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Revisiting decidual vasculopathy.

Jonathan L Hecht1, Zsuzsanna K Zsengeller2, Melissa Spiel3

  • 1Department of Pathology, Beth Israel Deaconess Medical Center (BIDMC), 330 Brookline Ave, Boston, MA 02215, USA.

Placenta
|May 31, 2016
PubMed
Summary
This summary is machine-generated.

Decidual vasculopathy (DV) is a vascular injury process seen in preeclampsia (PE), particularly when complicated by small for gestational age (SGA) infants. Endothelial markers may aid in detecting this subacute condition.

Keywords:
CD31CD34Decidual angiopathyDecidual vasculopathyPreeclampsia

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Area of Science:

  • Reproductive biology
  • Vascular pathology
  • Obstetrics

Background:

  • Decidual vasculopathy (DV) is observed in the free membranes of placentas from patients with preeclampsia (PE).
  • The precise nature and clinical associations of DV require further elucidation.

Purpose of the Study:

  • To characterize the histological features of decidual vasculopathy (DV) in preeclampsia (PE).
  • To investigate the frequency and severity of DV in relation to clinical presentation, including fetal growth restriction (small for gestational age, SGA).

Main Methods:

  • Histological examination of placental membrane roll sections using stains for endothelial markers (CD31, CD34), inflammatory cells (CD68), smooth muscle (desmin), fibrin, and extracellular matrix (Masson's trichrome).
  • Evaluation of DV frequency across different clinical groups: PE with and without SGA, and SGA with and without Doppler abnormalities.

Main Results:

  • Affected vessels in PE placentas exhibited endothelial proliferation, detachment, smooth muscle loss, and fibrin deposition.
  • DV was present in PE with SGA, PE without SGA, and SGA with Doppler abnormalities, but absent in SGA without Doppler abnormalities.
  • The most severe DV was observed in PE with SGA, while PE without SGA showed the least severe DV.

Conclusions:

  • DV appears to be a subacute vascular injury process that is exacerbated in PE, especially when complicated by SGA.
  • The findings suggest that endothelial markers could be valuable for recognizing DV.
  • Rampant endothelial injury in decidual vessels of PE with SGA may correlate with circulating endothelial microparticles observed in these patients.