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Placenta Feb 2016The labyrinthine zone of the placenta is where exchange of nutrients and waste occurs between maternal and fetal circulations. Proper development of the placental...
INTRODUCTION
The labyrinthine zone of the placenta is where exchange of nutrients and waste occurs between maternal and fetal circulations. Proper development of the placental labyrinth is essential for successful growth of the developing fetus and abnormalities in placental development are associated with intrauterine growth restriction (IUGR), preeclampsia and fetal demise. Our previous studies demonstrate that Hectd1 is essential for development of the junctional and labyrinthine zones of the placenta. Here we further characterize labyrinthine zone defects in the Hectd1 mutant placenta.
METHODS
The structure of the mutant placenta was compared to wildtype littermates using histological methods. The expression of cell type specific markers was examined by immunohistochemistry and in situ hybridization.
RESULTS
Hectd1 is expressed in the labyrinthine zone throughout development and the protein is enriched in syncytiotrophoblast layer type I cells (SynT-I) and Sinusoidal Trophoblast Giant cells (S-TGCs) in the mature placenta. Mutation of Hectd1 results in pale placentas with frequent hemorrhages along with gross abnormalities in the structure of the labyrinthine zone including a smaller overall volume and a poorly elaborated fetal vasculature that contain fewer fetal blood cells. Examination of molecular markers of labyrinthine trophoblast cell types reveals increased Dlx3 positive cells and Syna positive SynT-I cells, along with decreased Hand1 and Ctsq positive sinusoidal trophoblast giant cells (S-TGCs).
DISCUSSION
Together these defects indicate that Hectd1 is required for development of the labyrinthine zonethe mouse placenta.
Topics: Animals; Female; Giant Cells; Mice; Mice, Knockout; Placenta; Placenta Diseases; Placentation; Pregnancy; Trophoblasts; Ubiquitin-Protein Ligases
PubMed: 26907377
DOI: 10.1016/j.placenta.2015.12.002 -
Irish Journal of Medical Science May 2020The weight of the delivered placenta gives a useful representation of placental function in utero. In the absence of Irish data, many pathologists rely on data from...
BACKGROUND
The weight of the delivered placenta gives a useful representation of placental function in utero. In the absence of Irish data, many pathologists rely on data from other populations, many of which are now 15 to 30 years old. The development of a population-specific nomogram would aid in the examination of placentas after delivery, allowing pathologists and medical scientists to more easily distinguish between placental physiological changes and pathology.
AIMS
To record placental weights among women having a singleton delivery in Dublin and to establish median placental weights for each gestational age after 37 weeks.
METHODS
Prospective cohort study in a Tertiary level University Hospital. All singleton pregnancies were included; stillbirths, multiple gestations, and cases with obstetric complications involving the placenta were excluded. The placentas were weighed both untrimmed and trimmed with standard scales. Demographic features including birth weight and maternal parity were also recorded.
RESULTS
Four hundred thirty placentas were weighed over a 6-week period. A median term placental weight based on gestational age was established, with a range from the tenth to ninetieth centiles.
CONCLUSION
The weight of the placenta is one of several measurements that are easy to acquire, and when recorded in a systematic fashion, provide information not just on an individual, but also on a population basis. Birth weights have increased over the last century, and this study provides national data helping distinction between placental physiology and pathology.
Topics: Adult; Cohort Studies; Delivery, Obstetric; Female; Humans; Ireland; Placenta; Pregnancy; Prospective Studies; Young Adult
PubMed: 31691150
DOI: 10.1007/s11845-019-02102-8 -
Fetal Diagnosis and Therapy 2018Previous studies in singleton pregnancies reported conflicting trends in apparent diffusion coefficient (ADC) values with gestational age (GA) and stable relative ADC... (Comparative Study)
Comparative Study
UNLABELLED
Previous studies in singleton pregnancies reported conflicting trends in apparent diffusion coefficient (ADC) values with gestational age (GA) and stable relative ADC (rADC; ADC placenta divided by ADC globe) throughout pregnancy. The purpose of our study was to compare the ADC and rADC of placentas of twin and singleton pregnancies.
MATERIALS AND METHODS
Fetal MRI of 11 twin and 23 singleton pregnancies were retrospectively analyzed. Each group was further divided by GA (≤24 and >24 weeks). On ADC, 3 regions of interest were selected in the placenta and 1 in the globe. ADC and rADC measurements were compared between different GA and between singleton and twin placentas.
RESULTS
No significant difference was shown between ADC and rADC values of singleton and twin placentas as well as between ADC and rADC values of singleton and twin placentas at different GA. No significant difference was shown when accounting for both GA and number of fetuses.
CONCLUSION
The diffusion characteristics of twin placentas are similar to those of singleton placentas. ADC and rADC remain stable throughout pregnancy in twin and singleton placentas, reflecting stable extracellular water diffusion, despite changes associated with placental maturation.
Topics: Diffusion; Female; Humans; Magnetic Resonance Imaging; Placenta; Pregnancy; Pregnancy, Twin; Prenatal Diagnosis; Retrospective Studies
PubMed: 29518777
DOI: 10.1159/000479686 -
World Neurosurgery Nov 2023The development of microsurgical skills is crucial for neurosurgical education. The human placenta is a promising model for practicing vascular anastomosis due to its...
OBJECTIVE
The development of microsurgical skills is crucial for neurosurgical education. The human placenta is a promising model for practicing vascular anastomosis due to its similarities with brain vessels. We propose a 2-stage model for training in extracranial-to-intracranial anastomosis using the placenta.
METHODS
Initially, we propose practicing anastomosis in 2 adjacent placentas. Once successful, the procedure advances to a more challenging configuration that employs a 3-dimensionally printed skull with a window simulating a pterional craniotomy. It is positioned an intracranial placenta and an extracranial one, and the latter has a prominent vessel exposed toward the side of the craniotomy. Both placentas have one artery and vein cannulated in the umbilical cord, and we present an artificial placental circulation system for microvascular training that regulates pulsation and hydrodynamic pressure while keeping veins engorged with a pressurized bag. To verify anastomosis patency, we utilize sodium fluorescein and iodine contrast.
RESULTS
The 2-stage model simulated several aspects of microvascular anastomosis. Our perfusion system allowed for intraoperative adjustments of hydrodynamic pressure and pulsation. Using iodine contrast and fluorescein enabled proper evaluation of anastomosis patency and hydrodynamic features.
CONCLUSIONS
Training in the laboratory is essential for developing microsurgical skills. We have presented a model for microvascular anastomosis with artificial circulation and postoperative imaging evaluation, which is highly beneficial for enhancing the learning curve in microvascular procedures.
Topics: Humans; Female; Pregnancy; Neurosurgery; Placenta; Microsurgery; Anastomosis, Surgical; Iodine
PubMed: 37690578
DOI: 10.1016/j.wneu.2023.08.118 -
Frontiers in Immunology 2021Since the beginning of the pandemic, few papers describe the placenta's morphological and morphometrical features in SARS-CoV-2-positive pregnant women. Alterations,...
UNLABELLED
Since the beginning of the pandemic, few papers describe the placenta's morphological and morphometrical features in SARS-CoV-2-positive pregnant women. Alterations, such as low placental weight, accelerated villous maturation, decidual vasculopathy, infarcts, thrombosis of fetal placental vessels, and chronic histiocytic intervillositis (CHI), have been described.
OBJECTIVE
To analyze clinical data and the placental morphological and morphometric changes of pregnant women infected with SARS-CoV-2 (COVID-19 group) in comparison with the placentas of non-infected pregnant women, matched for maternal age and comorbidities, besides gestational age of delivery (Control group).
METHOD
The patients in the COVID-19 and the Control group were matched for maternal age, gestational age, and comorbidities. The morphological analysis of placentas was performed using Amsterdam Placental Workshop Group Consensus Statement. The quantitative morphometric evaluation included perimeter diameter and number of tertiary villi, number of sprouts and knots, evaluation of deposition of villous fibrin, and deposition of intra-villous collagen I and III by Sirius Red. Additionally, Hofbauer cells (HC) were counted within villi by immunohistochemistry with CD68 marker.
RESULTS
Compared to controls, symptomatic women in the COVID-19 group were more likely to have at least one comorbidity, to evolve to preterm labor and infant death, and to have positive SARS-CoV-2 RNA testing in their concepts. Compared to controls, placentas in the COVID-19 group were more likely to show features of maternal and fetal vascular malperfusion. In the COVID-19 group, placentas of symptomatic women were more likely to show CHI. No significant results were found after morphometric analysis.
CONCLUSION
Pregnant women with symptomatic SARS-CoV-2 infection, particularly with the severe course, are more likely to exhibit an adverse fetal outcome, with slightly more frequent histopathologic findings of maternal and fetal vascular malperfusion, and CHI. The morphometric changes found in the placentas of the COVID-19 group do not seem to be different from those observed in the Control group, as far as maternal age, gestational age, and comorbidities are paired. Only the deposition of villous fibrin could be more accentuated in the COVID-19 group (p = 0.08 borderline). The number of HC/villous evaluated with CD68 immunohistochemistry did not show a difference between both groups.
Topics: Adult; Brazil; COVID-19; Case-Control Studies; Female; Gestational Age; Host-Pathogen Interactions; Humans; Immunohistochemistry; Infectious Disease Transmission, Vertical; Placenta; Pregnancy; Pregnancy Complications, Infectious; RNA, Viral; SARS-CoV-2; Viral Load
PubMed: 34122449
DOI: 10.3389/fimmu.2021.685919 -
American Journal of Reproductive... Apr 2018Procalcitonin (PCT) is the prohormone of calcitonin which is usually released from neuroendocrine cells of the thyroid gland (parafollicular) and the lungs (K cells)....
PROBLEM
Procalcitonin (PCT) is the prohormone of calcitonin which is usually released from neuroendocrine cells of the thyroid gland (parafollicular) and the lungs (K cells). PCT is synthesized by almost all cell types and tissues, including monocytes and parenchymal tissue, upon LPS stimulation. To date, there is no evidence for PCT expression in the placenta both in physiological and pathological conditions.
METHOD
Circulating and placental PCT levels were analysed in pre-eclamptic (PE) and control patients. Placental cells and macrophages (PBDM), stimulated with PE sera, were analysed for PCT expression. The effect of anti-TNF-α antibody was analysed.
RESULTS
Higher PCT levels were detected in PE sera and in PE placentae compared to healthy women. PE trophoblasts showed increased PCT expression compared to those isolated from healthy placentae. PE sera induced an upregulation of PCT production in macrophages and placental cells. The treatment of PBDM with PE sera in the presence of anti-TNF-α completely abrogated the effect induced by pathologic sera.
CONCLUSION
Trophoblast cells are the main producer of PCT in PE placentae. TNF-α, in association with other circulating factors present in PE sera, upregulates PCT production in macrophages and normal placental cells, thus contributing to the observed increased in circulating PCT in PE sera.
Topics: Adult; Calcitonin; Cohort Studies; Female; Humans; Macrophages; Placenta; Pre-Eclampsia; Pregnancy; Trophoblasts; Tumor Necrosis Factor-alpha; Up-Regulation; Young Adult
PubMed: 29427369
DOI: 10.1111/aji.12823 -
Journal of Perinatology : Official... Apr 2019To determine if pre-specified placental abnormalities among newborns with hypoxic-ischemic encephalopathy (HIE) differ compared to newborns admitted to a NICU without...
OBJECTIVE
To determine if pre-specified placental abnormalities among newborns with hypoxic-ischemic encephalopathy (HIE) differ compared to newborns admitted to a NICU without encephalopathy.
STUDY DESIGN
Retrospective case-control study of newborns with HIE (2006-2014) and controls matched for birth year, gestational age, weight, and gender. One pathologist reviewed archived placental sections using pre-specified criteria.
RESULTS
Sixty-seven newborns had HIE, 46 had available placentas and were matched with 92 controls. HIE had more maternal vascular malperfusion (46% vs 25%, p = 0.02), fetal vascular malperfusion (13% vs 0%, p < 0.001), and clinical abruption (22% vs 4%, p = 0.001). Controls had more normal placentas (29% vs 7%, p = 0.002), and chorioamnionitis (30% vs 9%, p = 0.005). Pre-specified placental lesions occurred in 87% of HIE and 65% of controls (p = 0.008) and identified >90% of primary diagnoses.
CONCLUSIONS
Pre-specified placental lesions identified nearly all abnormalities in HIE and represented both acute and chronic processes.
Topics: Abruptio Placentae; Case-Control Studies; Female; Humans; Hypoxia-Ischemia, Brain; Infant, Newborn; Male; Placenta; Placental Circulation; Pregnancy; Retrospective Studies; Statistics, Nonparametric; Umbilical Cord
PubMed: 30770878
DOI: 10.1038/s41372-019-0334-9 -
Placenta Oct 2021Adequate development of the feto-placental circulation is critical for placental exchange function and healthy fetal growth. Understanding the structure of this...
Adequate development of the feto-placental circulation is critical for placental exchange function and healthy fetal growth. Understanding the structure of this circulation and how it informs fetal outcomes is important both in the human placenta, and the rodent, a purported comparative experimental model. Vascular casting and micro-CT imaging approaches enable detailed quantification of the complex vascular relationships in the feto-circulation, and provide detailed data to parameterise in silico models. Here, to assist researchers to apply these technically challenging methods we provide detailed approaches to cast and image; 1) human placentas at the cotyledon-level, and 2) whole rodent placentas.
Topics: Animals; Female; Fetus; Humans; Imaging, Three-Dimensional; Mice; Placenta; Placental Circulation; Pregnancy; Rats
PubMed: 34418753
DOI: 10.1016/j.placenta.2021.08.049 -
PloS One 2019Plasmodium (P.) falciparum malaria during pregnancy has been frequently associated with severe consequences such as maternal anemia, abortion, premature birth, and...
Plasmodium (P.) falciparum malaria during pregnancy has been frequently associated with severe consequences such as maternal anemia, abortion, premature birth, and reduced birth weight. Placental damage promotes disruption of the local homeostasis; though, the mechanisms underlying these events are still to be elucidated. Autophagy is a fundamental homeostatic mechanism in the natural course of pregnancy by which cells self-recycle in order to survive in stressful environments. Placentas from non-infected and P. falciparum-infected women during pregnancy were selected from a previous prospective cohort study conducted in the Brazilian Amazon (Acre, Brazil). Newborns from infected women experienced reduced birth weight (P = 0.0098) and placental immunopathology markers such as monocyte infiltrate (P < 0.0001) and IL-10 production (P = 0.0122). The placentas were evaluated for autophagy-related molecules. As a result, we observed reduced mRNA levels of ULK1 (P = 0.0255), BECN1 (P = 0.0019), and MAP1LC3B (P = 0.0086) genes in placentas from P. falciparum-infected, which was more striking in those diagnosed with placental malaria. Despite the protein levels of these genes followed the same pattern, the observed reduction was not statistically significant in placentas from P. falciparum-infected women. Nevertheless, our data suggest that chronic placental immunopathology due to P. falciparum infection leads to autophagy dysregulation, which might impair local homeostasis during malaria in pregnancy that may result in poor pregnancy outcomes.
Topics: Adolescent; Adult; Autophagy; Down-Regulation; Female; Humans; Placenta; Plasmodium falciparum; Pregnancy; RNA, Messenger; Young Adult
PubMed: 31805150
DOI: 10.1371/journal.pone.0226117 -
The Journal of Clinical Endocrinology... Sep 2023Pregnant women with mutations in the thyroid hormone receptor beta (THRB) gene expose their fetuses to high thyroid hormone (TH) levels shown to be detrimental to a...
CONTEXT
Pregnant women with mutations in the thyroid hormone receptor beta (THRB) gene expose their fetuses to high thyroid hormone (TH) levels shown to be detrimental to a normal fetus (NlFe) but not to an affected fetus (AfFe). However, no information is available about differences in placental TH regulators.
OBJECTIVE
To investigate whether there are differences in placentas associated with a NlFe compared with an AfFe, we had the unique opportunity to study placentas from 2 pregnancies of the same woman with THRB mutation G307D. One placenta supported a NlFe while the other an AfFe.
METHODS
Sections of placentas were collected and frozen at -80 °C after term delivery of a NlFe and an AfFe. Two placentas from healthy women of similar gestational age were also obtained. The fetal origin of the placental tissues was established by gDNA quantitation of genes on the X and Y chromosomes and THRB gene. Expression and enzymatic activity of deiodinases 2 and 3 were measured. Expression of following genes was also quantitated: MCT10, MCT8, LAT1, LAT2, THRB, THRA.
RESULTS
The placenta carrying the AfFe exhibited a significant reduction of deiodinase 2 and 3 activities as well as the expression of the TH transporters MCT10, LAT1 and LAT2, and THRA.
CONCLUSION
We present the first study of the effect of the fetal THRB genotype on the placenta. Though limited by virtue of the rarity of THRB mutations and sample availability, we show that the fetal THRB genotype influences the levels of TH regulators in the placenta.
Topics: Female; Pregnancy; Humans; Placenta; Genes, erbA; Thyroid Hormone Receptors beta; Thyroid Hormones; Fetus; Genotype
PubMed: 37149816
DOI: 10.1210/clinem/dgad243