Interpretation of syncytial sprouts and bridges in the human placenta

Human placental villi from normal and pathological material from the eighth to the 40th week of gestation were examined by light, scanning and transmission electron microscopy. Trophoblastic specializations--such as syncytial sprouts of early and late pregnancy, syncytial knots and syncytial bridges--were classified into proliferative and degenerative processes or artefacts caused by tangential sectioning. In early pregnancy and in diabetes mellitus most syncytial sprouts represent the initial phases in the development of villi. In late pregnancy, in particular in pre-eclampsia, most syncytial knots, sprouts and bridges are histological artefacts, caused by tangential sectioning of the trophoblastic surface. The chance of producing such artefacts is increased with increasing section thickness and with increasing branching and tortuosity of the villi. However, a small proportion of the syncytial knots, sprouts and bridges in the last-trimester placenta, those containing coarse pyknotic nuclei, are trophoblastic specializations of a probably degenerative character.