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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

Association of villitis of unknown etiology (VUE) with intrauterine growth restriction (IUGR). (A) VUE is found more frequently in singleton placentas of IUGR cases than in those of non-IUGR cases (***p<.001). (B) Non-basal VUE in singleton and twin placentas is more frequent in IUGR cases than in non-IUGR cases (singleton, ***p<.001; twin, *p<.05). (C, D) The frequencies of chronic chorioamnionitis (C) and chronic deciduitis (D) are not associated with IUGR.
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f5-jptm-2015-09-09: Association of villitis of unknown etiology (VUE) with intrauterine growth restriction (IUGR). (A) VUE is found more frequently in singleton placentas of IUGR cases than in those of non-IUGR cases (***p<.001). (B) Non-basal VUE in singleton and twin placentas is more frequent in IUGR cases than in non-IUGR cases (singleton, ***p<.001; twin, *p<.05). (C, D) The frequencies of chronic chorioamnionitis (C) and chronic deciduitis (D) are not associated with IUGR.

Mentions: VUE in singleton placentas was found more frequently in IUGR cases than in non-IUGR cases (12.9% [36/278] vs 6.5% [64/985], p<.001). Of these cases, non-basal VUE was more frequent in IUGR cases than in non-IUGR cases (7.6% [21/278] vs 2.0% [20/985]), p<.001). Non-basal VUE in twin placentas was more frequent in IUGR cases than in non-IUGR cases (9.8% [12/122] vs 3.4% [6/175], p<.05), though VUE showed no significant correlation with IUGR in twin placentas (13.1% [16/122] vs 10.3% [18/175]) (Fig. 5A, B). Neither CCA nor CD correlated with IUGR in this study (Fig. 5C, D).


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)

Association of villitis of unknown etiology (VUE) with intrauterine growth restriction (IUGR). (A) VUE is found more frequently in singleton placentas of IUGR cases than in those of non-IUGR cases (***p<.001). (B) Non-basal VUE in singleton and twin placentas is more frequent in IUGR cases than in non-IUGR cases (singleton, ***p<.001; twin, *p<.05). (C, D) The frequencies of chronic chorioamnionitis (C) and chronic deciduitis (D) are not associated with IUGR.
© Copyright Policy
Related In: Results  -  Collection

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

f5-jptm-2015-09-09: Association of villitis of unknown etiology (VUE) with intrauterine growth restriction (IUGR). (A) VUE is found more frequently in singleton placentas of IUGR cases than in those of non-IUGR cases (***p<.001). (B) Non-basal VUE in singleton and twin placentas is more frequent in IUGR cases than in non-IUGR cases (singleton, ***p<.001; twin, *p<.05). (C, D) The frequencies of chronic chorioamnionitis (C) and chronic deciduitis (D) are not associated with IUGR.
Mentions: VUE in singleton placentas was found more frequently in IUGR cases than in non-IUGR cases (12.9% [36/278] vs 6.5% [64/985], p<.001). Of these cases, non-basal VUE was more frequent in IUGR cases than in non-IUGR cases (7.6% [21/278] vs 2.0% [20/985]), p<.001). Non-basal VUE in twin placentas was more frequent in IUGR cases than in non-IUGR cases (9.8% [12/122] vs 3.4% [6/175], p<.05), though VUE showed no significant correlation with IUGR in twin placentas (13.1% [16/122] vs 10.3% [18/175]) (Fig. 5A, B). Neither CCA nor CD correlated with IUGR in this study (Fig. 5C, D).

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