CAN PLACENTAL HISTOPATHOLOGICAL LESIONS BE A GUIDE TO MATERNAL AND NEONATAL OUTCOMES IN PATIENTS WITH PREECLAMPSIA?

Öz

Objective: The aim of this study was to investigate the predictive role of massive perivillous fibrinoid deposition (MPFD), syncytial knots, and accompanying histopathological features of placentas of preeclampsia (PE) on maternal and neonatal outcomes.
Matherials and methods: A retrospective clinicopathological study was conducted in a tertiary unit. In the study, 51 pregnant women admitted with PD and 55 normotensive healthy pregnant women matched for age and gestational age were compared. Information regarding clinical characteristics, neonatal findings, and placental properties such as syncytial knots, vascular structure density, placental area, volume, and weight) was retrieved.
Results: Massive perivillous fibrinoid deposition, syncytial knots and decreased vessels in terminal villi were significantly frequent in the PE group compared to the controls. However, these histopathological findings were not associated with clinical and neonatal outcomes.
Conclusions: Syncytial knot and perivillous fibrin deposition are significant microscopic findings of preeclampsia. However, the presence and amount of fibrin deposition were not correlated with perinatal outcome.

Anahtar Kelimeler

• Preeclampsia
• Massive perivillous fibrinoid deposition
• Syncytial knots
• Neonatal outcomes
• Obstetric complications

PREEKLAMPSİLİ HASTALARDA PLASENTAL HİSTOPATOLOJİK LEZYONLAR MATERNAL VE NEONATAL SONUÇLAR İÇİN BİR REHBER OLABİLİR Mİ?

Öz

Amaç: Bu çalışma preeklampsi (PE) plasentalarında perivillöz fibrinoid birikimini (PFB), sinsityal düğümleri ve eşlik eden histopatolojik özelliklerin klinik etkisini araştırmayı amaçladı.
Gereç ve yöntem: Retrospektif bir klinikopatolojik çalışma olarak üçüncü basamak hastanede yürütüldü. Çalışmaya obstetri kliniğinde PE tanısı konmuş olan 51 gebe ile yaş ve gestasyonel süre açısından eşleştirilmiş 55 normotansif sağlıklı gebe dahil edildi. Klinik özellikler ve gebeliğe ait veriler (maternal-gestasyonel yaş, gravida, parite, intrauterin büyüme geriliği, oligohidramniyoz & anhidramniyoz durumu, koryoamniyonit varlığı, umblikal arter doppler pulsatilite indeksinde artış, preterm doğum, yenidoğanın 1. ve 5. dakika apgar skorları, doğum ağırlığı, hemogram parametreleri, umblikal kord kan gazı (umblikal arter) pH, baz açığı ve kalsiyum düzeyleri) karşılaştırıldı. Ayrıca, sinsityal düğümler, vasküler yapılanma yoğunluğu, plasental alan, volüm ve ağırlık gibi plasental veriler de hesaplandı.
Bulgular: Perivillöz fibrinoid birikimi ve sinsityal düğümler, PE grubunda kontrollere kıyasla anlamlı derecede sık ve yoğundu. Terminal villuslarda azalmış damarlar, artmış sinsityal düğüm ve artmış perivillöz fibrin birikimi PE ile ilişkilidir. Parametrelerin klinik ve neonatal etkileri araştırıldığında, sadece umblikal kord kan gazı analizinde kalsiyum seviyelerinde gruplar arasında anlamlı fark elde edildi (p=0.008).
Sonuç: Sinsityal düğüm ve perivillöz fibrin birikimi preeklampsinin önemli mikroskobik bulgularıdır. Fibrin birikiminin varlığı ve miktarı, fetal ağırlık ve plasentanın makroskopik özellikleri (plasenta ağırlığı, alanı ve hacmi) ile ilişkili değildi. Bu bulguların

Anahtar Kelimeler

• Preeklampsi
• Masif perivillöz fibrinoid birikimi
• Sinsityal düğümler
• Neonatal sonuçlar
• Obstetrik komplikasyonlar

Kaynakça

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