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Chronic Placental Inflammation in Twin Pregnancies.

Bang H, Bae GE, Park HY, Kim YM, Choi SJ, Oh SY, Roh CR, Kim JS - J Pathol Transl Med (2015)

Bottom Line: Chronic placental inflammation, such as villitis of unknown etiology (VUE) and chronic chorioamnionitis (CCA), is considered a placental manifestation of maternal anti-fetal rejection.Hematoxylin and eosin sections of tissue samples (full-thickness placental disc and chorioamniotic membranes) were reviewed.Separate dichorionic diamniotic twin placentas were affected by chronic deciduitis more frequently than singleton placentas (16.9% vs 9.7%, p<.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Background: Chronic placental inflammation, such as villitis of unknown etiology (VUE) and chronic chorioamnionitis (CCA), is considered a placental manifestation of maternal anti-fetal rejection. The aim of this study is to investigate its frequency in twin pregnancies compared to singleton pregnancies.

Methods: Three hundred twin placentas and 1,270 singleton placentas were consecutively collected at a tertiary medical center in Seoul, Republic of Korea from 2009 to 2012. Hematoxylin and eosin sections of tissue samples (full-thickness placental disc and chorioamniotic membranes) were reviewed.

Results: Non-basal VUE was more frequent in twin placentas than in singleton placentas (6.0% vs 3.2%, p < .05). In preterm birth, CCA was found less frequently in twin placentas than in singleton placentas (9.6% vs 14.8%, p < .05), reaching its peak at an earlier gestational age in twin placentas (29-32 weeks) than in singleton placentas (33-36 weeks). CCA was more frequent in twin pregnancies with babies of a different sex than with those with the same sex (13.8% vs 6.9%, p=.052). Separate dichorionic diamniotic twin placentas were affected by chronic deciduitis more frequently than singleton placentas (16.9% vs 9.7%, p<.05).

Conclusions: The higher frequency of non-basal VUE in twin placentas and of CCA in twin placentas with different fetal sex supports the hypothesis that the underlying pathophysiological mechanism is maternal anti-fetal rejection related to increased fetal antigens in twin pregnancies. The peak of CCA at an earlier gestational age in twin placentas than in singleton placentas suggests that CCA is influenced by placental maturation.

No MeSH data available.


Related in: MedlinePlus

The frequency of chronic chorioamnionitis (CCA) in twin placentas according to the gestational age. (A) CCA is less frequent in twin placentas than singleton placentas at preterm birth (*p<.05). (B) CCA in twin placentas is decreased significantly compared with singleton placentas at 33–36 weeks of gestation (*p<.05). Twin placentas are affected by CCA most frequently at 29–32 weeks, in contrast to singleton placentas at 33–36 weeks. GAD, gestational age at delivery
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f3-jptm-2015-09-09: The frequency of chronic chorioamnionitis (CCA) in twin placentas according to the gestational age. (A) CCA is less frequent in twin placentas than singleton placentas at preterm birth (*p<.05). (B) CCA in twin placentas is decreased significantly compared with singleton placentas at 33–36 weeks of gestation (*p<.05). Twin placentas are affected by CCA most frequently at 29–32 weeks, in contrast to singleton placentas at 33–36 weeks. GAD, gestational age at delivery

Mentions: CCA was found less frequently in twin placentas than singleton placentas of preterm birth (9.6% [22/230] vs 14.8% [131/886], p<.05) (Fig. 3A). Among preterm births, the decrease of CCA in twin placentas compared with singleton placentas was significant at 33–36 weeks of gestation (late preterm birth) (10.0% [12/120] vs 17.9% [90/503], p<.05). CCA in singleton placentas was most commonly observed at late preterm stage (33–36 weeks of gestation) during gestation as previously reported [8]; however, CCA in twin placentas was most frequent at 29–32 weeks unexpectedly (14.0% [6/43]) (Fig. 3B).


Chronic Placental Inflammation in Twin Pregnancies.

Bang H, Bae GE, Park HY, Kim YM, Choi SJ, Oh SY, Roh CR, Kim JS - J Pathol Transl Med (2015)

The frequency of chronic chorioamnionitis (CCA) in twin placentas according to the gestational age. (A) CCA is less frequent in twin placentas than singleton placentas at preterm birth (*p<.05). (B) CCA in twin placentas is decreased significantly compared with singleton placentas at 33–36 weeks of gestation (*p<.05). Twin placentas are affected by CCA most frequently at 29–32 weeks, in contrast to singleton placentas at 33–36 weeks. GAD, gestational age at delivery
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4696858&req=5

f3-jptm-2015-09-09: The frequency of chronic chorioamnionitis (CCA) in twin placentas according to the gestational age. (A) CCA is less frequent in twin placentas than singleton placentas at preterm birth (*p<.05). (B) CCA in twin placentas is decreased significantly compared with singleton placentas at 33–36 weeks of gestation (*p<.05). Twin placentas are affected by CCA most frequently at 29–32 weeks, in contrast to singleton placentas at 33–36 weeks. GAD, gestational age at delivery
Mentions: CCA was found less frequently in twin placentas than singleton placentas of preterm birth (9.6% [22/230] vs 14.8% [131/886], p<.05) (Fig. 3A). Among preterm births, the decrease of CCA in twin placentas compared with singleton placentas was significant at 33–36 weeks of gestation (late preterm birth) (10.0% [12/120] vs 17.9% [90/503], p<.05). CCA in singleton placentas was most commonly observed at late preterm stage (33–36 weeks of gestation) during gestation as previously reported [8]; however, CCA in twin placentas was most frequent at 29–32 weeks unexpectedly (14.0% [6/43]) (Fig. 3B).

Bottom Line: Chronic placental inflammation, such as villitis of unknown etiology (VUE) and chronic chorioamnionitis (CCA), is considered a placental manifestation of maternal anti-fetal rejection.Hematoxylin and eosin sections of tissue samples (full-thickness placental disc and chorioamniotic membranes) were reviewed.Separate dichorionic diamniotic twin placentas were affected by chronic deciduitis more frequently than singleton placentas (16.9% vs 9.7%, p<.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Background: Chronic placental inflammation, such as villitis of unknown etiology (VUE) and chronic chorioamnionitis (CCA), is considered a placental manifestation of maternal anti-fetal rejection. The aim of this study is to investigate its frequency in twin pregnancies compared to singleton pregnancies.

Methods: Three hundred twin placentas and 1,270 singleton placentas were consecutively collected at a tertiary medical center in Seoul, Republic of Korea from 2009 to 2012. Hematoxylin and eosin sections of tissue samples (full-thickness placental disc and chorioamniotic membranes) were reviewed.

Results: Non-basal VUE was more frequent in twin placentas than in singleton placentas (6.0% vs 3.2%, p < .05). In preterm birth, CCA was found less frequently in twin placentas than in singleton placentas (9.6% vs 14.8%, p < .05), reaching its peak at an earlier gestational age in twin placentas (29-32 weeks) than in singleton placentas (33-36 weeks). CCA was more frequent in twin pregnancies with babies of a different sex than with those with the same sex (13.8% vs 6.9%, p=.052). Separate dichorionic diamniotic twin placentas were affected by chronic deciduitis more frequently than singleton placentas (16.9% vs 9.7%, p<.05).

Conclusions: The higher frequency of non-basal VUE in twin placentas and of CCA in twin placentas with different fetal sex supports the hypothesis that the underlying pathophysiological mechanism is maternal anti-fetal rejection related to increased fetal antigens in twin pregnancies. The peak of CCA at an earlier gestational age in twin placentas than in singleton placentas suggests that CCA is influenced by placental maturation.

No MeSH data available.


Related in: MedlinePlus