Morphological and histological signs of placental abnormalities in women with preeclampsia giving birth for the first time
DOI:
https://doi.org/10.15574/HW.2026.1(182).5663Keywords:
pregnancy in women giving birth for the first time, preeclampsia, morphological and immunohistochemical studies of the placenta, placental mass, villous chorion, terminal villi, intervillous fibrinoidAbstract
Studying morphological and histological abnormalities in the placenta of women with preeclampsia (PE) who give birth for the first time is relevant and modern for the prediction and prevention of this complication.
Aim - to analyze morphological and histological changes in the placenta in women with PE giving birth for the first time, to predict and optimize obstetric tactics in them.
Materials and methods. A histological study of placentas was conducted in 58 women giving birth for the first time: the main group (MG) - 36 placentas from women with PE, the comparison group (CG) - 22 placentas from women without PE. For the morphological analysis of structural changes in the placenta, the following research methods were used: organometric, macroscopic, general histological.
Results. The average mass of placentas in MG was 391.21±11.82 g with a maternal surface area of 228.22±4.81 cm², in CG - 487.02±16.42 g, the maternal surface area was 284.16±8.16 cm², with linear dimensions of 16.2×14.1×2.2 cm and 17.4×16.3×3.8 cm, respectively, which reflects a significant decrease in organometric parameters in preeclampsia. The main structural changes in MG were recorded in the villous chorion: the predominance of signs of branched angiogenesis in the terminal villi of the chorion was determined; in the intervillous space of 6 (16.7%) placentas of MG women, there was a significant increased deposition of fibrinoid masses of different sizes and shapes; villi pathology - 7 (19.4%) cases; in 24 (66.7%) placentas there were pronounced syncytiocapillary membranes, there are a lot of them and they are combined with fibrinoid deposits, infarctions and are a clinical sign of chronic placental insufficiency.
Conclusions. Morphological and histological signs of placental disorders in the studied placentas and the degree of their severity indicate a significant impairment of placental blood flow, which initiates the development of adaptation and compensation processes; their sharp severity suggests the fact of insufficiency of compensatory and adaptive reactions in the placenta during PE in women giving birth for the first time.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the patients was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Baergen RN. (2011). Manual of Benirschke and Kaufmann's Pathology of the Human Placenta. New York: Springer. https://doi.org/10.1007/978-1-4419-7494-5
Bartsch E, Medcalf KE, Park AL, Ray JG. (2016). Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ. 353: i1753. https://doi.org/10.1136/bmj.i1753; PMid:27094586 PMCid:PMC4837230
Baschat AA. (2021). Fetal growth restriction: From placental pathology to perinatal outcomes. Am J Obstet Gynecol. 225(2): S789-S799.
Bhide A, Acharya G, Bilardo CM. (2021). ISUOG practice guidelines: Use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol. 58(3): 331-339. https://doi.org/10.1002/uog.23698; PMid:34278615
Burton GJ, Jauniaux E. (2018). Pathophysiology of placental-derived fetal growth restriction. Am J Obstet Gynecol. 218(2): S745-S761. https://doi.org/10.1016/j.ajog.2017.11.577; PMid:29422210
Chappell LC, Cluver CA, Kingdom J, Tong S. (2021). Pre-eclampsia. The Lancet. 398(10297): 341-354. https://doi.org/10.1016/S0140-6736(20)32335-7; PMid:34051884
Giuliani E, As-Sanie S, Marsh EE. (2020). Epidemiology and management of uterine fibroids. Int J Gynecol Obstet. 149(1): 3-9. https://doi.org/10.1002/ijgo.13102; PMid:31960950
Grannum PA, Berkowitz RL, Hobbins JC. (1979). The ultrasonic changes in the maturing placenta and their relation to fetal pulmonic maturity. Am J Obstet Gynecol. 133(8): 915-922. https://doi.org/10.1016/0002-9378(79)90312-0; PMid:434036
Gude NM, Roberts CT, Kalionis B, King RG. (2020). Growth and function of the normal human placenta. Placenta. 82: 1-8.
Heazell AEP, Siassakos D, Blencowe H et al. (2016). Stillbirths: economic and psychosocial consequences. The Lancet. 387(10018): 604-616. https://doi.org/10.1016/S0140-6736(15)00836-3; PMid:26794073 PMCid:PMC12780511
Ives CW, Sinkey R, Rajapreyar I et al. (2020). Preeclampsia - pathophysiology and clinical presentations. J Am Coll Cardiol.;76(14):1690-1702. https://doi.org/10.1016/j.jacc.2020.08.014; PMid:33004135 PMCid:PMC12042644
Khalil A, Thilaganathan B. (2023). Placental insufficiency in primigravidae of advanced maternal age: Mechanisms and outcomes. Best Pract Res Clin Obstet Gynaecol. 85: 1-12.
Khong TY, Mooney EE, Ariel I et al. (2016). Sampling and definitions of placental lesions: Amsterdam Placental Workshop Group Consensus Statement. Arch Pathol Lab Med. 140(7): 698-713.
Kingdom JC, Walker M. (2020). The fetal medicine foundation: Fetal growth restriction. Ultrasound Obstet Gynecol. 56(4): 476-482.
Lean SC, Derricott H, Jones RL, Heazell AE. (2017). Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS One. 12(10): e0186287. https://doi.org/10.1371/journal.pone.0186287; PMid:29040334 PMCid:PMC5645107
Lisonkova S, Potts J, Muraca GM et al. (2017). Maternal age and severe maternal morbidity: A population-based retrospective cohort study. PLoS Med. 14(5): e1002307. https://doi.org/10.1371/journal.pmed.1002307; PMid:28558024 PMCid:PMC5448726
Milovanov AP. (1991). On the rational morphological classification of placental maturation disorders. Arkh Patol. (12): 3-9.
Milovanov AP. (1999). Pathology of the mother-placenta-fetus system. М.: Meditsina.
Milovanov AP, Bybalkin LD. (1987). Possible mechanisms of placental damage during pregnancy in extreme regions of the USSR. In: Morpho-functional state of the mother-placenta-fetus-newborn system. Frunze: 25-34.
Mintser OP. (2018). Statistical methods of research in clinical medicine. Kyiv: Praktichna meditsina.
Ogge G, Chaiworapongsa T, Romero R et al. (2011). Placental lesions associated with maternal underperfusion are more frequent in early-onset than in late-onset preeclampsia. J Perinat Med. 39(6): 641-652. https://doi.org/10.1515/jpm.2011.098; PMid:21848483 PMCid:PMC3213694
Roberts JM, Bell MJ. (2013). If we know so much about preeclampsia, why haven't we cured the disease? J Reprod Immunol. 99(1-2): 1-9. https://doi.org/10.1016/j.jri.2013.05.003; PMid:23890710 PMCid:PMC4066309
Silver RM, Branch DW. (2019). Placenta accreta spectrum. N Engl J Med. 378: 1529-1536. https://doi.org/10.1056/NEJMcp1709324; PMid:29669225
Sotiriadis A, Makrydimas G. (2023). Advanced maternal age and placental dysfunction: A systematic review. J Matern Fetal Neonatal Med. 36(1): 218-226. https://doi.org/10.1080/14767058.2023.2287981; PMid:38016703
Vanky E, Stridsklev S, Carlsen SM. (2022). Placental hormones in pregnancy: Clinical implications. Trends Endocrinol Metab. 33(6): 401-413.
Wu P, Green M, Myers J. (2023). Hypertensive disorders of pregnancy. BMJ. 381: e071653.
https://doi.org/10.1136/bmj-2022-071653; PMid:37391211
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Ukrainian Journal Health of Woman
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
