Abstract
The placenta plays vital roles during fetal development and growth. The ultrastructure of the placenta together with remodeling of the uterine spiral arteries are very important to maintain the utero-placental blood flow. Preeclampsia (PE) is a multifactorial disorder with abnormal placentation affecting the mother and fetus. The aim of this study was to study the ultrastructural abnormalities of the placenta in cases of PE. The placentas of 10 PE women and 10 controls were studied. Women of PE group were delivered by caesarian section while seven control women were delivered vaginally, and three by caesarian section. Placental samples were studied both morphologically and histologically by light and transmission electron microscopy. Light microscopic study of control placentas showed numerous microvilli, few syncytial knots, thin-walled blood vessels. PE placentas showed reduced number of microvilli with numerous syncytial knots, thick-walled vessels, edematous spaces, fibrotic areas and fibrinoid degeneration. Electron microscopic study of the control placentas showed a thick layer of syncytiotrophoblast (Sy), numerous microvilli and a thin layer of cytotrophoblast (Cy). PE placenta showed hypertrophy of Cy with atrophy of Sy and scarce microvilli. The trophoblast showed edematous vacuoles and glycogen storage areas. The villous core had congested capillaries, edematous spaces, glycogen storage areas and widespread areas of fibrosis. All the changes in PE placentas were attributed to hypoxia and oxidative stress and reduced utero-placental flow due to abnormal remodeling of the uterine spiral arteries that was aggravated by the thick placental barrier and the presence of edema, fibrosis and glycogen storage areas.
Highlights
The intrauterine existence of the fetus depends upon a vital organ; the Placenta
The villi are covered by a multinucleated syncytial layer, the syncytiotrophoblast (Sy) and a deeper thin layer of cytotrophoblast (Cy) which gets thinner as pregnancy proceeds but persists until term [2]
Morphometric results The present study recorded significant changes in cases of PE as reduction of the gestational age and neonatal weight together with reduction of morphometric data regarding the placental diameter and weight when compared with control placentas. (Table 1)
Summary
The intrauterine existence of the fetus depends upon a vital organ; the Placenta. It is essential for maintenance of pregnancy and fetal growth and development [1]. It performs a lot of functions that will be taken later on by different organs as the lungs, liver, gut, kidneys and endocrine glands. The structure of the mature placenta has been dealt with in detail elsewhere; its fetal surface presents a tree of chorionic villi that invade the uterine vessels to let the maternal blood reach the intervillous spaces. The uterine spiral arteries undergo remodeling; loss of smooth muscle cells from their walls; resulting in their dilatation that will help reduction of the velocity of the maternal blood flow [5]
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