Am J Perinatol 2020; 37(12): 1217-1222
DOI: 10.1055/s-0039-1692716
Original Article

Placental Findings in Postpartum Preeclampsia: A Comparative Retrospective Study

1  Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, Texas
2  Departments of Internal Medicine Specialties and Gynecology and Obstetrics, University of Geneva, Switzerland
,
Baha Sibai
1  Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, Texas
,
Nina Tatevian
3  Department of Pathology and Laboratory Medicine, The University of Texas Medical School at Houston, Houston, Texas
› Author Affiliations
Funding A.D. received a grant from the Swiss National Science Foundation.

Abstract

Objective Preeclampsia is a multifactorial placental disease that can occur after delivery. The pathophysiology of postpartum preeclampsia remains unknown. The objective was to describe placental findings in postpartum preeclampsia.

Study Design This is a case–control study, comparing the placental histologic findings in four groups of 30 patients with postpartum preeclampsia, early-onset preeclampsia, late-onset preeclampsia, and normotensive controls.

Results Placentas of postpartum preeclampsia had a mean placental weight not different from that of late-onset preeclampsia at a similar gestational age (479.0 ± 152.7 vs. 521.3 ± 144.1 g, p = 0.07); they showed a higher rate of acute deciduitis of 42.4% than early preeclampsia (5.7%, p < 0.01) or in controls (3.2%, p < 0.01); 18.2% had decidual arteriolopathy, with no significant difference with other groups. These placentas had fewer villous infarcts as compared with early preeclampsia (9.1 vs. 62.9%, p < 0.01) and less accelerated maturation of villi (24.2 vs. 74.3%, p < 0.01).

Conclusion There were no significant differences for decidual arteriolopathy and villous infarcts among postpartum preeclampsia, late-onset preeclampsia, and the controls. This suggests that postpartum preeclampsia is more of a maternal disease in which the placenta may act as a priming effect in predisposed mothers and becomes clinically apparent after delivery.

Note

This work has been presented to the fall meeting of the Society for Pediatric Pathology 2016, Honolulu, Hawaii.


Supplementary Material



Publication History

Received: 19 December 2018

Accepted: 14 May 2019

Publication Date:
02 July 2019 (online)

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