Document Detail


The Frequency of Acute Atherosis in Normal Pregnancy and Preterm Labor, Preeclampsia, Small for Gestational Age, Fetal Death and Midtrimester Spontaneous Abortion.
MedLine Citation:
PMID:  25308204     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: Acute atherosis is characterized by subendothelial lipid-filled foam cells, fibrinoid necrosis and perivascular lymphocytic infiltration. This lesion is generally confined to non-transformed spiral arteries and is frequently observed in patients with preeclampsia. However, the frequency of acute atherosis in the great obstetrical syndrome is unknown. The purpose of this study was to determine the frequency and the topographic distribution of acute atherosis in the placentas and placental bed biopsy samples obtained from women with normal pregnancy and those affected by the great obstetrical syndromes. We also examined the relationship between acute atherosis and pregnancy outcome in patients with preeclampsia. Material and methods: A retrospective cohort study of pregnant women who delivered between July 1998 and July 2014 at Hutzel Women's Hospital/Detroit Medical Center was conducted examine 16,345 placentas. Patients were classified into the following groups: 1) uncomplicated pregnancy; 2) spontaneous preterm labor and preterm prelabor rupture of membranes (PPROM); 3) preeclampsia; 4) gestational hypertension; 5) small for gestational age; 6) chronic hypertension; 5) fetal death; 6) spontaneous abortion; and 7) others. A subset of patients had placenta bed biopsy. The incidence of acute atherosis was compared among the different groups. Results: 1) The prevalence of acute atherosis in uncomplicated pregnancies was 0.4% (29/6,961) based upon examination of nearly 7,000 placentas; 2) the frequency of acute atherosis was 10.2% (181/1,779) in preeclampsia, 9% (26/292) in fetal death, 2.5% (3/120) in midtrimester spontaneous abortion, 1.7% (22/1,298) in small for gestational age neonates, and 1.2% (23/1,841) in spontaneous preterm labor and PPROM; 3) among patients with preeclampsia, those with acute atherosis had significantly more severe disease, earlier onset, and a greater frequency of small for gestational age neonates (p < 0.05 all); 4) the lesion was more frequently observed in the decidua (parietalis or basalis) than in the decidual segment of the spiral arteries in patients with placental bed biopsies. Conclusions: Acute atherosis is rare in normal pregnancy, and occurs more frequently in patients with pregnancy complications, including preeclampsia, spontaneous preterm labor, preterm PROM, midtrimester spontaneous abortion, fetal death, and SGA.
Authors:
Yeon Mee Kim; Piya Chaemsaithong; Roberto Romero; Majid Shaman; Chong Jai Kim; Jung Sun Kim; Faisal Qureshi; Suzanne M Jacques; Ahmed I Ahmed; Tinnakorn Chaiworapongsa; Sonia S Hassan; Lami Yeo; Steven J Korzeniewski
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-13
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-13     Completed Date:  -     Revised Date:  2014-10-14    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-24     Citation Subset:  -    
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