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Placenta and Umbilical Cord and the Immunology of Pregnancy

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Fetal and Neonatal Pathology

Abstract

The placenta and extraplacental membranes are an apposition of fetal and maternal tissues for the purposes of physiological exchange. The gestation sac has a finite lifespan and is the body’s largest biopsy, yet its examination is often neglected, even from fetal and neonatal deaths, sick and premature neonates and maternal complications of pregnancy. This is perplexing because its function is embodied in its definition. It may be that placental pathology is considered complex since the organ is evolving rapidly over a short period of time, or that lesions found may be quantitative rather than qualitative. The response of the placenta to injury is limited and there is a need to correlate the macroscopic and microscopic findings with clinical and laboratory investigations.

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References

  • Abramowsky CR, Vegas ME, Swinehart G, Gyves MT (1980) Decidual vasculopathy of the placenta in lupus erythematosus. N Engl J Med 303: 668–672

    Article  PubMed  CAS  Google Scholar 

  • Aherne W, Dunnill MS (1982) Morphometry. Arnold, London

    Google Scholar 

  • Althabe Labarrere (1985) Chronic villitis of unknown aetiology and intrauterine growth-retarded infants of normal and low ponderal index. Placenta 6: 369–373

    Article  PubMed  CAS  Google Scholar 

  • Althabe Labarrere C, Telenta M (1985) Maternal vascular lesions in placentae of small-for-gestational-age infants. Placenta 6: 265–276

    Article  Google Scholar 

  • Altshuler G (1984) Chorangiosis. An important sign of neonatal morbidity and mortality. Arch Pathol Lab Med 108: 71–74

    PubMed  CAS  Google Scholar 

  • Altshuler G, Russell P (1975) The human villitides; a review of chronic intrauterine infection. Springer, Berlin, pp 63–112

    Google Scholar 

  • Andres RL, Kuyper W, Resnik R, Piacquadio KM, Benirschke K (1990) The association of maternal floor infarction of the placenta with adverse perinatal outcome. Am J Obstet Gynecol 163: 935–938

    PubMed  CAS  Google Scholar 

  • Baill IC, Moore GW, Hendrick LA (1989) Abscess of allantoic duct remnant. Am J Obstet Gynecol 161: 334–336

    PubMed  CAS  Google Scholar 

  • Baill IC, Witter FR (1990) Sickle trait and its association with birthweight and urinary tract infections in pregnancy. Int J Gynaecol Obstet 33: 19–21

    Article  PubMed  CAS  Google Scholar 

  • Bain C, Elliot BW (1976) Fetal distress in the first stage of labour associated with early fetal heart decelerations and a short umbilical cord. Aust NZ J Obstet Gynaecol 16: 51–56

    Article  Google Scholar 

  • Batcup G, Holt P, Hambling MH, Gerlis LM, Glass MR (1985) Placental and fetal pathology in Coxsackie virus A9 infection: a case report. Histopathology 9: 1227–1235

    Article  PubMed  CAS  Google Scholar 

  • Bendon RW, Ray MB (1986) The pathologic findings of the fetal membranes in very prolonged amniotic fluid leakage. Arch Pathol Lab Med 110: 47–50

    PubMed  CAS  Google Scholar 

  • Benirschke K, Driscoll S (1976) The pathology of the human placenta. Springer, Berlin

    Google Scholar 

  • Birkenfeld A, Mordel N, (1989) Direct demonstration of iron in a placenta in a case of β-thalassemia major. Am J Obstet Gynecol 160: 562–563

    PubMed  CAS  Google Scholar 

  • Björk Persson (1982) Placental changes in relation to the degree of metabolic control in diabetes mellitus. Placenta 3: 367–378

    Article  PubMed  Google Scholar 

  • Björk Persson (1984) Villous structure in different parts of the cotyledon in placentas of insulin-dependent diabetic women. Acta Obstet Gynecol Scand 63: 37–43

    Article  PubMed  Google Scholar 

  • Blanc WA (1981) Pathology of the placenta, membranes and umbilical cord in bacterial, fungal and viral infections in man. In: Naeye RL, Kissane JM, Kaufman N (eds) Perinatal disease. Williams and Wilkins, Baltimore, pp 67–132

    Google Scholar 

  • Bleker OP, Kloosterman GJ, Breur W, Mieras DJ (1977) The volumetric growth of the human placenta: a longitudinal ultrasonic study. Am J Obstet Gynecol 127: 657–661

    PubMed  CAS  Google Scholar 

  • Blickstein I, Shoham-Schwartz Z, Lancet M (1987) Predisposing factors in the formation of true knots of the umbilical cord—analysis of morphometric and perinatal data. Int J Gynaecol Obstet 25: 395–398

    Article  PubMed  CAS  Google Scholar 

  • Boyd JD, Hamilton WJ (1970) The human placenta. Heffer, Cambridge

    Google Scholar 

  • Boyd PA (1984) Quantitative structure of the normal human placenta from ten weeks of gestation to term. Early Hum Dev 9: 297–307

    Article  PubMed  CAS  Google Scholar 

  • Boyd PA, Scott A (1985) Quantitative structural studies in human placentas associated with pre-eclampsia, essential hypertension and intrauterine growth retardation. Br J Obstet Gynaecol 92: 714–721

    Article  PubMed  CAS  Google Scholar 

  • Boyd PA, Brown R, Stewart W (1980) Quantitative structural differences within the normal term human placenta: a pilot study. Placenta 1: 337–344

    Article  PubMed  CAS  Google Scholar 

  • Boyd PA, Scott A, Keeling JW (1986) Quantitative structural studies on placentas from pregnancies complicated by diabetes mellitus. Br J Obstet Gynaecol 93: 31–35

    Article  PubMed  CAS  Google Scholar 

  • Bryan EM (1986) The intrauterine hazards of twins. Arch Dis Child 61: 1044–1045

    Article  PubMed  CAS  Google Scholar 

  • Bruyniks N, Khong TY, Leong R (1988) Relation of site of umbilical cord insertion and birth weight. J Obstet Gynaecol 9: 34–35

    Article  Google Scholar 

  • Bulmer JN, Johnson PM (1983) Antigen expression by trophoblast populations in the human placenta and their possible immunobiological relevance. Placenta 6: 127–140

    Article  Google Scholar 

  • Burton GJ, Palmer ME, Dalton KJ (1989) Morphometric differences between the placental vasculature of non-smokers, smokers and ex-smokers. Br J Obstet Gynaecol 96: 907–915

    Article  PubMed  CAS  Google Scholar 

  • Carter J (1984) The maternal immunological response during pregnancy. In: Clarke JR (ed) Oxford reviews of reproductive biology, vol 6. Clarendon Press, Oxford, 47–128

    Google Scholar 

  • Christmas SE, Bulmer JN, Meager A, Johnson PM (1990) Phenotypic and functional analysis of human CD3-decidual leucocyte clones. Immunology 71: 182–189

    PubMed  CAS  Google Scholar 

  • Clark DA, Mowbray J, Underwood J, Liddell H (1987) Histopathologic alteration in the decidua in human spontaneous abortion: loss of cells with large cytoplasmic granules. Am J Reprod Immunol 13: 19–22

    CAS  Google Scholar 

  • Clarson C, Tevaarwerk GJM, Harding PGR, Chance GW, Haust MD (1989) Placental weight in diabetic pregnancies. Placenta 10: 275–281

    Article  PubMed  CAS  Google Scholar 

  • Clausen I (1989) Umbilical cord anomalies and antenatal fetal deaths. Obstet Gynecol Surv 44: 841–845

    Article  PubMed  CAS  Google Scholar 

  • Clewell WH, Manchester DK (1983) Recurrent maternal floor infarction: a preventable cause of fetal death. Am J Obstet Gynecol 147: 346–347

    PubMed  CAS  Google Scholar 

  • Coid CR, Fox H (1983) Short review: Campylobacters as placental pathogens. Placenta 4: 295–306

    Article  PubMed  CAS  Google Scholar 

  • Costoya AL, Leontic EA, Rosenberg HG, Delgado MA (1980) Morphological study of placental terminal villi in intrahepatic cholestasis of pregnancy: histochemistry, light and electron microscopy. Placenta 1: 361–368

    Article  PubMed  CAS  Google Scholar 

  • Danskin FH, Neilson JP (1989) Twin-to-twin transfusion syndrome: what are appropriate criteria? Am J Obstet Gynecol 161: 365–369

    PubMed  CAS  Google Scholar 

  • Davey DA, MacGillivray I (1988) The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol 158: 892–898

    PubMed  CAS  Google Scholar 

  • Denmead DT, Ariagno RL, Carson SH, Benirschke KB (1987) Placental pathology is not predictive for sudden infant death syndrome (SIDS). Am J Perinatol 4: 308–312

    Article  PubMed  CAS  Google Scholar 

  • Dildy GA III, Moise KJ Jr, Carpenter RJ Jr, Klima T (1989) Maternal malignancy metastatic to the products of conception. Obstet Gynecol Surv 44: 535–540

    Article  PubMed  Google Scholar 

  • Dougall A, Baird CH (1987) Vasa praevia—report of three cases and review of literature. Br J Obstet Gynaecol 94: 712–715

    Article  PubMed  CAS  Google Scholar 

  • Edmonds DK, Lindsay KS, Miller JF, Williamson E, Wood PJ (1982) Early embryonic mortality in women. Fertil Steril 38: 447–453

    PubMed  CAS  Google Scholar 

  • Ellis SA, Sargent IL, Redman CWG, McMichael AJ (1986) Evidence for a novel HLA antigen found on human extra villous trophoblast and a choriocarcinoma cell line. Immunology 59: 595–601

    PubMed  CAS  Google Scholar 

  • Ellis SA, Palmer MS, McMichael AJ (1990) Human trophoblast and the choriocarcinoma cell line BeWo express a truncated HLA class I molecule. J Immunol 144: 731–735

    PubMed  CAS  Google Scholar 

  • Faulk WP (1988) Haemostasis and fibrinolysis in human normal placentae: possible role in early pregnancy failure. In: Beard RW, Sharp F (eds) Early pregnancy loss. Mechanisms and treatment. Peacock Press, Ashton-under-Lyne, pp 193–198

    Chapter  Google Scholar 

  • Faulk WP, Temple A, Lovins R, Smith NC (1978) Antigens of human trophoblast: a working hypothesis for their role in normal and abnormal pregnancies. Proc Natl Acad Sci USA 75: 1947–1951

    Article  PubMed  CAS  Google Scholar 

  • Ferry BL, Starkey PM, Sargent IL, Watt GMO, Jackson M, Redman CWG (1990) Cell populations in the human early pregnancy decidua: natural killer activity and response to interleukin-2 of CD56-positive large granular lymphocytes. Immunology 70: 446–452

    PubMed  CAS  Google Scholar 

  • Fizet D, Bousquet J (1983) Absence of a factor blocking a cellular cytotoxicity reaction in the serum of women with recurrent abortions. Br J Obstet Gynaecol 90: 453–456

    Article  PubMed  CAS  Google Scholar 

  • Fox H (1969) Pathology of the placenta in maternal diabetes mellitus. Obstet Gynecol 34: 792–798

    PubMed  CAS  Google Scholar 

  • Fox H (1978) Pathology of the placenta. Saunders, London

    Google Scholar 

  • Fox H, Langley FA (1971) Leucocytic infiltration of the placenta and umbilical cord: a clinico-pathologic study. Obstet Gynecol 37: 451–458

    PubMed  CAS  Google Scholar 

  • Fox H, Laurini RN (1988) Intraplacental choriocarcinoma: a report of 2 cases. J Clin Pathol 41: 1085–1088

    Article  PubMed  CAS  Google Scholar 

  • Fox H, Sen DK (1972) Placenta extrachorialis: a clinico-pathological study. J Obstet Gynaecol Br Cmwlth 79: 32–35

    Article  CAS  Google Scholar 

  • Garcia AGP (1982) Placental morphology of low birth weight infants at term: gross and microscopic study of 50 cases. Contrib Gynecol Obstet 9: 100–112

    PubMed  CAS  Google Scholar 

  • Garite TJ, Freeman RK (1982) Chorioamnionitis in the preterm gestation. Obstet Gynecol 59: 538–545

    Google Scholar 

  • Geirsson RT, Ogston SA, Patel NB, Christie AD (1985) Growth of total intrauterine, intra-amniotic and placental volume in normal singleton pregnancy measured by ultrasound. Br J Obstet Gynaecol 92: 46–53

    Article  PubMed  CAS  Google Scholar 

  • Gough JD, Keeling JW, Castle B, Iliff PJ (1986) The obstetric management of non-immunological hydrops. Br J Obstet Gynaecol 93: 226–234

    Article  PubMed  CAS  Google Scholar 

  • Gregory CD, Lee H, Rees GB, Scott IV, Shah LP, Golding PR (1985) Natural killer cells in normal pregnancy: analysis using monoclonal antibodies and single-cell cytotoxicity assays. Clin Exp Immunol 62: 121–127

    PubMed  CAS  Google Scholar 

  • Gruenwald P (1975) The supply line of the fetus: definitions relating to fetal growth. In: Gruenwald P (ed) The placenta and its maternal supply line. MTP, Lancaster, pp 1–7

    Google Scholar 

  • Hallam LA, McLaren KM, El-Jabbour JN, Helm CW, Smart GE (1990) Intraplacental choriocarcinoma: a case report. Placenta 11: 247–251

    Article  PubMed  CAS  Google Scholar 

  • Harris BA Jr, Gore H, Flowers CE (1985) Peripheral placental separation: a possible relationship to premature labour. Obstet Gynecol 66: 774–778

    PubMed  Google Scholar 

  • Haust MD (1981) Maternal diabetes mellitus—effects of the fetus and placenta. Monogr Pathol 22: 201–285

    PubMed  Google Scholar 

  • Head JR, Drake BL, Zuckermann FA (1987) Major histocompatibility antigens on trophoblast and their regulation: implications in the maternal-fetal relationship. Am J Reprod Immunol Microbiol 15: 12–18

    PubMed  CAS  Google Scholar 

  • Heifetz SA (1984) Strangulation of the umbilical cord by amniotic bands: report of 6 cases and literature review. Pediatr Pathol 2: 285–304

    Article  PubMed  CAS  Google Scholar 

  • Heifetz SA (1988) Thrombosis of the umbilical cord: analysis of 52 cases and literature review. Pediatr Pathol 8: 37–54

    Article  PubMed  CAS  Google Scholar 

  • Herring AJ, Anderson IE, McClenaghan M et al. (1987) Restriction endonuclease analysis of DNA from two isolates of Chlamydia psittaci obtained from human abortion. Br Med J 295: 1239

    Article  CAS  Google Scholar 

  • Hill JA (1990) Immunological mechanisms of pregnancy maintenance and failure: a critique of theories and therapy. Am J Reprod Immunol 22: 33–41

    PubMed  CAS  Google Scholar 

  • Ho PC, Haynes WDG, Ing RMY, Jones WR (1982) Histological, ultrastructural and immunofluorescence studies on the amniochorionic membrane. Placenta 3: 109–126

    Article  PubMed  CAS  Google Scholar 

  • Hunt JS (1989) Macrophages in human uteroplacental tissues. A review. Am J Reprod Immunol 21: 119–122

    PubMed  CAS  Google Scholar 

  • Hunt JS (1990) Current topic: the role of macrophages in the uterine response to pregnancy. Placenta 11: 467–475

    Article  PubMed  CAS  Google Scholar 

  • Hurley VA, Beischer NA (1987) Placenta membranacea. Case reports. Br J Obstet Gynaecol 94: 798–802

    Article  PubMed  CAS  Google Scholar 

  • Hustin J, Jauniaux E, Schaaps JP (1990) Histological study of the materno-embryonic interface in spontaneous abortion. Placenta 11: 477–486

    Article  PubMed  CAS  Google Scholar 

  • Hyde S, Smotherman J, Moore JI, Altshuler G (1989) A model of bacterially induced umbilical vein spasm, relevant to fetal hypoperfusion. Obstet Gynecol 73: 966–970

    Article  PubMed  CAS  Google Scholar 

  • Jauniaux E, Nessmann Imbert MC, Meuris S, Puissant F, Hustin J (1988) Morphological aspects of the placenta in HIV pregnancies. Placenta 9: 633–642

    Article  PubMed  CAS  Google Scholar 

  • Jauniaux E, Zucker M, Meuris S, Verhest A, Wilkin P, Hustin J (1988) Chorangiocarcinoma: an unusual tumour of the placenta. The missing link? Placenta 9: 607–613

    Article  PubMed  CAS  Google Scholar 

  • Jones CJP, Lendon M, Chawner LE, Jauniaux E (1990) Ultrastructure of the human placenta in metabolic storage disease. Placenta 11: 395–411

    Article  PubMed  CAS  Google Scholar 

  • Jones KL (1988) Smith’s recognizable patterns of human malformation. Saunders, London

    Google Scholar 

  • Katz V, Blanchard G, Dingman Bowes WA, Cefalo RC (1987) Atenolol and short umbilical cords. Am J Obstet Gynecol 156: 1271–1272

    PubMed  CAS  Google Scholar 

  • Kaufmann P (1982) Development and differentiation of the human placental villous tree. Bibl Anat 22: 29–39

    PubMed  Google Scholar 

  • Khong TY (1987) Immunohistologic study of the leukocytic infiltrate in maternal uterine tissues in normal and preeclamptic pregnancies at term. Am J Reprod Immunol 15: 1–8

    CAS  Google Scholar 

  • Khong TY (1991) Acute atherosis in pregnancies complicated by hypertension, small-for-gestational-age infants, and diabetes mellitus. Arch Pathol Lab Med 115: 722–725

    PubMed  CAS  Google Scholar 

  • Khong TY, Dilly SA (1989) Calcification of umbilical artery: two distinct lesions. J Clin Pathol 42: 931–934

    Article  PubMed  CAS  Google Scholar 

  • Khong TY, George (1992) Chromosomal abnormalities associated with single umbilical artery. Prenat Diagn, (in press)

    Google Scholar 

  • Khong TY, Robertson WB (1987) Placenta creta and placenta praevia creta. Placenta 8: 399–409

    Article  PubMed  CAS  Google Scholar 

  • Khong TY, De Wolf F, Robertson WB, Brosens I (1986) Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational-age infants. Br J Obstet Gynaecol 93: 1049–1059

    Article  PubMed  CAS  Google Scholar 

  • Khong TY, Liddell HS, Robertson WB (1987a) Defective haemochorial placentation as a cause of spontaneous miscarriage: a preliminary study. Br J Obstet Gynaecol 94: 649–655

    Article  PubMed  CAS  Google Scholar 

  • Khong TY, Pearce JM, Robertson WB (1987b) Acute atherosis in pre-eclampsia: maternal determinants and fetal outcomes in the presence of the lesion. Am J Obstet Gynecol 157: 360–363

    PubMed  CAS  Google Scholar 

  • Khudr G, Benirschke K (1972) Placental lesions in viral hepatitis. Obstet Gynecol 40: 381–384

    PubMed  CAS  Google Scholar 

  • King A, Birkby C, Loke YW (1989) Early human decidual cells exhibit NK activity against the K562 cell line but not against first trimester trophoblast. Cell Immunol 118: 337–344

    Article  PubMed  CAS  Google Scholar 

  • Knowles S, Frost T (1989) Umbilical cord sclerosis as an indicator of congenital syphilis. J Clin Pathol 42: 1157–1159

    Article  PubMed  CAS  Google Scholar 

  • Knox WF, Fox H (1984) Villitis of unknown aetiology: its incidence and significance in placentae from a British population. Placenta 5: 395–402

    Article  PubMed  CAS  Google Scholar 

  • Koller BH, Geraghty DE, DeMars R, Duvick L, Rich SS, Orr HT (1989) Chromosomal organisation of the MHC class I gene family. J Exp Med 169: 469–480

    Article  PubMed  CAS  Google Scholar 

  • Krohn M, Voigt L, McKnight Daling JR, Starzyk P, Benedetti TJ (1987) Correlates of placental abruption. Br J Obstet Gynaecol 94: 333–340

    Article  PubMed  CAS  Google Scholar 

  • Kullander S, Kallen (1971) A prospective study of smoking and pregnancy. Acta Obstet Gynecol Scand 50: 83–94

    Article  Google Scholar 

  • Kundsin RB, Driscoll SG, Monson RR, Yeh C, Biano SA, Cochran WD (1984) Association of Ureaplasma urealyticum in the placenta with perinatal morbidity and mortality. N Engl J Med 310: 941–945

    Article  PubMed  CAS  Google Scholar 

  • Labarrere CA (1988) Review article. Acute atherosis: a histopathological hallmark of immune aggression? Placenta 9: 95–108

    Article  PubMed  CAS  Google Scholar 

  • Labarrere CA (1989) Allogeneic recognition and rejection reactions in the placenta. Am J Reprod Immunol 21: 94–99

    PubMed  CAS  Google Scholar 

  • Labarrere C, Althabe O, Telenta M (1982) Chronic villitis of unknown aetiology in placentae of idiopathic small for gestational age infants. Placenta 3: 309–318

    Article  PubMed  CAS  Google Scholar 

  • Labarrere C, Alonso J, Manni J, Domenichini E, Althabe Immunohistochemical findings in acute atherosis associated to intrauterine growth retardation. Am J Reprod Immunol Microbiol 7: 149–155

    Google Scholar 

  • Labarrere C, Sebastiani M, Siminovich M, Torassa E, Althabe O (1985b) Absence of Wharton’s jelly around the umbilical arteries: an unusual cause of perinatal mortality. Placenta 6: 555–559

    Article  PubMed  CAS  Google Scholar 

  • Labarrere CA, McIntyre JA, Faulk WP (1990) Immunohistologic evidence that villitis in human normal term placentas is an immunologic lesion. Am J Obstet Gynecol 162: 515–522

    PubMed  CAS  Google Scholar 

  • Lala PK, Kennedy TG, Parhar RS (1988) Suppression of lymphocyte alloreactivity by early gestational human decidua. II Characterization of the suppressor mechanisms. Cell Immunol 116: 411–422

    Article  PubMed  CAS  Google Scholar 

  • Larsson S, Cronberg S, Winblad S (1979) Listeriosis during pregnancy and neonatal period in Sweden 1958-1984. Acta Paediatr Scand 68: 485–493

    Article  Google Scholar 

  • Lessin DL, Hunt JS, King CR, Wood GW (1988) Antigen expression by cells near the maternal-fetal interface. Am J Reprod Immunol Microbiol 16: 1–7

    PubMed  CAS  Google Scholar 

  • Lewis SH, Reynolds-Kohler C, Fox HE, Nelson JA (1990) HIV-1 in trophoblastic and villous Hofbauer cells, and haematological precursors in eight-week fetuses. Lancet 335: 565–568

    Article  PubMed  CAS  Google Scholar 

  • Lilja M (1991a) Infants with single umbilical artery studied in a national registry. General epidemiological characteristics. Paediatr Perinat Epidemiol 5: 27–36

    Article  PubMed  CAS  Google Scholar 

  • Lilja M (1991b) Single umbilical artery and maternal smoking. Br Med J 302: 569–570

    Article  CAS  Google Scholar 

  • Lilja M (1991c) Infants with single umbilical artery studied in a national registry 2. Survival and malformations in infants with single umbilical artery. Paediatr Perinat Epidemiol

    Google Scholar 

  • Lowden JA, Cutz E, Conen PE, Rudd N, Doran TA (1973) Prenatal diagnosis of GM1 gangliosidosis. N Engl J Med 288: 225–228

    Article  PubMed  CAS  Google Scholar 

  • MacGillivray I, Nylander PPS, Corney G (1975) Human multiple reproduction. Saunders, London

    Google Scholar 

  • Marzusch K, Dietl J, Horny H-P et al. (1991) Tolerance and the fetal graft. Lancet 337: 52

    Article  PubMed  CAS  Google Scholar 

  • Matorras R, Diez J, Pereira JG (1990) True knots in the umbilical cord: clinical findings and fetal consequences. J Obstet Gynaecol 10: 383–386

    Article  Google Scholar 

  • Mayhew TM, Burton GJ (1988) Methodological problems in placental morphometry: apologia for the use of stereology based on sound sampling practice. Placenta 9: 565–581

    Article  PubMed  CAS  Google Scholar 

  • Mclntyre JA, Faulk WP (1983) Recurrent spontaneous abortion in human pregnancy: results of immuno-genetical, cellular and humoral studies. Am J Reprod Immunol 4: 165–170

    Google Scholar 

  • Michel MZ, Khong TY, Clark DA, Beard RW (1990) A morphological and immunological study of human placental bed biopsies in miscarriage. Br J Obstet Gynaecol 97: 984–988

    Article  PubMed  CAS  Google Scholar 

  • Mills JL, Harley EE, Moessinger AC (1983) Standards for measuring umbilical cord length. Placenta 4: 423–426

    Article  PubMed  CAS  Google Scholar 

  • Minkoff H, Nanda D, Menez R, Fikrig S (1987) Pregnancies resulting in infants with acquired immunodeficiency syndrome or AIDS-related complex. Obstet Gynecol 69: 285–287

    PubMed  CAS  Google Scholar 

  • Mochizuki M, Maruo T, Masuko K, Ohtsu T (1984) Effects of smoking on fetoplacental-maternal system during pregnancy. Am J Obstet Gynecol 149: 413–420

    PubMed  CAS  Google Scholar 

  • Moessinger AC, Blanc WA, Marone PA, Polsen DC (1982) Umbilical cord length as an indicator of fetal activity: experimental study and clinical implications. Pediatr Res 16: 109–112

    Article  PubMed  CAS  Google Scholar 

  • Moller D, Ipsen L, Asschenfeldt P (1986) Fatal course of malignant melanoma during pregnancy with dissemination to the products of conception. Acta Obstet Gynecol Scand 65: 501–502

    Article  PubMed  CAS  Google Scholar 

  • Mortimer G, MacDonald DJ, Smeeth A (1985) A pilot study of the frequency and significance of placental villitis. Br J Obstet Gynaecol 92: 629–633

    Article  PubMed  CAS  Google Scholar 

  • Moscuna M, Gross Z, Korenblum R, Volfson M, Oetinger M (1989) Septic abortion due to Campylobacter jejuni. Eur J Clin Microbiol Infect Dis 8: 800–801

    Article  PubMed  CAS  Google Scholar 

  • Mossman HW (1974) Structural changes in vertebrate fetal membranes associated with the adoption of viviparity. Obstet Gynecol Annu 3: 7–32

    PubMed  CAS  Google Scholar 

  • Mostofi-Zadeh M, Driscoll SG, Biano SA, Kundsin RB (1984) Placental evidence of cytomegalovirus infection of the fetus and neonate. Arch Pathol Lab Med 108: 403–406

    Google Scholar 

  • Mowbray JF, Underwood JL (1985) Immunology of abortion. Clin Exp Immunol 60: 1–7

    PubMed  CAS  Google Scholar 

  • Naeye RL (1977) Placental abnormalities in victims of sudden infant death syndrome. Biol Neonate 32: 189–192

    Article  PubMed  CAS  Google Scholar 

  • Naeye RL (1978) Effects of maternal cigarette smoking on the fetus and placenta. Br J Obstet Gynecol 85: 732–737

    Article  CAS  Google Scholar 

  • Naeye RL (1980) Placental disorders and smoking. Obstet Gynecol 55: 701–704

    PubMed  CAS  Google Scholar 

  • Naeye RL (1985a) Maternal floor infarction. Hum Pathol 16: 823–828

    Article  PubMed  CAS  Google Scholar 

  • Naeye RL (1985b) Umbilical cord length: clinical significance. J Pediatr 107: 278–281

    Article  PubMed  CAS  Google Scholar 

  • Naeye RL, Blanc W (1970) Relation of poverty and race to antenatal infection. N Engl J Med 283: 558–560

    Article  Google Scholar 

  • Ogita S, Oka T, Imanaka M et al. (1989) Effect of amniotic fluid volume on umbilical cord length. Asia Oceania J Obstet Gynaecol 15: 203–208

    Article  PubMed  CAS  Google Scholar 

  • O’Herlihy O’Driscoll (1987) Disease associated with abnormal placenta. In: The human placenta. Lavery JP (ed) Aspen Publishers, Rockville, pp 237-256

    Google Scholar 

  • Ollendorff DA, Goldberg JM, Abu-Jawdeh GM, Lurain JR (1990) Markedly elevated maternal serum alpha-fetoprotein associated with a normal fetus and choriocarcinoma of the placenta. Obstet Gynecol 76: 494–497

    PubMed  CAS  Google Scholar 

  • Peckham CH, Yerulshamy J (1965) Aplasia of one umbilical artery: incidence by race and certain obstetric factors. Obstet Gynecol 26: 359–366

    PubMed  CAS  Google Scholar 

  • Philippe E, Boué JG (1969) Le placenta dans les abérrations chromosomiques léthales. Ann Anat Pathol 14: 249–266

    CAS  Google Scholar 

  • Pijnenborg R, Bland JM, Robertson WB, Dixon G, Brosens I (1981) The pattern of interstitial trophoblast invasion of the myometrium in early human pregnancy. Placenta 2: 303–316

    Article  PubMed  CAS  Google Scholar 

  • Popli S, Leehey DJ, Molnar ZV, Nawab ZM, Ing TS (1990) Demonstration of Fabry’s disease deposits in placenta. Am J Obstet Gynecol 162: 464–465

    PubMed  CAS  Google Scholar 

  • Powell HC, Benirschke K, Favara BE, Pfluoger OH Jr (1976) Foamy changes of placental cells in fetal storage disorders. Virchows Arch [A] 369: 191–196

    Article  CAS  Google Scholar 

  • Redman CWG, McMichael AJ, Stirrat GM, Sunderland CA, Ting A (1984) Class I MHC complex antigens on human extravillous trophoblast. Immunology 52: 457–468

    PubMed  CAS  Google Scholar 

  • Ritson A, Bulmer JN (1989) Isolation and functional studies of granulated lymphocytes in first trimester human decidua. Clin Exp Immunol 77: 263–268

    PubMed  CAS  Google Scholar 

  • Roberts CJ, Lowe CR (1975) Where have all the conceptions gone? Lancet i: 498–499

    Article  Google Scholar 

  • Robinson LK, Jones KL, Benirschke K(1983) The nature of structural defects associated with velamentous and marginal insertion of the umbilical. Am J Obstet Gynecol 146: 191–193

    PubMed  CAS  Google Scholar 

  • Rock JA, Shirey RS, Braine HG, Ness PM, Kickler TS, Niebyl JR (1985) Plasmapheresis for the treatment of repeated early pregnancy wastage associated with anti-P. Obstet Gynecol 66 suppl 3: 57S–60S

    PubMed  CAS  Google Scholar 

  • Rocklin RE, Kitzmiller J, Carpenter B, Garovoy M, David JR (1976) Maternal-fetal reactions: absence of an immunologic blocking factor from the serum of women with chronic abortions. N Engl J Med 295: 1209–1213

    Article  PubMed  CAS  Google Scholar 

  • Russell P (1980) Inflammatory lesions of the human placenta. III The histopathology of villitis of unknown aetiology. Placenta 1: 227–244

    Article  PubMed  CAS  Google Scholar 

  • Russell P, Atkinson K, Krishnan L (1980) Recurrent reproductive failure due to severe placental villitis of unknown etiology. J Reprod Med 24: 93–98

    PubMed  CAS  Google Scholar 

  • Salafia CM, Mangam HE, Weigl CA, Foye GJ, Silberman L (1989) Abnormal fetal heart rate patterns and placental inflammation. Am J Obstet Gynecol 160: 140–147

    PubMed  CAS  Google Scholar 

  • Saller DN, Keene CL, Sun C-CJ, Schwartz S (1990) The association of single umbilical artery with cytogenetically abnormal pregnancies. Am J Obstet Gynecol 163:922–925

    PubMed  Google Scholar 

  • Sander CH, Kinnane L, Stevens NG, Echt R (1986) Haemorrhagic endovasculitis of the placenta: a review with clinical correlation. Placenta 7: 551–574

    Article  PubMed  CAS  Google Scholar 

  • Sands J, Dobbing J (1985) Continuing growth and development of the third trimester human placenta. Placenta 6: 13–22

    Article  PubMed  CAS  Google Scholar 

  • Schoenfeld A, Abramovici A, Klibanski C, Ovadia J (1985) Placental, ultrasonographic, biochemical and histo-chemical studies in fetuses affected with Niemann—Pick disease type A. Placenta 6: 33–44

    Article  PubMed  CAS  Google Scholar 

  • Schuhmann RA, Wynn RM (1980) Regional ultrastructural differences in placental villi in cotyledons of a mature human placenta. Placenta 1: 345–353

    Article  PubMed  CAS  Google Scholar 

  • Shanklin DR, Scott JS (1975) Massive subchorial thrombo-haematoma (Breus’ mole). Br J Obstet Gynaecol 82: 476–487

    Article  PubMed  CAS  Google Scholar 

  • Shen-Schwarz S, Ruchelli E, Brown D (1989) Villous oedema of the placenta: a clinicopathological study. Placenta 10: 297–307

    Article  PubMed  CAS  Google Scholar 

  • Simor AE, Karmali MA, Jadaviji T, Roscoe M (1986) Abortion and perinatal sepsis associated with Campylobacter infection. Rev Infect Dis 8: 397–402

    Article  PubMed  CAS  Google Scholar 

  • Soernes T, Bakke T (1987) The length of the human umbilical cord in twin pregnancies. Am J Obstet Gynecol 157: 1229–1230

    PubMed  CAS  Google Scholar 

  • Sprecher S, Soumenkoff S, Puissant F, Degueldre M (1986) Vertical transmission of HIV in 15-week fetus. Lancet ii: 288–289

    Article  Google Scholar 

  • Strong SJ, Corney G (1967) The placenta in twin pregnancy. Pergamon, Oxford

    Google Scholar 

  • Teasdale F (1980) Gestational changes in the functional structural of the human placenta in relation to fetal growth. Am J Obstet Gynecol 137: 560–568

    PubMed  CAS  Google Scholar 

  • Tuchmann-Duplessis H, David G, Haezel P (1971) Illustrated human embryology, vol 1. Springer, New York; Chapman and Hall, London; Masson et Cie, Paris

    Google Scholar 

  • Uyanwah-Akpom P, Fox H (1977) The clinical significance of marginal and velamentous insertion of the cord. Br J Obstet Gynaecol 84: 941–943

    Article  PubMed  CAS  Google Scholar 

  • Van der Veen F, Fox H (1982) The effects of cigarette smoking on the human placenta: a light and electron microscopic study. Placenta 3: 243–256

    Article  PubMed  Google Scholar 

  • Van der Veen F, Fox H (1983) The human placenta in idiopathic intrauterine growth retardation: a light and electron microscopic study. Placenta 4: 65–78

    Article  PubMed  Google Scholar 

  • Van der Velde WJ, Peereboom-Stegeman JHJC, Treffers PE, James J (1983) Structural changes in the placenta of smoking mothers: a quantitative study. Placenta 4: 231–240

    Article  PubMed  Google Scholar 

  • Wells M, Bennett J, Bulmer JN, Jackson P, Holgate CS (1987) Complement component deposition in uteroplacental (spiral) arteries in normal human pregnancy. J Reprod Immunol 12: 125–135

    Article  PubMed  CAS  Google Scholar 

  • Wharton B, Edwards JH, Cameron AH (1968) Mono-amniotic twins. J Obstet Gynaecol Br Cmwlth 75: 158–163

    Article  CAS  Google Scholar 

  • Wigglesworth J (1964) Morphological variations in the insufficient placenta. J Obstet Gynaecol Br Cmwlth 71: 871–884

    Article  CAS  Google Scholar 

  • Wilkin P (1965) Pathologie du placenta. Masson et Cie, Paris

    Google Scholar 

  • Zaaijman J du T, Wilkinson AR, Keeling JW, Mitchell RG, Turnbull AC (1982) Spontaneous premature rupture of the membranes: bacteriology, histology and neonatal outcome. J Obstet Gynecol 2: 155–160

    Article  Google Scholar 

  • Zhang J, Kraus FT, Aquino TI (1985) Chorioamnionitis: a comparative histologic, bactériologic, and clinical study. Int J Gynecol Pathol 4: 1–10

    Article  PubMed  Google Scholar 

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© 1993 Springer-Verlag London

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Khong, T.Y. (1993). Placenta and Umbilical Cord and the Immunology of Pregnancy. In: Keeling, J.W. (eds) Fetal and Neonatal Pathology. Springer, London. https://doi.org/10.1007/978-1-4471-3802-0_2

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