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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 placental inflammation in spontaneous preterm birth and indicated preterm birth. (A) Villitis of unknown etiology (VUE) is more frequent in indicated preterm birth than in spontaneous birth of singleton placentas (*p<.05). (B) Non-basal VUE is detected more frequently in indicated preterm birth than in spontaneous birth of singleton placentas as well as twin placentas (*p<.05). (C, D) The frequencies of chronic chorioamnionitis (C) and chronic deciduitis (D) are not different between spontaneous and indicated preterm birth.
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f6-jptm-2015-09-09: The frequency of chronic placental inflammation in spontaneous preterm birth and indicated preterm birth. (A) Villitis of unknown etiology (VUE) is more frequent in indicated preterm birth than in spontaneous birth of singleton placentas (*p<.05). (B) Non-basal VUE is detected more frequently in indicated preterm birth than in spontaneous birth of singleton placentas as well as twin placentas (*p<.05). (C, D) The frequencies of chronic chorioamnionitis (C) and chronic deciduitis (D) are not different between spontaneous and indicated preterm birth.

Mentions: VUE was more frequent in indicated preterm birth than in spontaneous birth of singleton placentas (10.2% [24/235] vs 6.3% [41/651], p<.05) (Fig. 6A). Non-basal VUE was more frequent in indicated preterm birth than in spontaneous birth of both singleton and twin placentas (singleton, 5.5% [13/235] vs 2.2% [14/651]; twin, 9.1% [5/55] vs 2.3% [4/175], p<.05) (Fig. 6B). When the frequencies of chronic placental inflammation were compared after preterm cases were divided into spontaneous and indicated preterm birth groups, none of the chronic inflammation conditions showed any statistically significant differences between singleton and twin placentas (Fig. 6A–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)

The frequency of chronic placental inflammation in spontaneous preterm birth and indicated preterm birth. (A) Villitis of unknown etiology (VUE) is more frequent in indicated preterm birth than in spontaneous birth of singleton placentas (*p<.05). (B) Non-basal VUE is detected more frequently in indicated preterm birth than in spontaneous birth of singleton placentas as well as twin placentas (*p<.05). (C, D) The frequencies of chronic chorioamnionitis (C) and chronic deciduitis (D) are not different between spontaneous and indicated preterm birth.
© Copyright Policy
Related In: Results  -  Collection

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

f6-jptm-2015-09-09: The frequency of chronic placental inflammation in spontaneous preterm birth and indicated preterm birth. (A) Villitis of unknown etiology (VUE) is more frequent in indicated preterm birth than in spontaneous birth of singleton placentas (*p<.05). (B) Non-basal VUE is detected more frequently in indicated preterm birth than in spontaneous birth of singleton placentas as well as twin placentas (*p<.05). (C, D) The frequencies of chronic chorioamnionitis (C) and chronic deciduitis (D) are not different between spontaneous and indicated preterm birth.
Mentions: VUE was more frequent in indicated preterm birth than in spontaneous birth of singleton placentas (10.2% [24/235] vs 6.3% [41/651], p<.05) (Fig. 6A). Non-basal VUE was more frequent in indicated preterm birth than in spontaneous birth of both singleton and twin placentas (singleton, 5.5% [13/235] vs 2.2% [14/651]; twin, 9.1% [5/55] vs 2.3% [4/175], p<.05) (Fig. 6B). When the frequencies of chronic placental inflammation were compared after preterm cases were divided into spontaneous and indicated preterm birth groups, none of the chronic inflammation conditions showed any statistically significant differences between singleton and twin placentas (Fig. 6A–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