title: Relationship between placental morphology and histological findings in an unselected population near term.
abstract: Whilst individual histological features are well described, there are no universally agreed criteria as to what constitutes a clinically significant histological lesion of the placenta in an uncomplicated pregnancy, nor has the presence of such histological findings been systematically related to quantitative morphological characteristics of the placenta (such as placental shape, cord insertion and cord coiling). This study aims to explore this relationship and further to describe the incidence of predefined categories of histological lesions of the placenta in an unselected obstetric population recruited prior to delivery. The study is based upon the placental examination of 1,156 women with singleton pregnancies recruited prospectively in a single unit. Placentas were analysed where deliveries occurred between 34-43 weeks. The incidence of normal histological findings and specific histological categories, such as ascending genital tract infection, chronic placental underperfusion, intervillous thrombus and villitis of unknown aetiology, were noted. The relationship between placental morphological indices: coiling index, cord centrality index (distance of cord insertion on the chorionic plate from the centre) and eccentricity (shape of the placenta) and histological lesions was investigated. There were no significant differences between cord centrality and eccentricity between placentas with and without histological lesions except an association between hypercoiling of the umbilical cord and intervillous thrombosis and villitis of unknown aetiology (p = 0.024 and p = 0.009, respectively). The macroscopic morphological features of the placenta cannot predict the presence or absence of the histological placental lesions, nor are these lesions in general associated with differences in cord centrality, placental eccentricity or cord coiling.
authors.affiliation: Division of Fetal-Maternal Medicine, Rosie Maternity-Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 2QQ, UK.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Pathak
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Sebire
authors.forename: Liz
authors.initials: L
authors.lastname: Hook
authors.forename: Gerald
authors.initials: G
authors.lastname: Hackett
authors.forename: Edile
authors.initials: E
authors.lastname: Murdoch
authors.forename: Flora
authors.initials: F
authors.lastname: Jessop
authors.forename: Christoph
authors.initials: C
authors.lastname: Lees
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D008423:Maternal Age; D010920:Placenta / Q000098:blood supply / Q000473:pathology*; D010922:Placenta Diseases / Q000175:diagnosis*; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D047929:Term Birth