Preeclampsia with and without intrauterine growth restriction-Two pathogenetically different entities?
OBJECTIVE
The objective of this study is to determine the differences in histopathological features of basal decidua and placenta in cases of preeclampsia with or without fetal intrauterine growth restriction (IUGR).


METHODS
A prospective case-control study included a study group consisting of 30 pregnant women with preeclampsia completed by cesarean section (CS), in 19 of whom preeclampsia was associated with IUGR, and in 11 it was not. The control group consisted of 20 healthy pregnant women delivered by elective CS. Placentas and samples of placental bed obtained during CS were histopathologically (HP) analyzed after hematoxylin-eosin staining and immunohistochemical labeling of Cytokeratin 7 (CK7) trophoblastic cells in decidua.


RESULTS
Regarding the HP changes in the spiral arteries in preeclampsia, the most frequent features were inadequate transformation of spiral arteries with poor trophoblastic invasion (70.0%) and fibrinoid necrosis of the media (66.7%), and rarely acute atherosis (33.3%) and thrombosis (30.0%). Villous hypermaturity was more frequently found in placentas of patients with preeclampsia with IUGR (p < 0.05), while there were no differences between subgroups of preeclampsia with and without IUGR regarding some of HP alterations of placental bed.


CONCLUSIONS
Alterations of the placental bed in terms of decidual vasculopathy are more the characteristics of the preeclampsia itself than IUGR, while changes in placental villi primarily follow the presence of IUGR, which could indicate that preeclampsia with and without IUGR are two pathogenetically different entities.
a Department of Gynecology and Obstetrics, Faculty of Medicine , University of Nis , Nis , Serbia.|c Clinic of Gynecology and Obstetrics , Clinical Center Nis , Nis , Serbia.
Jelena
J
Milosevic-Stevanovic
b Department of Pathology, Faculty of Medicine , University of Nis , Nis , Serbia.|d Center for Pathology , Clinical Center Nis , Nis , Serbia.
Miljan
M
Krstic
a Department of Gynecology and Obstetrics, Faculty of Medicine , University of Nis , Nis , Serbia.|c Clinic of Gynecology and Obstetrics , Clinical Center Nis , Nis , Serbia.
Dragana
D
Radovic-Janosevic
a Department of Gynecology and Obstetrics, Faculty of Medicine , University of Nis , Nis , Serbia.|c Clinic of Gynecology and Obstetrics , Clinical Center Nis , Nis , Serbia.
Milan
M
Stefanovic
c Clinic of Gynecology and Obstetrics , Clinical Center Nis , Nis , Serbia.
Vladimir
V
Antic
b Department of Pathology, Faculty of Medicine , University of Nis , Nis , Serbia.
Ivana
I
Djordjevic
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D053552:Keratin-7 / Q000378:metabolism; D009336:Necrosis / Q000378:metabolism / Q000473:pathology; D010920:Placenta / Q000378:metabolism / Q000473:pathology*; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
D053552:Keratin-7
Decidua; intrauterine growth restriction; placenta; preeclampsia; throphoblast