title: A case-control study of placental lesions associated with pre-eclampsia.
abstract: OBJECTIVE
  To investigate gross and microscopic placental lesions associated with pre-eclampsia and to determine which lesions are most strongly linked to serious pregnancy complications.
  
  
  METHODS
  A retrospective case-control study of 173 placentas from women with pre-eclampsia and 173 placentas from healthy normotensive women was conducted.
  
  
  RESULTS
  The mean placental weight in the pre-eclampsia group was lower than that recorded for the control group (280 g vs 360 g; P<0.001). Infarcts (65.9% vs 13.2%; P<0.001) and placental abruption (P<0.001) were most frequent among women with pre-eclampsia. Microscopic findings showed the following lesions to be associated with pre-eclampsia: hypermature villi, defined by absence of intermediate villi (72% vs 16%; P<0.001), excessive syncytial knots (90% vs 9%; P<0.001), decidual vasculopathy (51% vs 8%; P<0.001), villous fibrosis (6% vs 0%; P<0.001), erythroblastosis (11% vs 4%; P<0.01), and avascular terminal villi (9% vs 3%; P<0.05). Increased syncytial knots, infarcts, basal decidual vasculopathy, hypermature villi, and placental erythroblastosis were still associated with pre-eclampsia after logistic regression modeling.
  
  
  CONCLUSIONS
  Placental lesions most strongly associated with pre-eclampsia were all causes or expressions of placental hypoxia or ischemia, which appears as the primary mechanism of pre-eclampsia.
authors.affiliation: Department of Pathology, Biology-Pathology Center CHRU de Lille, Lille Cedex, France.
authors.forename: Louise
authors.initials: L
authors.lastname: Devisme
authors.forename: Benjamin
authors.initials: B
authors.lastname: Merlot
authors.forename: Anne
authors.initials: A
authors.lastname: Ego
authors.forename: Veronique
authors.initials: V
authors.lastname: Houfflin-Debarge
authors.forename: Philippe
authors.initials: P
authors.lastname: Deruelle
authors.forename: Damien
authors.initials: D
authors.lastname: Subtil
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007238:Infarction / Q000473:pathology; D016015:Logistic Models; D015999:Multivariate Analysis; D009929:Organ Size; D010920:Placenta / Q000098:blood supply / Q000473:pathology*; D011225:Pre-Eclampsia / Q000473:pathology*; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult