Objectives: To evaluate histological changes of placental villi and blood vessels in pregnancy complicated by pre-eclampsia (PE) and their relation to clinical data.
Patients & Methods: The study included 100 pregnant women developing PE at any time throughout pregnancy (PE group) and another 100 pregnant free of PE (Control group). Collected data included age, gestational age (GA), manifestations and severity of PE, neonatal birth weight (BW) and placental weight (PW). Placental tissue was obtained for light and electron microscopic examination
Results: BW and PW showed negative significant correlation with maternal BMI, presence and severity of PE. GA and development of PE were significant predictors for low PW which is significant predictor for low BW. Placentas of PE group showed aggregation of syncytiotrophoblast cells, hyaline degeneration of connective tissue core and endothelial lining of stem blood vessel (SBV) and villous core is devoid of fetal blood vessel. Diffuse fibrous tissue formation, hypertrophic musculosa of SBV up to endarteritis obliterans (EAO) and placental tissue bridges crossing intervillous spaces and villous arborization formed only of connective tissue with no cellular elements. Electron microscopy confirmed these findings and showed attenuated blood vessels and excessive villous arborization covered with fibrin like material.
Conclusion: Development of placental EAO with diminution of placental growth and proper invasion may underlie development of PE. Reduced PW is a reflection of this histological affection and was negatively correlated with severity of PE. Early PE is associated with more severe clinical manifestation and aggressive histological changes.