[Pathologic analysis of the placenta in preterm deliveries]

Area of Science:

• Obstetrics and Gynecology
• Pathology
• Perinatology

Context:

• Preterm delivery presents significant challenges in perinatal care.
• Placental pathology plays a crucial role in understanding pregnancy complications.
• Analysis of placental and umbilical cord morphology provides insights into fetal development and pregnancy outcomes.

Purpose:

• To present pathological findings of placentae from preterm deliveries.
• To compare placental and umbilical cord characteristics between preterm and term deliveries.
• To identify potential pathological causes of preterm birth, including infections and hypertensive disorders.

Summary:

• Pathological analysis of 198 placentae from preterm deliveries (28-37 weeks) revealed statistically significant differences in gross findings like placenta previa, bipartate placenta, large placenta, short cord, and velamentous cord insertion compared to term deliveries.
• Microscopic examination of 165 placentae showed membrane and umbilical vessel infection in 11.52%, with 8 cases potentially causing preterm delivery.
• In 72 cases of pregnancy with hypertension (PIH), 90.28% exhibited arteriopathy of the decidual capsularis, with 25% of these cases being clinically undiagnosed until microscopic examination.

Impact:

• Placental examination aids in determining the causes of preterm delivery, encompassing issues with the placenta, amniotic fluid, or umbilical cord.
• The study highlights the high prevalence of arteriopathy of the decidual capsularis in PIH, suggesting its importance in clinical diagnosis.
• Further research is needed to investigate the link between decidual arteriopathy and premature rupture of membranes in PIH cases.