van der Merwe J L, Hall D R, Wright C, Schubert P, Grové D
Department of Obstetrics and Gynaecology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
Hypertens Pregnancy. 2010;29(4):457-67. doi: 10.3109/10641950903572282.
To compare histopathological differences in placentas from early- and late-onset preeclampsia, as well as late-onset preeclampsia and normal term deliveries.
This prospective study was performed at Tygerberg Hospital, a secondary and tertiary referral center in South Africa. Placentas from 100 women, 25 each with early and late-onset preeclampsia, and an equal number of controls matched for gestational age, underwent routine preparation and were evaluated independently by two pathologists in a strictly predetermined, standardized manner.
Compared to late preeclampsia, placentas in the early preeclampsia group were smaller (p < 0.01), had more infarction (odds ratio [OR] = 4.03, 95% confidence interval [CI] = 1.2-13.5) and inappropriate maturation (OR = 16.62, 95% CI = 4.1-68.0). Placentas from the late-onset preeclampsia group showed increased decidual arteriopathy (OR = 5.09, 95% CI = 1.45-17.92) and abruptio placentae (OR = 5.41, 95% CI = 1.01-28.79) compared to controls.
The early- and late-onset preeclampsia placentas showed clear histopathological differences, whereas late-onset preeclampsia and normal term placentas differed less. These findings support the contention that early- and late-onset preeclampsia are different subclasses of disease.
比较早发型和晚发型子痫前期胎盘以及晚发型子痫前期与足月正常分娩胎盘的组织病理学差异。
本前瞻性研究在南非的二级和三级转诊中心泰格伯格医院进行。对100名女性的胎盘进行研究，其中25名患有早发型子痫前期，25名患有晚发型子痫前期，另有相同数量的与孕周匹配的对照组，胎盘均进行常规制备，并由两名病理学家以严格预先确定的标准化方式独立评估。
与晚发型子痫前期相比，早发型子痫前期组的胎盘较小（p < 0.01），梗死更多（优势比[OR] = 4.03，95%置信区间[CI] = 1.2 - 13.5）且成熟异常（OR = 16.62，95% CI = 4.1 - 68.0）。与对照组相比，晚发型子痫前期组的胎盘显示蜕膜小动脉病增加（OR = 5.09，95% CI = 1.45 - 17.92）和胎盘早剥（OR = 5.41，95% CI = 1.01 - 28.79）。
早发型和晚发型子痫前期胎盘显示出明显的组织病理学差异，而晚发型子痫前期与足月正常胎盘的差异较小。这些发现支持早发型和晚发型子痫前期是不同疾病亚类的观点。
