Histological characteristics of singleton placentas delivered before the 28th week of gestation.
OBJECTIVE
The placenta is a record of the fetal environment and its examination may provide information about the baby's subsequent growth and development. We describe the histological characteristics of 947 singleton placentas from infants born between 23 and 27 weeks gestation.


METHODS
Consent was obtained from mothers who delivered before 28 weeks (clinical estimate). We evaluated the gross and histopathological features of the placenta and assessed pair-wise correlations between variables.


RESULTS
Lesions of uteroplacental circulation (abruption, extensive infarction or thrombosis, marked basal or perivillous fibrin deposition, increased syncytial knots) were inversely related to those associated with inflammation of the membranes and cord. Earlier age favoured inflammatory variables, while older age favoured characteristics attributed to impaired blood flow. We observed inflammation of the chorionic plate in 43%, the cord in 19%, and of chorionic plate vessels in 30%. Of the placentas with umbilical cord inflammation, 8% had no inflammation of the chorionic plate.


CONCLUSIONS
This study population is unique in its size and recruitment by gestational age rather than birth weight. Inflammation occurred frequently, but not in placentas that had characteristics of vasculopathy. The prevalence of inflammation decreased with increasing gestational age, while vasculopathy increased. Funisitis need not be accompanied by chorionic inflammation.
Hecht
Jonathan L
JL
Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02118, USA. jlhecht@bidmic.harvard.edu
Allred
Elizabeth N
EN
Kliman
Harvey J
HJ
Zambrano
Eduardo
E
Doss
Barbara J
BJ
Husain
Aliya
A
Pflueger
Solveig M V
SM
Chang
Chung-Ho
CH
Livasy
Chad A
CA
Roberts
Drucilla
D
Bhan
Ina
I
Ross
Dennis W
DW
Senagore
Patricia Kaman
PK
Leviton
Alan
A
D000328:Adult; D002821:Chorioamnionitis / Q000473:pathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D009929:Organ Size; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D047928:Premature Birth