Placental pathology and antiphospholipid antibodies: a descriptive study.
We described placental pathology in antiphospholipid antibody (APL) syndrome, APL and no history of recurrent pregnancy loss, and in treated and untreated pregnancies of APL syndrome. Thirty-nine pregnancies of 28 patients were studied: 23 placentas delivered from 23 women with APL (13 with APL syndrome and 10 with serological APL); 8 untreated miscarriages before APL diagnosis from 6 of the 13 patients with APL syndrome and 1 of 10 with serological APL; and 8 miscarriages by 5 additional women before APL syndrome diagnosis. Histopathology was reviewed by a pathologist blinded except to gestational age. Contingency tables and analysis of variance (ANOVA) considered p < 0.05 significant. Comparing the placentas delivered at > 18 weeks' gestation, excessive perivillous coagulation, avascular terminal villi, and chronic villitis/uteroplacental vasculitis tended to be more common in treated APL syndrome than serological APL cases (p = 0.07). Of the 16 miscarriages before diagnosis of APL, 11 were lost at < 18 weeks' gestation. None had pathology typical of APL, but 4 of 11 (36%) had chronic intervillositis. Five of 16 miscarriages before the diagnosis of APL were miscarried between 18-22 weeks. Three of 5 (60%) miscarried after 18 weeks had multifocal uteroplacental thromboses, compared to 6 of 13 (46%) treated pregnancies with APL syndrome and 0 of 10 cases with serological APL.
Salafia
C M
CM
Department of Pathology, Montefiore Medical Center, Bronx, New York, USA.
Cowchock
F S
FS
D000022:Abortion, Spontaneous / Q000276:immunology; D016736:Antiphospholipid Syndrome / Q000276:immunology / Q000473:pathology*; D002824:Chorionic Villi / Q000473:pathology; D005260:Female; D006801:Humans; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology / Q000473:pathology*; D012008:Recurrence