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Classification of Villous Maldevelopment

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Pathology of the Human Placenta

Abstract

The histopathology of villous maldevelopment is based on the light microscopy of paraffin sections. Thus, the normal and pathological features of the placenta are usually described in terms of the two dimensions apparent by light microscopy. These two-dimensional findings very often do not reflect the underlying three-dimensional malformation of villi, as becomes particularly obvious when considering the pathologically meaningful finding of “syncytial knotting” (Tenney—Parker changes).

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References

  • Alvarez, H., De Bejar, R. and Aladjem, S.: La placenta human Aspectos morfologicos y fisio-patologicos. In, 4th Uruguayan Congress for Obstetrics and Gynecology, Vol. 1, pp. 190–261, 1964.

    Google Scholar 

  • Alvarez, H., Morel, R.L., Benedetti, W.L. and Scavarelli, M.: Trophoblast hyperplasia and maternal arterial pressure at term. Am. J. Obstet. Gynecol. 105: 1015–1021, 1969.

    PubMed  CAS  Google Scholar 

  • Alvarez, H., Benedetti, W.L., Morel, R.L. and Scavarelli, M.: Trophoblast development gradient and its relationship to placental hemodynamics. Am. J. Obstet. Gynecol. 106: 416–420, 1970.

    PubMed  CAS  Google Scholar 

  • Amaladoss, A.S.P. and Burton, G.J.: Organ culture of human placental villi in hypoxic and hyperoxic conditions: a morphometric study. J. Dev. Physiol. (Oxf.) 7: 113–118, 1985.

    CAS  Google Scholar 

  • Bacon, B.J., Gilbert, R.D., Kaufmann, P., Smith A.D., Trevino, F.T. and Longo, L.D.: Placental anatomy and diffusing capacity in guinea pigs following long-term maternal hypoxia. Placenta 5: 475–488, 1984.

    Article  PubMed  CAS  Google Scholar 

  • Becker, V.: Funktionelle Morphologie der Plazenta. Arch. Gynäkol. 198: 3–28, 1963.

    Article  PubMed  CAS  Google Scholar 

  • Becker, V.: Pathologie der Ausreifung der Plazenta. In, Die Plazenta des Menschen. V. Becker, T.H. Schiebler and F. Kubli, eds., pp. 266–281. Thieme, Stuttgart, 1981.

    Google Scholar 

  • Becker, V. and Röckelein, G.: Pathologie der Plazenta und des Abortes. Springer, Heidelberg, 1989.

    Google Scholar 

  • Beischer, N.A., Sivasamboo, R., Vohra, S., Silpisornkosal, S. and Reid, S.: Placental hypertrophy in severe pregnancy anaemia. J. Obstet. Gynaecol. Br. Commonw. 77: 398–409, 1970.

    Article  PubMed  CAS  Google Scholar 

  • Boyd, J.D. and Hamilton, W.J.: The Human Placenta. Heffer, Cambridge, 1970.

    Google Scholar 

  • Brosens, I.: The utero-placental vessels at term—the distribution and extent of physiological changes. Trophoblast Res. 3: 61–68, 1988.

    Google Scholar 

  • Brosens, I., Robertson, W.B. and Dixon, H.G.: The physiological response of the vessels of the placental bed to normal pregnancy. J. Pathol. Bacteriol. 93: 569–579, 1967.

    Article  PubMed  CAS  Google Scholar 

  • Burton, G.J.: Intervillous connections in the mature human placenta: Instances of syncytial fusion or section artifacts? J. Anat. 145: 13–23, 1986a.

    PubMed  CAS  Google Scholar 

  • Burton, G.J.: Scanning electron microscopy of intervillous connections in the mature human placenta. J. Anat. 147: 245–254, 1986b.

    PubMed  CAS  Google Scholar 

  • Burton, G.J.:.The fine structure of the human placental villus as revealed by scanning electron microscopy. Scannings Microsc. 1: 1811–1828, 1987.

    CAS  Google Scholar 

  • Burton, G.J., Mayhew, T.M. and Robertson, L.A.: Stereological re-examination of the effects of varying oxygen tensions on human placental villi maintained in organ culture for up to 12 h. Placenta 10: 263–273, 1989.

    Article  PubMed  CAS  Google Scholar 

  • Cantle, S.J., Kaufmann, P., Luckhardt, M. and Schweikhart, G.: Interpretation of syncytial sprouts and bridges in the human placenta. Placenta 8: 221–234, 1987.

    Article  PubMed  CAS  Google Scholar 

  • Castellucci, M., Scheper, M., Scheffen, I., Celona, A. and Kaufmann, P.: The development of the human placental villous tree. Anat. Embryol. (Berl.) 181: 117–128, 1990.

    Article  CAS  Google Scholar 

  • Emmrich, P. and Mälzer, G.: Zur Morphologie der Plazenta bei Übertragung. Pathol. Microbiol. 32: 285–302, 1968.

    CAS  Google Scholar 

  • Emmrich, P., Gödel, E., Amendt, P. and Müller, G.: Schwangerschaft bei Diabetikerinnen mit diabetischer Angiolopathie. Klinische Ergebnisse in Korrelation zu morphologischen Befunden an der Plazenta. Zentralbi. Gynäkol. 97: 875–883, 1975.

    CAS  Google Scholar 

  • Essbach, H. and Röse, I.: Plazenta und Eihäute. Fischer, Jena, 1966.

    Google Scholar 

  • Fox, H.: Villous immaturity in the term placenta. Obstet. Gynecol. 31: 9–12, 1968.

    Article  PubMed  CAS  Google Scholar 

  • Fox, H.: Effect of hypoxia on trophoblast in organ culture. Am. J. Obstet. Gynecol. 107: 1058–1064, 1970.

    PubMed  CAS  Google Scholar 

  • Fox, H.: Pathology of the Placenta. 2nd Ed. Saunders, London, 1997.

    Google Scholar 

  • Geisen, C., Mottaghy, K., Scheffen, I. and Kaufmann, P.: Effect of long-term hypoxia on oxygen transport properties of blood in pregnant guinea pigs. In, Oxygen Transport to Tissue, Vol. XII. J. Piiper, T.K. Goldstick and D. Meyer, eds., pp. 767–777. Plenum Press, New York, 1990.

    Google Scholar 

  • Gödel, E. and Emmrich, P.: Morphologie der Plazenta und Qualität der metabolischen Kontrolle während der Schwangerschaft bei Diabetes mellitus. Zentralbl. Gynäkol. 98: 1307–1311, 1976.

    PubMed  Google Scholar 

  • Greco, M.A., Kamat, B.R. and Demopolulos, R.I.: Placental protein distribution in maternal diabetes mellitus: an immunocytochemical study. Pediatr. Pathol. 9: 679–690, 1989.

    Article  PubMed  CAS  Google Scholar 

  • Huppertz, B., Frank, H.G., Kingdom, J.C.P., Reister, F. and Kaufmann, P.: Villous cytotrophoblast regulation of the syncytial apoptotic cascade in the human placenta. Histochem. Cell Biol. 110: 495–508, 1998.

    Article  PubMed  CAS  Google Scholar 

  • Jackson, M.R., Mayhew, T.M. and Haas, J.D.: Morphometric studies on villi in human term placentae and the effects of altitude, ethnic grouping and sex of newborn. Placenta 8: 487–495, 1987.

    Article  PubMed  CAS  Google Scholar 

  • Jackson, M.R., Mayhew, T.M. and Haas, J.D.: On the factors which contribute to thinning of the villous membrane in human placentae at high altitude. I. Thinning and regional variation in thickness of trophoblast. Placenta 9: 1–8, 1988a.

    Article  PubMed  CAS  Google Scholar 

  • Jackson, M.R., Mayhew, T.M. and Haas, J.D.: On the factors which contribute to thinning of the villous membrane in human placentae at high altitude. II. An increase in the degree of peripheralization of fetal capillaries. Placenta 9: 9–18, 1988b.

    Article  PubMed  CAS  Google Scholar 

  • Jones, C.J.P. and Fox, H.: Syncytial knots and intervillous bridges in the human placenta: an ultrastructural study. J. Anat. 124: 275–286, 1977.

    PubMed  CAS  Google Scholar 

  • Kadyrov, M., Kosanke, G., Kingdom, J. and Kaufmann, P.: Increased fetoplacental angiogenesis during first trimester in anaemic women. Lancet 352: 1747–1749, 1998.

    Article  PubMed  CAS  Google Scholar 

  • Kaufmann, P.: Entwicklung der Plazenta. In, Die Plazenta des Menschen. V. Becker, T.H. Schiebler and F. Kubli, eds., pp. 13–50. Thieme, Stuttgart, 1981.

    Google Scholar 

  • Kaufmann, R, Luckhardt, M., Schweikhart, G. and Cantle, S.J.: Cross-sectional features and three-dimensional structure of human placental villi. Placenta 8: 235–247, 1987.

    Article  PubMed  CAS  Google Scholar 

  • Kemnitz, P. and Theuring, E: Makroskopische, licht-und elektronenmikroskopische Plazentabefunde bei Übertragung. Zentralbi. Allg. Pathol. 118: 43–54, 1974.

    CAS  Google Scholar 

  • Kingdom, J.C.P. and Kaufmann, P.: Oxygen and placental villous development: origins of fetal hypoxia. Placenta 18: 613–621, 1997.

    Article  PubMed  CAS  Google Scholar 

  • Kingdom, J.C.P., Macara, L.M., Krebs, C., Leiser, R. and Kaufmann, R: Pathological basis for abnormal umbilical artery Doppler waveforms in pregnancies complicated by intrauterine growth restriction. Trophoblast Res. 10: 291–309, 1997.

    Google Scholar 

  • Kloos, K. and Vogel, M.: Pathologie der Perinatalperiode. Grundlage, Methodik und erste Ergebnisse einer Kyematopathologie. Thieme, Stuttgart, 1974.

    Google Scholar 

  • Kosanke, G., Kadyrov, M., Korr, H. and Kaufmann, P.: Maternal anemia results in increased proliferation in human placental villi. Trophoblast Res. 11: 339–357, 1998.

    Google Scholar 

  • Krebs, C., Macara, L.M., Leiser, R., Bowman, A.W., Greer, I.A. and Kingdom, J.C.P.: Intrauterine growth restriction with absent end-diastolic flow velocity in the umbilical artery is associated with maldevelopment of the placental terminal villous tree. Am. J. Obstet. Gynecol. 175: 1534–1542, 1996.

    Article  PubMed  CAS  Google Scholar 

  • Krebs, C., Longo, L.D. and Leiser, R.: Term ovine placental vasculature: comparison of sea level and high altitude conditions by corrosion cast and histomorphometry. Placenta 18: 43–51, 1997.

    Article  PubMed  CAS  Google Scholar 

  • Küstermann, W.: Über “Proliferationsknoten” und “Syncytialknoten” der menschlichen Placenta. Anat. Anz. 150: 144–157, 1981.

    PubMed  Google Scholar 

  • Macara, L., Kingdom, J.C.P., Kaufmann, R, Kohnen, G., Hair, J., More, I.A.R., Lyall, E. and Greer, I.A.: Structural analysis of placental terminal villi from growth-restricted pregnancies with abnormal umbilical artery Doppler waveforms. Placenta 17: 37–48, 1996.

    Article  PubMed  CAS  Google Scholar 

  • Martin, B.J. and Spicer, S.S.: Ultrastructural features of cellular maturation and aging in human trophoblast. J. Ultrastruct. Res. 43: 133–149, 1973.

    Article  PubMed  CAS  Google Scholar 

  • Mikolajczak, J., Ruhrberg, A., Fetzer, M., Kaufmann, P. and Goecke, C.: Irreguläre Zottenreifung bei Frühgeburtlichkeit und Übertragung, und ihre Darstellbarkeit im Ultraschall. Gynäkol. Rundsch. 27: 145–146, 1987.

    Article  Google Scholar 

  • Mohr, H.: Zur Histologie der übertragenen Plazenta. Zentralbi. Gynäkol. 72: 1530, 1950.

    CAS  Google Scholar 

  • Ong, P.J. and Burton, G J. Thinning of the placental villous membrane during maintenance in hypoxic organ culture: structural adaptation or syncytial degeneration? Eur. J. Obstet. Gynecol. Reprod. Biol. 39: 103–110, 1991.

    Article  PubMed  CAS  Google Scholar 

  • Panigel, M. and Myers, R.E.: Histological and ultrastructural changes in rhesus monkey placenta following interruption of fetal placental circulation by fetectomy or interplacental umbilical vessel ligation. Acta Anat. (Basel) 81: 481–506, 1972.

    Article  CAS  Google Scholar 

  • Pilz, I., Schweikhart, G. and Kaufmann, R: Zur Abgrenzung normaler, artefizieller und pathologischer Struckturen in reifen menschlichen Plazentazotten. III. Morphometrische Untersuchungen bei Rh-Inkompatibilität. Arch. Gynecol. Obstet. 229: 137–154, 1980.

    CAS  Google Scholar 

  • Piotrowicz, B., Niebroj, T,K. and Sieron, G.: The morphology and histochemistry of the full term placenta in anaemic patients. Folia Histochem. Cytochem. (Krakow) 7: 435–444, 1969.

    CAS  Google Scholar 

  • Reshetnikova, O.S., Burton, G.J. and Milovanov, A.P.: The effects of hypobaric hypoxia on the terminal villi of the human placenta. J. Physiol. (Lond.) 459: 308P, 1993.

    Google Scholar 

  • Salvatore, C.A.: The placenta in acute toxemia. A comparative study. Am. J. Obstet. Gynecol. 102: 347–353, 1968.

    PubMed  CAS  Google Scholar 

  • Scheffen, I., Kaufmann, P., Philippens, L., Leiser, R., Geisen, C. and Mottaghy, K.: Alterations of the fetal capillary bed in the guinea pig placenta following long-term hypoxia. In, Oxygen Transfer to Tissue, Vol. XII. J. Piiper, T.K. Goldstick and D. Meyer, eds., pp. 779–790. Plenum Press, New York, 1990.

    Google Scholar 

  • Schiebler, T.H. and Kaufmann, P.: Reife Plazenta. In, Die Plazenta des Menschen. V. Becker, T.H. Schiebler and E. Kubli, eds., pp. 51–111. Thieme, Stuttgart, 1981.

    Google Scholar 

  • Schuhmann, R. and Geier, G.: Histomorphologische Placentabefunde bei EPG-Gestose. Arch. Gynäkol. 213: 31–47, 1972.

    Article  PubMed  CAS  Google Scholar 

  • Schweikhart, G.: Morphologie des Zottenbaumes der menschlichen Plazenta—Orthologische und pathologische Entwicklung und ihre klinische Relevanz. Thesis, Medical Faculty, University of Mainz, 1985.

    Google Scholar 

  • Schweikhart, G. and Kaufmann, P.: Histologie und Morphometrie der Plazenta bei intrauteriner Mangelentwicklung des Feten. Arch. Gynäkol. 235: 566–567, 1983.

    Google Scholar 

  • Schweikhart, G. and Kaufmann, P.: Endzottenmangel und klinische Relevanz. Gynäkol. Rundsch. 27 (suppl. 2): 147–148, 1987.

    Article  Google Scholar 

  • Schweikhart, G., Kaufmann, P. and Beck, T.: Morphology of placental villi after premature delivery and its clinical relevance. Arch. Gynecol. Obstet. 239: 101–114, 1986.

    CAS  Google Scholar 

  • Stoz, E, Schuhmann, R.A. and Schebesta, B.: The development of the placental villus during normal pregnancy: morphometric data base. Arch. Gynecol. Obstet. 244: 23–32, 1988.

    Article  PubMed  CAS  Google Scholar 

  • Tenney, B. and Parker, E: The placenta in toxemia of pregnancy. Am. J. Obstet. Gynecol. 39: 1000–1005, 1940.

    Google Scholar 

  • Todros, T., Sciarrone, A., Piccoli, E., Guiot, C., Kaufmann, P. and Kingdom, J.: Umbilical Doppler waveforms and placental villous angiogenesis in pregnancies complicated by fetal growth restriction. Obstet. Gynecol. 93: 499–503, 1999.

    Article  PubMed  CAS  Google Scholar 

  • Tominaga, T. and Page, E.W.: Accommodation of the human placenta to hypoxia. Am. J. Obstet. Gynecol. 94: 679–691, 1966.

    PubMed  CAS  Google Scholar 

  • Vogel, M.: Pathologie der Schwangerschaft, der Plazenta und des Neugeborenen. In, Pathologie, Vol. 3. Remmele, W., ed. Springer-Verlag, Heidelberg, 1984.

    Google Scholar 

  • Vogel, M.: Histologische Entwicklungsstadien der Chorionzotten in der Embryonal-und der frühen Fetalperiode (5. bis 20. SSW). Pathologe 7: 59–61, 1986.

    PubMed  CAS  Google Scholar 

  • Vogel, M.: Atlas der morphologischen Plazentadiagnostik. 2nd Ed. Springer, Berlin, 1996.

    Book  Google Scholar 

  • Wentworth, D.: The placenta in cases of hemolytic disease of the newborn. Am. J. Obstet. Gynecol. 98: 283–289, 1967.

    PubMed  CAS  Google Scholar 

  • Werner, C. and Schneiderhan, W.: Plazentamorphologie und Plazentafunktion in Abhängigkeit von der diabetischen Stoffwechselführung. Geburtsh. Frauenheilkd. 32: 959–966, 1972.

    CAS  Google Scholar 

  • Werner, C., Göbel, U., Kramartz, N., Werners, P. and Haering, M.: Plazentareifungsstörungen und Schweregrad des Morbus haemolyticus neonatorum. Geburtsh. Frauenheilkd. 33: 776–785, 1973.

    CAS  Google Scholar 

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Benirschke, K., Kaufmann, P. (2000). Classification of Villous Maldevelopment. In: Pathology of the Human Placenta. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-4199-5_15

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  • DOI: https://doi.org/10.1007/978-1-4757-4199-5_15

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