Trophoblast Thickness Research Articles

PSX-B-21 Equine Embryo Viability Based on Morphokinetics

Abstract The objective of this study was to analyze equine embryo morphokinetics and whether or not they were indicative of survivability upon successful implantation into the uterus of a recipient female. In equine reproduction, fertility is a lowly heritable trait that has an exceedingly large financial impact on the ability to grow genetic lines. In order to increase pregnancy rates, producers must have access to accurate decision-making tools. Ten (n = 10) fertilized equine embryos collected via flushing by licensed veterinarian, Dr. Gregg Veneklasen, DVM in Canyon, TX. Flushed embryos were filmed for a thirty-five (35) second observation period with an Iolight Microscope and then processed through video motion magnification (VMM) software Lambda Vue, that amplified embryo activity 300x their normal movement. These VMM embryos were then assessed for time specific morphological changes using Image J software. Embryo morphological dimension shifts previously unseen under a simple microscope became humanly perceptible and measurable. For morula stage embryos, measurements of significance were taken on the inner cell mass (ICM), total embryo area, trophoblast to ICM distance, and finally the vertical, diagonal, and horizontal axis of the sub-zonal distance. Protocols were developed for embryos in the blastocyst stages, where measurements were taken on the vertical, diagonal, and horizontal axis of the total embryo, area of the embryo, notation of general ICM location, and trophoblast thickness around the embryo face. All measurements were taken in microns every five seconds for the thirty-five second recording period. Findings presented that embryos with a greater ICM, total embryo area, and sub-zonal vertical, diagonal, and horizontal distance established pregnancies as frequently as embryos with less momentous differences in distance (P < 0.1). This research has shown the relationship between morphokinetics and pregnancy had no significance of determining pregnancy viability. This resulted in enhanced prediction of embryo transfer techniques based on traditional grading, making pregnancy rates more predictable and consistent.

VP60.03: An observational study: does pregnancy implantation site and trophoblastic ring thickness at early gestational scan predict outcomes of pregnancy?

VP60.03: An observational study: does pregnancy implantation site and trophoblastic ring thickness at early gestational scan predict outcomes of pregnancy?

Combining early (

Placental related adverse pregnancy outcomes such as fetal growth restriction have significant short- and long-term implications for both mother and fetus. This study aimed to determine if conventional and novel early first trimester ultrasound measures are associated with small for gestational age (SGA) neonates. In addition, we aimed to assess whether a combination of ultrasound measures, maternal characteristics and biochemistry improved the prediction of this adverse pregnancy outcome. This was a prospective cohort study including ultrasound measurements: trophoblast thickness (TT), trophoblast volume (TV), mean uterine artery pulsatility index, crown-rump length, fetal heart rate, mean sac diameter (MSD) and yolk sac diameter. Biochemical markers considered in the analysis were placental growth factor (PIGF), pregnancy - associated plasma protein A (PAPP-A), beta human chorionic gonadotropin and alpha fetoprotein. Regression models were fitted for ultrasound parameters using multiples of the median (MoM). All measures were compared with normal birthweight (BW) ≥10th centile and SGA (BW<10th centile). Logistic regression analysis was used to create a clinical prediction model for SGA based on maternal characteristics, ultrasound measurements at <11weeks gestational age and maternal biochemistry collected at 10-14weeks. As compared to pregnancies delivered of babies with normal BW (n=1068), MoM values for TT, TV, MSD, PAPP-A and PIGF were significantly reduced (P<0.05) in pregnancies delivered of SGA babies (n=73). The proposed logistic regression model includes maternal height, TV and PIGF resulting in an area under the receiver operator curve 0.70 (95% CI 0.63-0.76) for the prediction of SGA. A significantly decreased TV, measured <11weeks gestation, is predictive of BW<10th centile. With addition of maternal height and PIGF, this three-marker algorithm provided a reasonable predictive value for the development of SGA later in pregnancy.

First-trimester ultrasound features associated with subsequent miscarriage: A prospective study.

First-trimester miscarriage is common, with women increasingly offered an ultrasound scan early in the first trimester to assess the status of their pregnancy. Ultrasound is uniquely situated to significantly impact the clinical management of these women. This study aims to determine whether there were any differences in the early ultrasound appearances of pregnancies that continued to be viable or resulted in miscarriage before 12 weeks gestation. This was a prospective cohort study including ultrasound measurements: mean sac diameter (MSD), yolk sac diameter (YSD), crown-rump length (CRL), fetal heart rate (FHR), trophoblast thickness, trophoblast volume (TTV) and mean uterine artery pulsatility index (meanUAPI). Regression models were fitted for each parameter and Z-scores compared between cohorts that progressed or miscarried after the scan but before 12 weeks gestation. Logistic regression analysis was used to create a prediction model for miscarriage prior to 12 weeks gestation based on the standardised ultrasound measurements recorded during the early first-trimester scan. Comparison of Z-Scores for meanUAPI, TTV, FHR and MSD demonstrated significant variation between the two groups. The proposed logistic regression model resulted in an area under the receiver operator curve of 0.81. At a false-positive rate of 30%, the model resulted in a sensitivity of 76% (95% CI 64-89%). The combination of FHR, meanUAPI, TTV in a prediction model for miscarriage may prove to be of value for ongoing pregnancy management in the first trimester.

Placental features of mirror syndrome: a case report

Mirror syndrome, is a rare condition characterised by the combination of fetal hydrops and maternal oedema. Mirror syndrome is rare, consequently the pathogenesis and pathophysiology is unknown. It is associated...

P04.15: Correlations between trophoblast thickness and spontaneous abortion—statistical study

P04.15: Correlations between trophoblast thickness and spontaneous abortion—statistical study

Review: Marsupials: Placental Mammals with a Difference

The placenta is the most varied organ within the Mammalia. There are many similarities, as well as some differences, between the marsupial embryo and those of eutherian mammals. The most striking difference is the lack of the inner cell mass in the blastocyst which consists solely of a single layer of trophoblast cells. The trophoblast expands and eventually becomes part of the definitive chorio-vitelline placenta. The degree of functional differentiation between the vascular and non-vascular parts of the yolk sac placenta differs between species in the relative surface area that is attached to the endometrium, in trophoblast thickness, in yolk sac fusion with the luminal epithelium and most markedly in the degree of invasiveness. In marsupials, placental physiology has been best studied in the tammar wallaby. Despite the lack of invasion in the tammar, there is nevertheless maternal recognition of pregnancy in response to trophoblast formation. Contrary to popular opinion, the tammar placenta also elaborates hormones: at term it secretes prostaglandin F2α and accumulates cortisol, and it expresses genes for hormones such as growth hormone, IGF2 and relaxin. As in eutherian mammals, genomic imprinting is important for placental function. Despite the relatively short period of placentation, it is clear that the trophoblast and the placenta it forms are as important for successful pregnancy in marsupial as in eutherian mammals. Marsupials are certainly placental mammals. However marsupials have an additional trick in their pouches, with the physiologically sophisticated and extended lactation that has allowed them to exchange the umbilical cord for the teat.

P422 Correlations between trophoblast thickness and spontaneous abortion – statistical study

International Journal of Gynecology & ObstetricsVolume 107, Issue S2 p. S534-S534 Poster presentations P422 Correlations between trophoblast thickness and spontaneous abortion – statistical study N. Cernea, N. CerneaSearch for more papers by this authorL. Novac, L. NovacSearch for more papers by this authorD. Iliescu, D. IliescuSearch for more papers by this authorA. Comanescu, A. ComanescuSearch for more papers by this authorR. Capitanescu, R. CapitanescuSearch for more papers by this authorS. Tudorache, S. TudoracheSearch for more papers by this author N. Cernea, N. CerneaSearch for more papers by this authorL. Novac, L. NovacSearch for more papers by this authorD. Iliescu, D. IliescuSearch for more papers by this authorA. Comanescu, A. ComanescuSearch for more papers by this authorR. Capitanescu, R. CapitanescuSearch for more papers by this authorS. Tudorache, S. TudoracheSearch for more papers by this author First published: 20 November 2009 https://doi.org/10.1016/S0020-7292(09)61914-7AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume107, IssueS2Abstracts of XIX FIGO World Congress of Gynecology and ObstetricsOctober 2009Pages S534-S534 RelatedInformation

Particulate Urban Air Pollution Affects the Functional Morphology of Mouse Placenta1

In humans, adverse pregnancy outcomes (low birth weight, prematurity, and intrauterine growth retardation) are associated with exposure to urban air pollution. Experimental data have also shown that such exposure elicits adverse reproductive outcomes. We hypothesized that the effects of urban air pollution on pregnancy outcomes could be related to changes in functional morphology of the placenta. To test this, future dams were exposed during pregestational and gestational periods to filtered or nonfiltered air in exposure chambers. Placentas were collected from near-term pregnancies and prepared for microscopical examination. Fields of view on vertical uniform random tissue slices were analyzed using stereological methods. Volumes of placental compartments were estimated, and the labyrinth was analyzed further in terms of its maternal vascular spaces, fetal capillaries, trophoblast, and exchange surface areas. From these primary data, secondary quantities were derived: vessel calibers (expressed as diameters), trophoblast thickness (arithmetic mean), and total and mass-specific morphometric diffusive conductances for oxygen of the intervascular barrier. Two-way analysis of variance showed that both periods of exposure led to significantly smaller fetal weights. Pregestational exposure to nonfiltered air led to significant increases in fetal capillary surface area and in total and mass-specific conductances. However, the calibers of maternal blood spaces were reduced. Gestational exposure to nonfiltered air was associated with reduced volumes, calibers, and surface areas of maternal blood spaces and with greater fetal capillary surfaces and diffusive conductances. The findings indicate that urban air pollution affects placental functional morphology. Fetal weights are compromised despite attempts to improve diffusive transport across the placenta.

Maternal Insulin-like Growth Factor-II Promotes Placental Functional Development Via the Type 2 IGF Receptor in the Guinea Pig

In guinea pigs, maternal insulin-like growth factor (IGF) infusion in early-pregnancy enhances placental transport near-term, increasing fetal growth and survival. The effects of IGF-II, but not IGF-I, appear due to enhanced placental labyrinthine (exchange) development. To determine if the type-2 IGF receptor (IGF2R) mediates these distinct actions of exogenous IGF-II in the mother, we compared the impact of IGF-II with an IGF-II analogue, Leu 27-IGF-II, which only binds the IGF2R. IGF-II, Leu 27-IGF-II (1 mg/kg per day.sc) or vehicle were infused from days 20–38 of pregnancy (term = 67 days) and placental structure and uptake and transfer of [ 3H]-methyl- d-glucose (MG) and [ 14C]-amino-isobutyric acid (AIB) and fetal growth and plasma metabolites, were measured on day 62. Both IGF-II and Leu 27-IGF-II increased the volume of placental labyrinth, trophoblast and maternal blood space within the labyrinth and total surface area of trophoblast for exchange, compared to vehicle. Leu 27-IGF-II also reduced the barrier to diffusion (trophoblast thickness) compared to vehicle and IGF-II. Both IGF-II and Leu 27-IGF-II increased fetal plasma amino acid concentrations and placental transfer of MG to the fetus compared to vehicle, with Leu 27-IGF-II also increasing AIB transport compared with vehicle and IGF-II. In addition, Leu 27-IGF-II increased fetal weight compared to vehicle. In conclusion, maternal treatment with IGF-II or Leu 27-IGF-II in early gestation, induce similar placental and fetal outcomes near term. This suggests that maternal IGF-II in early gestation acts in part via the IGF2R to persistently enhance placental functional development and nutrient delivery and promote fetal growth.

Histological classification of chorionic villous vascularization in early pregnancy

The objective of the study was to assess the reproducibility of a new classification for early pregnancy chorionic villous vascularization (Grade: I, normal; IIA, mild hypoplasia; IIB, severe hypoplasia and III, avascular) for routine microscopic examination in daily clinical practice. In this observational study, four observers scored first trimester chorionic villous vascularization. Scoring was performed in microscopic slides of chorionic tissue obtained by D&C in 30 patients with early pregnancy loss due to empty sac (n = 10), fetal death (n = 10) and termination of pregnancy (n = 10) using the new classification. Ultrasonographic measurement of trophoblastic thickness (TT) at the implantation site was available in all patients and in a reference group of 100 ongoing singleton pregnancies. The vascularization score could therefore be related to the TT. The new classification resulted in a good-to-excellent agreement in histological scoring (0.73-0.90) between investigators (kappa 0.64-0.86). TT was not related to either vascularization or pregnancy outcome and only partly to hydropic degeneration. The vascularization scoring system is a simple, valid and effective method for assessment of chorionic villous vascularization. It is helpful in understanding the underlying cause of pregnancy loss, as the classification can distinguish between normal and abnormal embryonic development. We did not find either a relation between TT and pregnancy outcome or between TT and vascularization.

Influence Of Ethnicity On The Human Term Placenta

Objective: To perform a morphometric comparative analysis of placentas from Indigenous mothers (Guajajara communities) and non-Indigenous mothers, inhabitants in the rural areas of Imperatriz County, Maranhao State, Brazil. Methods: Ten placentas from Indigenous mothers and 10 from non-Indigenous mothers, collected in a case-control study design, were submitted to stereological analysis. Results: Several differences between Indigenous placentas and non-Indigenous placentas were demonstrated. The placentas from Indigenous mothers were oval-shaped and pale (50%), heavier and larger, with higher placental weight index, surface of insertion, diameter, ratio between diameters, eccentricity and index of contour, and smaller shape coefficient. Volumes occupied by syncytiotrophoblast, trophoblast and villi, the villous surface and the trophoblast thickness were all bigger in the Indigenous placentas. Conclusion: The Indigenous placenta possesses a bigger functional reserve, being able, if necessary, to increase the number of vasculosyncytial membranes by the peripheral displacement of capillaries, facilitating the exchanges between maternal and fetal bloods.

Stereological Investigation of Placental Morphology in Pregnancies Complicated by Pre-eclampsia with and without Intrauterine Growth Restriction

The aim of this study was to quantify placental morphology in pregnancies complicated by pre-eclampsia with and without intrauterine growth restriction. Particular attention is given to the dimensions and composition of peripheral (intermediate+terminal) villi. Placentae from 9 control pregnancies, 5 cases of pre-eclampsia, 5 cases of intrauterine growth restriction and 5 cases of pre-eclampsia with intrauterine growth restriction were randomly sampled for location and position. Formalin-fixed, wax-embedded sections stained by the Masson trichrome method were subjected to stereological analysis in order to quantify the volumes of placental components and the surfaces and derived diameters for peripheral villi and fetal capillaries. Group comparisons were drawn using two-way analysis of variance. Fetal weights were reduced in all complicated pregnancies but only intrauterine growth restriction was accompanied by a significantly smaller placenta. Pre-eclampsia was not associated with main effects on placental morphology and (except for trophoblast thickness) there were no interaction effects involving pre-eclampsia. In contrast, intrauterine growth restriction was associated with a placenta which had reduced volumes of intervillous space and all types of villi (stem, intermediate, terminal). The impoverished growth of peripheral villi affected all tissues (trophoblast, stroma, capillaries) and was accompanied by smaller exchange surface areas and a thicker trophoblastic epithelium. The derived mean diameters of villi and capillaries were not affected. It is concluded that intrauterine growth restriction, but not pre-eclampsia, is associated with substantial changes in placental morphology including impoverished growth of villi and fetal vasculature. These changes are likely to reduce placental oxygen diffusive conductances and contribute to fetal hypoxic stress.

Biochemical and sonographic values in early pregnancy in women with a history of early spontaneous abortion

The aim of this study was to examine interconnections between changes in serum levels of biochemical parameters during pregnancy and sonographic parameters relevant for evaluation of early pregnancy. We analyzed serum levels of human chorionic gonadotropin (hCG), estradiol (E2), progesterone (PRG) and prolactin (PRL) using ELISA method, in cases of complicated pregnancies with symptoms of imminent miscarriage, and in patients with uncomplicated pregnancies. We evaluated their impact on mean gestational sac diameter (MSD), crown-rump length (CRL), inner diameter of the vitelline sac (SV), trophoblast (Trf) thickness and embryonic heart rate (STP). All results were correlated using Pearson's test and regression. Changes in biochemical parameters of pregnancy correlate significantly with dimensions of analyzed sonographic parameters. Levels of chorionic gonadrotropin affect production of ovarian and placental steroidogenesis. Interrelations were also discussed. Changes in biochemical values of pregnancy hormones affect dimensions of analyzed sonographic parameters. During uncomplicated pregnancy, levels of chorionic gonadotropin, progesterone and estradiol affect mean gestation-sac diameter, embryo length, depth of trophoblast invasion and formation and function of vitelline sac, and thus they alter the embryonic heart rate.

Villous Trophoblast: Morphometric Perspectives on Growth, Differentiation, Turnover and Deposition of Fibrin-type Fibrinoid During Gestation

Villous trophoblast growth and deposition of perivillous fibrin-type fibrinoid were examined in human placentas from 10–41 weeks of gestation. The main aims were: (1) to study growth of different trophoblast domains implicated in epithelial turnover (proliferation, differentiation, extrusion, denudation); (2) to test predictions about relationships between fibrinoid deposits and intervillous volume or villous surface area; and (3) to derive baseline data for future studies on complicated pregnancies. Microscopical fields on trichrome-stained paraffin sections were selected by systematic random sampling. Volumes were estimated stereologically by point counting and surface areas by intersection counting. Apparent differences were tested by analyses of variance and relationships by regression and contingency table analyses. All compartments increased in absolute volume and/or surface area although not at the same rates. Relative volumes of cytotrophoblast were greater at earlier stages (10–20 weeks) but, due to differential growth, syncytiotrophoblast nuclear aggregation sites (syncytial knots and ‘bridges’) occupied greater proportions of trophoblast volume and surface near term (37–41 weeks). Fibrinoid volume correlated positively with intervillous volume and villous surface area but, relative to intervillous volume, seemed to increase near term. Findings confirm that the incidence of syncytial knots increases during gestation and contributes to trophoblast thickness variability. Greater relative volumes and surfaces of syncytial ‘bridges’ are consistent with increased incidences of true intervillous bridges and/or villous branching points. These findings support the notion that fibrinoid deposition during normal gestation is influenced by the quality of vascular perfusion but also emphasize that the villous surface is another important factor. Haemostatic events operate at the maternal surface of trophoblastic epithelium and influence the steady state between coagulation and fibrinolysis. Fibrinoid is deposited at sites of trophoblast de-epithelialization and these arise following trauma (e.g. abruption of intervillous bridges) or during the extrusion phase of normal epithelial turnover. Like knots and bridges, sites of de-epithelialization also expand at a faster rate than overall villous surface area. These and other events in villous development can be interpreted in terms of a coherent concept of epithelial turnover in which proliferation early in gestation is mainly for growth whilst that at later stages is mainly for renewal and repair.

Is trophoblastic thickness at the embryonic implantation site a new sign of negative evolution in first trimester pregnancy?

In this study a new sign to evaluate the evolution of pregnancy is described: the trophoblastic thickness at the embryonic implantation site. A prospective, observational study of 592 normal pregnancies with no known risk factors was carried out from January 1998 to February 1999. Serial ultrasound scans were performed from week 5 to week 12 of pregnancy. Trophoblastic thickness was measured at the embryonic implantation site to determine the significance of a difference in gestational age in weeks and a trophoblastic thickness of >/=3 mm in predicting poor prognosis in pregnancy outcome. The sensitivity of this sign in the prediction of spontaneous abortion was 82%, the specificity was 93%, the positive predictive value was 63% and the negative predictive value was 97%.

Effect of cigarette smoke on human placenta morphometry

Objective: To evaluate the placental alterations in smoking mothers. Method: A case-control stereologic study of 10 placentas from smokers and 10 from non-smokers. Result: The authors found a significant increase in stromal volume density, villus size and trophoblast thickness, and a significant decrease in villus and vessel surface densities, total surfaces, and number/mm 2 histological field in the smokers' placenta. Conclusions: The alterations found in the smokers' placenta greatly contribute to impairing the exchanges between maternal and fetal blood.

Quantitative evidence for the spatial dispersal of trophoblast nucleic in human placental villi during gestation

A common assertion in the literature is that Langhans cells in placental villi decline in number during gestation but this is a misinterpretation which may be caused by the greater growth of villous surface area compared with trophoblast volume. To test this possibility, human placentae were collected at 12-41 weeks of gestation for a cross-sectional study on the packing density of nuclei within villous trophoblast. Numbers of nuclei in the cyto- and syncytiotrophoblast were estimated using a design-based stereological device, the physical disector (parallel pairs of sections). Surface areas were estimated in order to assess the overall growth of villous arborizations. Packing densities of nuclei were calculated and expressed as numbers/1000 microns 2 of villous surface. Densities decreased during gestation and this can be explained by expansion of villous surface area and thinning of trophoblast. The biggest drop in packing density of cytotrophoblast nuclei (30 per cent) occurred between 17-21 and 22-26 weeks and this period coincided with the largest changes in villous surface area (62 per cent increase) and trophoblast thickness (30 per cent decrease). Results are consistent with the notion of an epithelial proliferative unit of constant volume and comprising about nine syncytiotrophoblast nuclei per Langhans cell.

Growth and maturation of villi in placentae from well-controlled diabetic women

Summary Placentae from controls and two groups of diabetic women (one White classes A, B, C and the other classes D, F/R) were collected at 37–42 weeks of gestation. Tissue sections were analysed using stereological methods in order to quantify the growth and maturational status of villi. Birth and placental weights were recorded and placentae sampled in a systematic manner. Fields of view on formalin-fixed, paraffin-embedded sections were analysed to obtain estimates of volumes, surface areas, lengths and diffusion (harmonic mean) distances. Comparisons were drawn using three-way analyses of variance with group, mode of delivery and sex of newborn as the principal effects. Mean weights were similar in controls and diabetic groups. Diabetic placentae had a more voluminous fetal capillary bed of greater length, diameter and surface area. In addition, the diffusion distances across fetal plasma (erythrocyte to endothelium) were shorter. Stromal diffusion distance and villous diameter were greater in vaginal deliveries. Interaction effects influenced also villous capillarization, capillary volume, capillary diameter, trophoblast thickness and stromal thickness. Our results emphasize the importance of adaptations on the fetal side of the diabetic placenta. They show that changes can affect the placentae of appropriate-for-age as well as large-for-age babies and provide no evidence that they increase with the severity and duration of diabetes.

A morphometric approach to the relation of karyotype, gestational age and histological features in early spontaneous abortions

Previous studies revealed that chorionic villus size and proliferation of trophoblast were of little value as predictors of chromosomal abnormality. Since these findings might be due to the known intraand inter-observer variation in histological assessments of early placentae, objective measurement of features might be more valuable to predict abnormal karyoCype. Also, gestational age might influence structural development of villi in different karyotypes in a variable way, obscuring a possible relationship between features and karyotype. We, therefore, quantified villus size composed of stromal and trophoblastic tissues in 82placentae using the point counting method and related the results to karyotype and gestational age. At the group level there appeared to be no difference in the median mean cross-sectional villus-, stromal and trophoblastic area, trophoblast/ stroma ratio and trophoblastic thickness between chromosomally normal and abnormal placentae. O f the abnormal placentae only triploid placentae showed areas larger than normal and other abnormal placentae. In respect of gestational age villous profile area increased with age in triploid placentae, but decreased in trisomic abortions. At the individual case levd parameter values outside the 'normal' range appeared to be rather insensitive, but highly specific for the prediction of karyotypic aberrations, again mainly triploidy.