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PloS One 2022Knowledge about the relation of histopathological characteristics and mediators of physiological processes in the placenta malaria (PM) is poor, and that PM caused by... (Clinical Trial)
Clinical Trial
Knowledge about the relation of histopathological characteristics and mediators of physiological processes in the placenta malaria (PM) is poor, and that PM caused by Plasmodium vivax is almost null. The objective was to compare histopathological characteristics, cytokines and mediators of physiological processes in PM depending on the parasitic species, through a cross-sectional study in three groups: negative-PM, vivax-PM, falciparum-PM from Northwestern Colombia. The diagnosis of PM was made with thick blood smear, qPCR, and histopathology. Immuno-histochemical was made with EnVision system (Dako) and Zeiss Axio Imager M2 with light microscope. Cells in apoptosis were studied with the TUNEL technique. To measure the expression level of cytokines and mediators qRT-PCR was used. We included 179 placentas without PM and 87 with PM (53% P. vivax and 47% P. falciparum). At delivery, anemia was 25% in negative-PM, 60% in vivax-PM, and 44% in falciparum-PM group. The neonatal weight had an intense difference between groups with 3292±394g in negative-PM, 2,841±239 in vivax-PM, and 2,957±352 in falciparum-PM. The histopathological characteristics and CD+ cells in placenta with statistical differences (Dunn´s test) between negative-PM vs vivax-PM (P. falciparum was similar to P. vivax) were infarction, fibrinoid deposits, calcification, cells in apoptosis, immune infiltrates in decidua and intervillous space, CD4+, CD8+, CD14+, CD56+, CD68+. The expression levels of mediators in the placenta with statistical differences (Dunn´s test) between negative-PM vs vivax-PM (P. falciparum was similar to P. vivax) were Fas, FasL, HIF1α, Cox1, Cox2, VEGF, IL4, IL10, IFNγ, TNF, TGFβ, FOXP3, and CTLA4. PM with P. falciparum and P. vivax, damages this organ and causes significant alteration of various physiological processes, which cause maternal anemia and a reduction in neonatal weight in degrees that are statistically and clinically significant. It is necessary that the search for plasmodial infection in pregnant and placenta goes from passive to active surveillance with adequate diagnostic capacity.
Topics: Adolescent; Adult; Colombia; Cytokines; Female; Humans; Malaria, Falciparum; Malaria, Vivax; Placenta; Plasmodium falciparum; Plasmodium vivax; Pregnancy; Pregnancy Complications, Parasitic; Real-Time Polymerase Chain Reaction
PubMed: 35077516
DOI: 10.1371/journal.pone.0263092 -
Frontiers in Medicine 2022Systemic lupus erythematosus (SLE) may cause pathogenic changes in the placentas during human pregnancy, such as decreased placental weight, intraplacental hematoma,...
BACKGROUND
Systemic lupus erythematosus (SLE) may cause pathogenic changes in the placentas during human pregnancy, such as decreased placental weight, intraplacental hematoma, ischemic hypoxic change, placental infarction, and decidual vasculopathy, which contribute to high maternal and fetal mortality and morbidity. Sex-specific adaptations of the fetus are associated with SLE pregnancies. The present study aimed to determine the transcriptomic profiles of female and male placentas from women with SLE.
METHODS
RNA sequencing (RNA-seq) was performed to identify differentially expressed protein-coding genes (DEGs) in placentas from women with SLE vs. normal term (NT) pregnancies with female and male fetuses ( = 3-5/sex/group). Real-time-quantitative PCR was performed ( = 4 /sex/group) to validate the RNA-seq results. Bioinformatics functional analysis was performed to predict the biological functions and pathways of SLE-dysregulated protein-coding genes.
RESULTS
Compared with NT-female (NT-F) placentas, 119 DEGs were identified in SLE-female (SLE-F) placentas. Among these 119 DEGs, five and zero are located on X- and Y-chromosomes, respectively, and four are located on the mitochondrial genome. Compared with NT-male (NT-M) placentas, 458 DEGs were identified in SLE-male (SLE-M) placentas, among which 16 are located on the X-chromosome and zero on the Y-chromosome and mitochondrial genome. Twenty-four DEGs were commonly dysregulated in SLE-F and -M placentas. Functional analysis showed that SLE-dysregulated protein-coding genes were associated with diverse biological functions and pathways, including angiogenesis, cellular response to growth factor stimulus, heparin-binding, HIF (hypoxia-inducible factor)-1 signaling pathway, and Interleukin-17 (IL-17) signaling pathway in both SLE-F and -M placentas. Biological regulations were differentially enriched between SLE-F and -M placentas. Regulation of blood circulation, response to glucocorticoid, and rhythmic process were all enriched in SLE-F, but not SLE-M placentas. In contrast, tumor necrosis factor production, Th17 cell differentiation, and MDA (melanoma differentiation-associated gene)-5 signaling pathway were enriched in SLE-M but not SLE-F placentas.
CONCLUSION
This report investigated the protein-coding gene profiles of placenta tissues from SLE patients using RNA-seq. The results suggest that the SLE-dysregulated protein-coding genes in placentas may contribute to the pathophysiological progress of SLE pregnancies in a fetal sex-specific manner, leading to adverse pregnancy outcomes.
PubMed: 35372436
DOI: 10.3389/fmed.2022.798907 -
American Family Physician Mar 1998A one-minute examination of the placenta performed in the delivery room provides information that may be important to the care of both mother and infant. The findings of... (Review)
Review
A one-minute examination of the placenta performed in the delivery room provides information that may be important to the care of both mother and infant. The findings of this assessment should be documented in the delivery records. During the examination, the size, shape, consistency and completeness of the placenta should be determined, and the presence of accessory lobes, placental infarcts, hemorrhage, tumors and nodules should be noted. The umbilical cord should be assessed for length, insertion, number of vessels, thromboses, knots and the presence of Wharton's jelly. The color, luster and odor of the fetal membranes should be evaluated, and the membranes should be examined for the presence of large (velamentous) vessels. Tissue may be retained because of abnormal lobation of the placenta or because of placenta accreta, placenta increta or placenta percreta. Numerous common and uncommon findings of the placenta, umbilical cord and membranes are associated with abnormal fetal development and perinatal morbidity. The placenta should be submitted for pathologic evaluation if an abnormality is detected or certain indications are present.
Topics: Female; Humans; Placenta; Placenta Diseases; Pregnancy
PubMed: 9518951
DOI: No ID Found -
American Journal of Obstetrics and... Jan 2022Prenatal alcohol exposure is the most common cause of birth defects and intellectual disabilities and can increase the risk of stillbirth and negatively impact fetal...
BACKGROUND
Prenatal alcohol exposure is the most common cause of birth defects and intellectual disabilities and can increase the risk of stillbirth and negatively impact fetal growth.
OBJECTIVE
To determine the effect of early prenatal alcohol exposure on nonhuman primate placental function and fetal growth. We hypothesized that early chronic prenatal alcohol would alter placental perfusion and oxygen availability that adversely affects fetal growth.
STUDY DESIGN
Rhesus macaques self-administered 1.5 g/kg/d of ethanol (n=12) or isocaloric maltose-dextrin (n=12) daily before conception through the first 60 days of gestation (term is approximately 168 days). All animals were serially imaged with Doppler ultrasound to measure fetal biometry, uterine artery volume blood flow, and placental volume blood flow. Following Doppler ultrasound, all animals underwent both blood oxygenation level-dependent magnetic resonance imaging to characterize placental blood oxygenation and dynamic contrast-enhanced magnetic resonance imaging to quantify maternal placental perfusion. Animals were delivered by cesarean delivery for placental collection and fetal necropsy at gestational days 85 (n=8), 110 (n=8), or 135 (n=8). Histologic and RNA-sequencing analyses were performed on collected placental tissue.
RESULTS
Placental volume blood flow was decreased at all gestational time points in ethanol-exposed vs control animals, but most significantly at gestational day 110 by Doppler ultrasound (P<.05). A significant decrease in total volumetric blood flow occurred in ethanol-exposed vs control animals on dynamic contrast-enhanced magnetic resonance imaging at both gestation days 110 and 135 (P<.05); moreover, a global reduction in T∗, high blood deoxyhemoglobin concentration, occurred throughout gestation (P<.05). Similarly, evidence of placental ischemic injury was notable by histologic analysis, which revealed a significant increase in microscopic infarctions in ethanol-exposed, not control, animals, largely present at middle to late gestation. Fetal biometry and weight were decreased in ethanol-exposed vs control animals, but the decrease was not significant. Analysis with RNA sequencing suggested the involvement of the inflammatory and extracellular matrix response pathways.
CONCLUSION
Early chronic prenatal alcohol exposure significantly diminished placental perfusion at mid to late gestation and also significantly decreased the oxygen supply to the fetal vasculature throughout pregnancy, these findings were associated with the presence of microscopic placental infarctions in the nonhuman primate. Although placental adaptations may compensate for early environmental perturbations to fetal growth, placental blood flow and oxygenation were reduced, consistent with the evidence of placental ischemic injury.
Topics: Animals; Disease Models, Animal; Ethanol; Female; Fetal Development; Humans; Macaca mulatta; Placenta; Pregnancy; Prenatal Exposure Delayed Effects
PubMed: 34364844
DOI: 10.1016/j.ajog.2021.07.028 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Aug 2023Globular placenta is a rare type of abnormal placental morphology. It shows small placental volume and placental thickening on imaging, and the placental edge is round...
Globular placenta is a rare type of abnormal placental morphology. It shows small placental volume and placental thickening on imaging, and the placental edge is round and blunt. Some studies have pointed out that it may be due to the invasion of superficial villi into maternal tissue and insufficient transformation of spiral arterioles. It leads to placental ischemia, and early poor perfusion causes abnormal placenta morphology, which is manifested as fibrin deposition around the villi under the microscope. Because the effective exchange area of the globular placenta is smaller than that of the normal placenta, its influence on the fetus gradually appears with the increase of gestational age. Studies have observed that placental volume and placental thickness are associated with fetal growth restriction during pregnancy. Growth-restricted fetuses are at increased risk for perinatal diseases such as intraventricular hemorrhage, periventricular leukomalacia, respiratory distress syndrome, necrotizing enterocolitis, etc. Hemodynamic parameters will reflect the problem of placental perfusion, such as the peak systolic/diastolic blood flow of the uterine artery and umbilical artery, etc. During pregnancy, these two ultrasound indicators and placental morphology should be monitored to detect the disease at an early stage and in the early stage of disease progression. The use of drug intervention may improve perinatal outcomes, but the current clinical evidence is insufficient. Most physicians use empirical treatment, that is, to improve placental circulation and increase perfusion, but there is currently no obvious effective drug. There is no consensus on the doses of drugs such as aspirin and heparin, and the reported obstetric outcomes vary from study to study. In order to better treat these diseases, provide more adequate clinical data, and lay the foundation for further research in the later period, this report describes a young woman who was treated in our hospital. This report describes a young woman who presented to our hospital with a thickening of the placenta on mid-trimester ultrasonography, aggressive use of drug therapy and close follow-up when the fetus did not lag behind, and who developed fetal lag in the third trimester and was accompanied by The fetus was hemodynamically abnormal, and a live birth was obtained after timely termination of the pregnancy, but early necrotizing enteritis developed. Finally, we combined the literature review to understand the pathological mechanism, clinical characteristics, disease prognosis and corresponding treatment methods of the disease.
Topics: Pregnancy; Female; Humans; Infant, Newborn; Placenta; Fetal Growth Retardation; Ultrasonography; Prognosis; Infarction; Ultrasonography, Prenatal
PubMed: 37534664
DOI: 10.19723/j.issn.1671-167X.2023.04.031 -
Cardiac Restoration Stemming From the Placenta Tree: Insights From Fetal and Perinatal Cell Biology.Frontiers in Physiology 2018Efficient cardiac repair and ultimate regeneration still represents one of the main challenges of modern medicine. Indeed, cardiovascular disease can derive from... (Review)
Review
Efficient cardiac repair and ultimate regeneration still represents one of the main challenges of modern medicine. Indeed, cardiovascular disease can derive from independent conditions upsetting heart structure and performance: myocardial ischemia and infarction (MI), pharmacological cardiotoxicity, and congenital heart defects, just to name a few. All these disorders have profound consequences on cardiac tissue, inducing the onset of heart failure over time. Since the cure is currently represented by heart transplantation, which is extremely difficult due to the shortage of donors, much effort is being dedicated to developing innovative therapeutic strategies based on stem cell exploitation. Among the broad scenario of stem/progenitor cell subpopulations, fetal and perinatal sources, namely amniotic fluid and term placenta, have gained interest due to their peculiar regenerative capacity, high self-renewal capability, and ease of collection from clinical waste material. In this review, we will provide the state-of-the-art on fetal perinatal stem cells for cardiac repair and regeneration. We will discuss different pathological conditions and the main therapeutic strategies proposed, including cell transplantation, putative paracrine therapy, reprogramming, and tissue engineering approaches.
PubMed: 29695981
DOI: 10.3389/fphys.2018.00385 -
Circulation Journal : Official Journal... Mar 2023This study investigated the association between placental pathology and fetal heart failure.Methods and Results: Singletons with a congenital heart defect (CHD)...
BACKGROUND
This study investigated the association between placental pathology and fetal heart failure.Methods and Results: Singletons with a congenital heart defect (CHD) and/or arrhythmia (n=168) and gestational age-matched controls (n=52) were included in the study. The associations between macro- and microscopic abnormal findings of the placenta and the severity of fetal heart failure were evaluated using the cardiovascular profile (CVP) score. Nine features were microscopically identified and assessed in sections of the placenta: premature villi, edematous villi, fibrotic villi, chorioamnionitis, chorangiosis, fibrin deposition, subchorionic hematoma, infarcted villi, and nucleated red blood cells in villous vessels. Among singletons with CHD and/or arrhythmia, the final CVP score was ≥8 in 140 cases, 6 or 7 in 15 cases, and ≤5 in 13 cases. Microscopic analysis showed that the frequency and severity of premature and edematous villi and increased nucleated red blood cells in villous vessels were greater in cases of fetal heart failure. These microscopic findings were more common and severe in cases with a final CVP score ≤5 than in gestational age-matched controls. The prevalence of abnormal macroscopic findings of the placenta and umbilical cord was similar regardless of the severity of fetal heart failure.
CONCLUSIONS
Premature and edematous villi and increased nucleated red blood cells in villous vessels were correlated with the severity of fetal heart failure in cases of CHD and/or arrhythmia.
Topics: Pregnancy; Female; Humans; Placenta; Fetal Diseases; Heart Failure; Heart Defects, Congenital; Premature Birth; Edema; Arrhythmias, Cardiac
PubMed: 36436951
DOI: 10.1253/circj.CJ-22-0568 -
Reproductive Sciences (Thousand Oaks,... Jan 2018The placenta is a vital organ necessary for healthy fetal development. Placental insufficiency creates an in utero environment where the fetus is at risk of insufficient...
The placenta is a vital organ necessary for healthy fetal development. Placental insufficiency creates an in utero environment where the fetus is at risk of insufficient oxygen or nutrient exchange. This is primarily caused by impairment of either maternal or fetal circulation or vascular thrombosis such as placental infarction. As a result of placental dysfunction, affected fetuses may be growth restricted, neurologically impaired, and at risk of increased morbidity and mortality. In a cohort of 4 pregnant Rhesus macaques, we describe antenatal detection of naturally occurring intrauterine growth restriction (IUGR) and aberrant fetal neurodevelopment in 1 animal. Abnormal growth parameters were detected by Doppler ultrasound, and vascular insufficiency in the intervillous space was characterized by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Furthermore, placental oxygen reserve was shown to be reduced compared to control animals by measurements of placental water T*. To characterize the effects of IUGR on fetal brain development, T and diffusion anisotropy images of the fetal brain were acquired in utero. Reduced brain volume and cerebral cortical surface area were apparent macroscopically. Microstructural abnormalities within the developing white matter and cerebral cortex were also observed through analysis of water diffusion anisotropy. After delivery by cesarean section, pathological examination confirmed placental insufficiency with hypoxia. These findings exemplify how DCE-MRI and T*-based measurements of blood oxygenation within the placenta can provide noninvasive imaging methods for assessing in vivo placental health to potentially identify pregnancies affected by placental insufficiency and abnormal fetal neurodevelopment prior to the onset of fetal and neonatal distress.
Topics: Animals; Female; Fetal Growth Retardation; Macaca mulatta; Magnetic Resonance Imaging; Placenta; Placental Circulation; Placental Insufficiency; Pregnancy
PubMed: 28330415
DOI: 10.1177/1933719117699704 -
Turk Patoloji Dergisi 2020Sirenomelia, which is also known as mermaid syndrome and characterized by the fusion of the lower extremities, is the most severe form of caudal regression syndrome and...
Sirenomelia, which is also known as mermaid syndrome and characterized by the fusion of the lower extremities, is the most severe form of caudal regression syndrome and one of the rare and lethal congenital malformations. The anomalies that might be seen in this syndrome include pelvic-sacral dysplasia, genital anomalies, bilateral pelvic renal fusion accompanied by renal dysplasia, colon atresia, unilateral umbilical artery, and imperforated anus. The incidence of sirenomelia is 0.8-1 cases in 60,000-100,000 deliveries and the male/female ratio is 2.7-3:1. The case reported in the present study was a 13-week-old male fetus 30 g in weight with a macerated appearance. The upper extremities had a relatively normal appearance but the lower extremities were conjoined and there was a single lower extremity consisting of conjoined feet and toes. In the face, the nasal bridge was sunken, the ears had a low position, and there were cleft palate and cleft lip. Examination of the external genital organs revealed that the penile part was in the anal region. There was no anus opening. The crown-rump length was 8.5cm, the heel-toe length was approx. 1cm, and the rump-heel length was approx. 3.7cm. There were none of the two kidneys, ureter, bladder, urethra, or rectum. In the umbilical cord, there were 2 venous structures, one of which was the artery. Perivillous congestion and hyperemia, perivillous calcification, deciduitis, and focal infarct regions were observed in placental tissues. This report aims to discuss this very rare case together with the literature.
Topics: Abnormalities, Multiple; Ectromelia; Female; Fetus; Humans; Male; Pregnancy
PubMed: 32525213
DOI: 10.5146/tjpath.2020.01491 -
Polish Journal of Pathology : Official... 2022CD34 immunostaining increases the sensitivity of placental diagnosis of foetal vascular malperfusion (FVM). This comparative retrospective study was performed to find...
Placental recent/on-going foetal vascular malperfusion with endothelial fragmentation is diagnostically equivalent to established distal villous lesions of foetal vascular malperfusion.
CD34 immunostaining increases the sensitivity of placental diagnosis of foetal vascular malperfusion (FVM). This comparative retrospective study was performed to find out whether recent distal FVM lesions diagnosed with CD34 are diagnostically equivalent to remote FVM lesions diagnosed with haematoxylin-eosin (H&E). Clinical and placental phenotypes of 562 placentas from ≥ 20-week, high-risk pregnancies were analysed: Group 1-158 placentas with remote distal villous FVM (by H&E only), Group 2-142 placentas showing clustered endothelial fragmentation by CD34 immunostaining, 98 of them also with H&E distal FVM lesions (on-going, temporal heterogeneity), and Group 3-262 placentas without distal villous FVM. In Group 1, gestational age was the shortest, postnatal mortality most frequent, placental weight the smallest, and intra villous haemorrhage, erythroblasts in foetal blood, hypertrophic decidual arteriopathy, and foetal vascular thrombi most common. In Group 2, placental infarction, post-uterine pattern of chronic placental injury, and excessive extra villous trophoblasts of chorionic disc were most common (p < 0.05). In this cohort of foetuses/neonates dominated by congenital malformations, distal villous FVM was the most common pattern of placental injury, and those diagnosed by CD34 and by H&E are diagnostically/prognostically equivalent. CD34 immunostaining is therefore a powerful tool in the diagnosis of distal villous FVM.
Topics: Humans; Pregnancy; Female; Placenta; Retrospective Studies; Placenta Diseases; Gestational Age; Uterus
PubMed: 36734434
DOI: 10.5114/pjp.2022.124487