Aldahmash Waleed, Aljerian Khaldoon, Alwasel Saleh
Zoology Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
Pathology Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia.
Life (Basel). 2024 Jan 2;14(1):79. doi: 10.3390/life14010079.
Long-term health consequences are influenced by circumstances that occur during pregnancy. The convergence of the maternal and fetal circulations occurs in the placenta, which is the first organ to develop. Placental pathology provides an accurate diagnosis of amniotic sac inflammation, and pathological alterations in preterm placentas provide evidence for the causes of numerous perinatal pathologies, including spontaneous preterm births. This retrospective study aimed to re-examine placentas regarded as normal by the Obstetrics and Gynecology Department at our institution. Thirty-seven male and forty-seven female placentas were collected following full-term delivery, and the grading and staging of any evident inflammatory responses were evaluated and correlated with the babies' sex. Full-thickness placental samples that were considered normal and not sent to the histopathology department were obtained from the central and marginal regions of placental discs. Morphological examination of the fresh placenta was conducted, and fetal and maternal inflammatory response syndromes were assessed. In addition, placental villitis of unknown etiology (VUE) and chronic deciduitis were evaluated. Immunohistochemistry was performed to evaluate the patterns of inflammation in the placenta using anti-CD8 and anti-CD68 antibodies. The correlation between silent pathologies and clinical complications or the development of fetal inflammatory response syndrome was measured. In this study, 17 (20%) maternal and 10 (12%) fetal samples showed inflammatory responses. The frequencies of chronic deciduitis and VUE were higher among pregnant Saudi women than previously reported, probably because fetal inflammatory response syndrome goes unnoticed in Saudi Arabia. In addition, the prevalence of fetal and maternal inflammatory responses was higher in the placentas of the mothers of males than in those of females, suggesting that differences occur in the inflammatory response in the placenta depending on the sex of the newborn. Grading placental inflammation (in cases of VUE) typically predicts the degree of maternal anti-fetal cellular rejection; therefore, increasing the number of placental samples sent for microscopic inspection may be preferable because of their significance in identifying the causes of chronic disorders.
长期健康后果受孕期发生的各种情况影响。母体和胎儿循环在胎盘处交汇，胎盘是首个发育的器官。胎盘病理学能准确诊断羊膜囊炎症，早产胎盘的病理改变为包括自发性早产在内的众多围产期疾病的病因提供了证据。这项回顾性研究旨在重新检查我院妇产科认为正常的胎盘。足月分娩后收集了37份男性胎盘和47份女性胎盘，评估了任何明显炎症反应的分级和分期，并将其与婴儿性别相关联。从胎盘盘的中央和边缘区域获取被认为正常且未送往组织病理学科室的全层胎盘样本。对新鲜胎盘进行形态学检查，并评估胎儿和母体炎症反应综合征。此外，还评估了病因不明的胎盘绒毛炎（VUE）和慢性蜕膜炎。使用抗CD8和抗CD68抗体进行免疫组织化学检查，以评估胎盘中的炎症模式。测量了隐匿性病变与临床并发症或胎儿炎症反应综合征发展之间的相关性。在本研究中，17份（20%）母体样本和10份（12%）胎儿样本显示出炎症反应。沙特孕妇中慢性蜕膜炎和VUE的发生率高于先前报道，可能是因为在沙特阿拉伯胎儿炎症反应综合征未被注意到。此外，男性母亲的胎盘中胎儿和母体炎症反应的发生率高于女性母亲的胎盘，这表明胎盘的炎症反应因新生儿性别而异。对胎盘炎症进行分级（在VUE病例中）通常可预测母体抗胎儿细胞排斥的程度；因此，由于其在确定慢性疾病病因方面的重要性，增加送去显微镜检查的胎盘样本数量可能更好。
