo que a presença de modificações fisiológicas foi estatisticamente mais significante no GC. Nasceu a nossa motivação de estudar os aspectos histopatológicos dos vasos uteroplacentários em gestações complicadas pelo descolamento placentário, com o desiderato de contribuir para o melhor entendimento da fisiopatologia desta grave enfermidade obstétrica
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