Original Article

Archives of Gynecology and Obstetrics

, Volume 277, Issue 3, pp 201-206

Placental morphometrical and histopathology changes in the different clinical presentations of Hypertensive Syndromes in Pregnancy

  • Rosana R. M. CorrêaAffiliated withGeneral Pathology Department, Triângulo Mineiro Federal UniversityDisciplina de Patologia Geral. Departamento de Ciências Biológicas, Universidade Federal do Triângulo Mineiro Email author 
  • , Daniel B. GilioAffiliated withGeneral Pathology Department, Triângulo Mineiro Federal University
  • , Camila L. CavellaniAffiliated withGeneral Pathology Department, Triângulo Mineiro Federal University
  • , Marina C. PaschoiniAffiliated withGynecology and Obstetrics, Triângulo Mineiro Federal University
  • , Flávia A. OliveiraAffiliated withDepartment of Pathology Anatomy, Goiás Federal University
  • , Luís C. PeresAffiliated withDepartment of Pathology Anatomy, Ribeirão Preto Medical School
  • , Marlene A. ReisAffiliated withGeneral Pathology Department, Triângulo Mineiro Federal University
  • , Vicente P. A. TeixeiraAffiliated withGeneral Pathology Department, Triângulo Mineiro Federal University
  • , Eumenia C. C. CastroAffiliated withGeneral Pathology Department, Triângulo Mineiro Federal University

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Abstract

Objective

Even though there are clinical studies emphasizing the diagnosis and the perinatal intercurrent diseases of the Hypertensive Syndromes in Pregnancy, few of these studies establish the clinical forms of the specific hypertensive syndromes with the associated morphological placental alterations. The lack of studies on placental morphology and the etiopathogenesis of the different clinical standards for HSP, together with the need to objectively characterize these morphological placental lesions justify this study.

Study design

A retrospective study was carried out with 91 placentas examined throughout the period from 2000 to 2003. All placentas from patients presenting HSP in this period were included in the study. These were classified according to features well established by the literature such as laboratory and clinical criteria into: gestational hypertension (GH), chronic hypertension (CH), pre-eclampsia (PE) and pre-eclampsia superimposed on chronic hypertension (PSCH).

Results

The number of knots presented a positive correlation with the length of time and severity of the hypertension during gestation (Spearman correlation: 0.253; P = 0.0158). The fibrin deposit was greater in all HSP groups but the pattern of distribution changes in the most severe cases from perivillous to intravillous as in the PSCH group (P = 0.002). There was no statistically significant difference in the area of the stem vessel walls among the groups. The cases with PE and CH presented a larger number of terminal villi vessels (P < 0.001).

Conclusion

This report suggests, that although they could be different types of hypertension or an evaluation of the same disease, the final pathway that leads to microscopic lesions in the placenta is the same, with only different intensity due to the severity of the disease.

Keywords

Gestational Hypertension Morphological Morphometric Placenta