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Placenta Throughout Gestation
Published in Mary C. Peavey, Sarah K. Dotters-Katz, Ultrasound of Mouse Fetal Development and Human Correlates, 2021
Mary C. Peavey, Sarah K. Dotters-Katz
Although the placenta is a temporary organ in an organism’s life, it is a critical interface between the mother and fetus, providing gas exchange, nutrients, and serving as a barrier between the mother and fetus. As such, placental anomalies have often been associated with poor fetal health. Two of the most prevalent and morbid complications of human pregnancy -pre-eclampsia and fetal growth restriction -are associated with placental pathology.
Possible Role of Trophoblast in Preeclampsia
Published in Gérard Chaouat, The Immunology of the Fetus, 2020
Some knowledge of placental structure and development is necessary over and above that provided in preceding chapters, because we depend on it for “a true understanding of many aspects of placental pathology”.16 The information in Table 1 must, therefore, be interpreted with the following caveats in mind: The morphology of the placenta is in a state of continual flux.16Its appearances alter not only as gestation advances but depend on what area is examined.16The fetally derived tissue recognized at parturition as “the placenta” is only part of the maternofetal interaction. The interrelationship and interaction of fetal trophoblast with maternal decidua in the placental bed are of key importance.Our understanding is far from complete. New techniques for examining tissues are rightly constrained by the ethics of obtaining tissue from normal human pregnancies.
The female reproductive system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
The placenta is formed from both maternal and fetal components: the decidua is formed by alteration of the maternal endometrium, and the chorionic villi and fetal membranes (including the chorion) are derived from fetal tissues. Formation of the placenta involves alteration of the maternal vascular bed within the endometrium and myometrium to support placental function and fetal demand. It is now thought that abnormality of this vascularization is the fundamental abnormality in pregnancy-associated hypertension (pre-eclampsia). Further details of placental pathology are beyond the scope of this text, but can be found in textbooks of obstetric and gynaecological pathology (see Further Reading).
Pathology of the Placenta in Singletons after Assisted Reproductive Technology Compared to Singletons after Spontaneous Conception: A Systematic Review
Published in Fetal and Pediatric Pathology, 2023
Urška Belak, Bojana Pinter, Helena Ban Frangež, Mojca Velikonja, Sara Korošec
It would be of great interest to diagnose these placental abnormalities during pregnancy and study their possible effects on the fetus. Unfortunately, studies on ultrasound and magnetic resonance imaging of the placenta during pregnancy have mainly focused on abnormally invasive and low-lying placentas. Few studies have investigated placental morphology, pathology and vascular abnormalities. Identification and description of placental pathology requires a pathologist with expertise in this area. A methodical sonographic assessment of the placenta should include localization of the placenta, visual assessment of the size, thickness, morphology, location and anatomy of the placenta and a search for abnormalities [41]. Increased echogenicity of the placenta may be due to associated placental hemorrhage or hypoxia, and premature calcification may reflect vascular insufficiency and be associated with an unfavorable outcome [42].
Histological Evaluation of Products of Conception, Who Benefits from It?
Published in Fetal and Pediatric Pathology, 2023
Haleh Soltanghoraee, Arash Mohazzab, Azadeh Soltani, Soheila Ansaripour, Maryam Tavakoli, Maryam Rafati, Amir Hassan Zarnani, Saeed Reza Ghaffari
The systematic approach to placental pathology was presented at the International Federation of Placenta Associations meeting in 2006 [24]. Subsequently a comprehensive system was suggested in Amsterdam in 2014 [17]. Based on the Amsterdam consensus, in the clinical setting of recurrent miscarriage, further diagnostic information regarding the underlying cause of the pregnancy failure may be obtained from examination of products of conception [14,17]. There are three recurrent pathologies with clinical significance: villitis of unknown etiology, massive perivillous fibrin deposition and chronic intervillositis of unknown etiology. Villitis of unknown etiology happens specifically at the third trimester [16], therefore, it was not included in our study. Massive perivillous fibrin deposition/maternal floor infarction is seen generally at the third trimester, while inter/perivillous fibrin deposition is its equivalent pathology in the first trimester; therefore, it has been included in our study.
Recurrence of Basal Plate Myofibers, with Further Consideration of Pathogenesis
Published in Fetal and Pediatric Pathology, 2019
Debra S. Heller, Rachel Wyand, Stewart Cramer
The placenta is the only tissue routinely submitted to pathology that had contributions from two separate human beings – the mother and her newborn; thus, placental pathology reports can also have implications for the future health of the mother (6). Placenta accreta can cause life-threatening postpartum hemorrhage, and its frequency has increased tenfold as the rate of Cesarean section has increased (9). This has caused increasing concern amongst clinicians, but it is not listed in the 1997 CAP guidelines for placental examination; at least partly because much of the important work in this area has been done after 1997. In 2001, Khong and Werger brought to the attention of general pathologists that basal plate myofibers (BPMF) can be found in the absence of clinical evidence of placenta accreta (10). Ernst and coworkers have suggested that BPMF are a risk factor for future placenta accreta (11,12). Most recently, it was reported that half the cases with major hemorrhage (>1500 cc) in the following pregnancy were in cases where the only evidence of placenta accreta was histologic (13). Both submitting more blocks, and adjunctive immunostaining for muscle markers can enhance detection of BPMF (6,10). In addition, it is only recently that the pathogenesis of pre-delivery basal plate damage in BPMF placentas has been seriously addressed (6,9,14).