Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature
Abstract Introduction Preeclampsia (PE) is a pregnancy complication associated with increased maternal and perinatal morbidity and mortality. The disease presents with recent onset hypertension (after 20 weeks of gestation) and proteinuria, and can progress to multiple organ dysfunction, with wors...
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| Format: | Article |
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Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
2021-10-01
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| Series: | Revista Brasileira de Ginecologia e Obstetrícia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032021000700560&tlng=en |
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| author | Luciana Pietro José Paulo de Siqueira Guida Guilherme de Moraes Nobrega Arthur Antolini-Tavares Maria Laura Costa |
| author_facet | Luciana Pietro José Paulo de Siqueira Guida Guilherme de Moraes Nobrega Arthur Antolini-Tavares Maria Laura Costa |
| author_sort | Luciana Pietro |
| collection | DOAJ |
| description | Abstract Introduction Preeclampsia (PE) is a pregnancy complication associated with increased maternal and perinatal morbidity and mortality. The disease presents with recent onset hypertension (after 20 weeks of gestation) and proteinuria, and can progress to multiple organ dysfunction, with worse outcomes among early onset preeclampsia (EOP) cases (<34 weeks). The placenta is considered the root cause of PE; it represents the interface between the mother and the fetus, and acts as a macromembrane between the two circulations, due to its villous and vascular structures. Therefore, in pathological conditions, macroscopic and microscopic evaluation can provide clinically useful information that can confirm diagnosis and enlighten about outcomes and future therapeutic benefit. Objective To perform an integrative review of the literature on pathological placental findings associated to preeclampsia (comparing EOP and late onset preeclampsia [LOP]) and its impacts on clinical manifestations. Results: Cases of EOP presented worse maternal and perinatal outcomes, and pathophysiological and anatomopathological findings were different between EOP and LOP placentas, with less placental perfusion, greater placental pathological changes with less villous volume (villous hypoplasia), greater amount of trophoblastic debris, syncytial nodules, microcalcification, villous infarcts, decidual arteriolopathy in EOP placentas when compared with LOP placentas. Clinically, the use of low doses of aspirin has been shown to be effective in preventing PE, as well asmagnesium sulfate in preventing seizures in cases of severe features. Conclusion The anatomopathological characteristics between EOP and LOP are significantly different, with large morphological changes in cases of EOP, such as |
| first_indexed | 2024-04-11T15:31:24Z |
| format | Article |
| id | doaj.art-89f09bf98e8b498fb4d96bb4c4cef1de |
| institution | Directory Open Access Journal |
| issn | 0100-7203 |
| language | English |
| last_indexed | 2024-04-11T15:31:24Z |
| publishDate | 2021-10-01 |
| publisher | Federação Brasileira das Sociedades de Ginecologia e Obstetrícia |
| record_format | Article |
| series | Revista Brasileira de Ginecologia e Obstetrícia |
| spelling | doaj.art-89f09bf98e8b498fb4d96bb4c4cef1de2022-12-22T04:16:07ZengFederação Brasileira das Sociedades de Ginecologia e ObstetríciaRevista Brasileira de Ginecologia e Obstetrícia0100-72032021-10-0143756056910.1055/s-0041-1730292Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the LiteratureLuciana Pietrohttps://orcid.org/0000-0002-8511-2196José Paulo de Siqueira Guidahttps://orcid.org/0000-0002-3648-6159Guilherme de Moraes Nobregahttps://orcid.org/0000-0001-9406-4256Arthur Antolini-Tavareshttps://orcid.org/0000-0001-5964-4407Maria Laura Costahttps://orcid.org/0000-0001-8280-3234Abstract Introduction Preeclampsia (PE) is a pregnancy complication associated with increased maternal and perinatal morbidity and mortality. The disease presents with recent onset hypertension (after 20 weeks of gestation) and proteinuria, and can progress to multiple organ dysfunction, with worse outcomes among early onset preeclampsia (EOP) cases (<34 weeks). The placenta is considered the root cause of PE; it represents the interface between the mother and the fetus, and acts as a macromembrane between the two circulations, due to its villous and vascular structures. Therefore, in pathological conditions, macroscopic and microscopic evaluation can provide clinically useful information that can confirm diagnosis and enlighten about outcomes and future therapeutic benefit. Objective To perform an integrative review of the literature on pathological placental findings associated to preeclampsia (comparing EOP and late onset preeclampsia [LOP]) and its impacts on clinical manifestations. Results: Cases of EOP presented worse maternal and perinatal outcomes, and pathophysiological and anatomopathological findings were different between EOP and LOP placentas, with less placental perfusion, greater placental pathological changes with less villous volume (villous hypoplasia), greater amount of trophoblastic debris, syncytial nodules, microcalcification, villous infarcts, decidual arteriolopathy in EOP placentas when compared with LOP placentas. Clinically, the use of low doses of aspirin has been shown to be effective in preventing PE, as well asmagnesium sulfate in preventing seizures in cases of severe features. Conclusion The anatomopathological characteristics between EOP and LOP are significantly different, with large morphological changes in cases of EOP, such ashttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032021000700560&tlng=enplacentamaternal mortality and morbiditypreeclampsia early onsetpreeclampsia late onsetanatomopathological characteristics |
| spellingShingle | Luciana Pietro José Paulo de Siqueira Guida Guilherme de Moraes Nobrega Arthur Antolini-Tavares Maria Laura Costa Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature Revista Brasileira de Ginecologia e Obstetrícia placenta maternal mortality and morbidity preeclampsia early onset preeclampsia late onset anatomopathological characteristics |
| title | Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature |
| title_full | Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature |
| title_fullStr | Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature |
| title_full_unstemmed | Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature |
| title_short | Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature |
| title_sort | placental findings in preterm and term preeclampsia an integrative review of the literature |
| topic | placenta maternal mortality and morbidity preeclampsia early onset preeclampsia late onset anatomopathological characteristics |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032021000700560&tlng=en |
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