Placental Histopathologic Findings Associated with Antepartum Eclampsia [1P]

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Abstract

INTRODUCTION:

The aim of this study was to describe placental pathology among women with antepartum eclampsia.

METHODS:

This was a retrospective cohort study of placental pathology of women with antepartum eclampsia who delivered from May 2009 to December 2016 at Parkland Hospital. Placentas were processed using an institutionalized standardized examination. Placental pathology lesions were grouped into categories including inflammation (vasculitis, funisitis, amnionitis), vasculopathy (infarcts, atheroma), meconium exposure, placenta hypoplasia/hyperplasia, and no pathologic abnormality. Each placenta may have had numerous findings in different categories.

RESULTS:

There were 44 women with antepartum eclampsia at our institution during the study period. Of these, 31 women had placental pathology examined according to institutional protocol. These women were majority Hispanic (83%), primagravidas (65%), and the average age as 23 +/- 7 years. Eclampsia developed at an average gestational age of 36 +/-4 weeks. Sixteen women (52%) had cesarean deliveries, eight (26%) had vaginal deliveries, and seven (22%) had forcep-assisted vaginal deliveries. Overall, the finding of inflammatory lesions was observed in 61%, meconium staining in 55%, and vasculopathy in 42%. Placental hypoplasia was noted in 29% and hyperplasia in 19%. Only one placenta was found to have no histopathologic abnormality.

CONCLUSION:

In women with antepartum eclampsia, 97% of placentas examined revealed a histopathologic abnormality such as meconium exposure, vasculopathy, or inflammatory lesions. More than half were observed to have evidence of meconium exposure and 65% were noted to have more than one histopathologic finding.

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