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Relationship between placental morphology and histological findings in an unselected population near term

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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.

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Acknowledgement

SP’s salary was in part funded through Cambridge Fetal Care and Pathology costs through a grant from Addenbrooke's Charitable Trust.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Division of Fetal-Maternal Medicine, Rosie Maternity-Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 2QQ, UK

    Sangeeta Pathak, Gerald Hackett & Christoph Lees

  2. Histopathology Department, Great Ormond Street Hospital, London, WC1N 3JH, UK

    Neil J. Sebire

  3. Department of Pathology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 2QQ, UK

    Liz Hook & Flora Jessop

  4. Neonatal Unit, Rosie Maternity-Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 2QQ, UK

    Edile Murdoch

Authors
  1. Sangeeta Pathak
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  2. Neil J. Sebire
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  3. Liz Hook
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  4. Gerald Hackett
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  5. Edile Murdoch
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  6. Flora Jessop
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  7. Christoph Lees
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Correspondence to Christoph Lees.

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Pathak, S., Sebire, N.J., Hook, L. et al. Relationship between placental morphology and histological findings in an unselected population near term. Virchows Arch 459, 11–20 (2011). https://doi.org/10.1007/s00428-011-1061-6

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  • DOI: https://doi.org/10.1007/s00428-011-1061-6

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