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Placental histopathology in syphilis
F Qureshi1, S M Jacques, M P Reyes
1Department of Pathology, Hutzel Hospital, Detroit, MI 48201.
Human Pathology
|July 1, 1993
Summary
Placental histopathology can aid in diagnosing congenital syphilis (CS) when infant signs are absent. Specific placental changes, including villitis and vascular alterations, suggest CS and warrant further investigation.
Area of Science:
- Pathology
- Obstetrics
- Infectious Diseases
Background:
- Congenital syphilis (CS) diagnosis at birth is challenging due to absent clinical and serologic findings.
- Placental evaluation is crucial for identifying CS when neonatal indicators are lacking.
Purpose of the Study:
- To identify histopathologic features in placentas that suggest congenital syphilis (CS).
- To determine the diagnostic utility of placental examination in suspected CS cases.
Main Methods:
- Examined 25 placentas from mothers with confirmed syphilis (RPR and FTA-ABS positive).
- Evaluated histopathologic features including villitis, vascular changes, and villous maturity.
- Used special stains to detect spirochetes and identified plasma cells in the basal decidua.
Main Results:
- Eleven of 23 liveborn infants met criteria for probable CS.
- Seven placentas exhibited a distinct pattern of histopathologic changes: proliferative vascular changes, chronic villitis, relative villous immaturity, and acute villitis.
- Spirochetes were detected in all seven placentas with characteristic changes; six also showed basal decidual plasma cells.
Conclusions:
- Specific placental histopathologic findings, while not diagnostic alone, raise suspicion for CS.
- Placental examination is a valuable adjunct in diagnosing congenital syphilis, prompting further clinical and laboratory evaluation.