T O Junaid1, P Brownbill2, N Chalmers3, E D Johnstone2, J D Aplin2. 1. Maternal and Fetal Health Research Centre, Institute of Human Development, Manchester Academic Health Science Centre, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, University of Manchester, Manchester M13 9WL, UK. Electronic address: toluwalope.junaid@postgrad.manchester.ac.uk. 2. Maternal and Fetal Health Research Centre, Institute of Human Development, Manchester Academic Health Science Centre, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, University of Manchester, Manchester M13 9WL, UK. 3. Department of Radiology, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK.
Abstract
INTRODUCTION: Placental functional impairment in pregnancies with fetal growth restriction (FGR) can arise from fetoplacental vascular abnormalities. We aimed to compare the micro and macrovasculature of placentas from normal pregnancies with those showing late onset FGR. METHODS: Placental arterial casts (n = 12 normal, 6 FGR) were prepared. Chorionic arterial number and inter-branch length were examined. Microvascular features were quantified in CD34-stained tissue sections obtained by systematic (n = 12 normal, 12 FGR) and targeted (n = 6 normal, 6 FGR) sampling from the placental periphery and centre. RESULTS: Adjusted for the weight of the placenta or the surface area of the chorionic plate, the number of chorionic arteries was similar in normal and FGR arterial casts. Inter-branch length per unit placental weight was greater in the first generation of arterial branches in FGR (p < 0.05). Villi in FGR placentas were more poorly vascularised, particularly at the periphery and in grossly visible hypovascular regions. Intermediate and terminal FGR villi in these areas exhibited reduced vessel lumens, loss of CD34, and infilling with CD34-negative cells of what appeared to be previously existing vascular spaces. CONCLUSION: Differences in chorionic arterial branching patterns between normal and FGR placentas arise from differences in placental size. FGR placentas show microvascular regression and extreme hypovascularity in peripheral areas. These features may well limit the ability of the placenta to meet fetal nutrient requirements late in gestation. Targeted sampling is more effective than systematic random sampling in revealing vascular defects.
INTRODUCTION: Placental functional impairment in pregnancies with fetal growth restriction (FGR) can arise from fetoplacental vascular abnormalities. We aimed to compare the micro and macrovasculature of placentas from normal pregnancies with those showing late onset FGR. METHODS: Placental arterial casts (n = 12 normal, 6 FGR) were prepared. Chorionic arterial number and inter-branch length were examined. Microvascular features were quantified in CD34-stained tissue sections obtained by systematic (n = 12 normal, 12 FGR) and targeted (n = 6 normal, 6 FGR) sampling from the placental periphery and centre. RESULTS: Adjusted for the weight of the placenta or the surface area of the chorionic plate, the number of chorionic arteries was similar in normal and FGR arterial casts. Inter-branch length per unit placental weight was greater in the first generation of arterial branches in FGR (p < 0.05). Villi in FGR placentas were more poorly vascularised, particularly at the periphery and in grossly visible hypovascular regions. Intermediate and terminal FGR villi in these areas exhibited reduced vessel lumens, loss of CD34, and infilling with CD34-negative cells of what appeared to be previously existing vascular spaces. CONCLUSION: Differences in chorionic arterial branching patterns between normal and FGR placentas arise from differences in placental size. FGR placentas show microvascular regression and extreme hypovascularity in peripheral areas. These features may well limit the ability of the placenta to meet fetal nutrient requirements late in gestation. Targeted sampling is more effective than systematic random sampling in revealing vascular defects.
Authors: Carolyn M Salafia; Ruchit G Shah; Dawn P Misra; Jennifer K Straughen; Drucilla J Roberts; Larry Troxler; Simon P Morgan; Barbara Eucker; John M Thorp Journal: Placenta Date: 2017-08-30 Impact factor: 3.481
Authors: Sarah Jones; Helen Bischof; Ingrid Lang; Gernot Desoye; Sue L Greenwood; Edward D Johnstone; Mark Wareing; Colin P Sibley; Paul Brownbill Journal: J Physiol Date: 2015-06-08 Impact factor: 5.182
Authors: Lucy E Higgins; Nicolas Rey de Castro; Naa Addo; Mark Wareing; Susan L Greenwood; Rebecca L Jones; Colin P Sibley; Edward D Johnstone; Alexander E P Heazell Journal: PLoS One Date: 2015-06-29 Impact factor: 3.240
Authors: Samantha C Lean; Alexander E P Heazell; Mark R Dilworth; Tracey A Mills; Rebecca L Jones Journal: Sci Rep Date: 2017-08-29 Impact factor: 4.379
Authors: Natalie Cureton; Iana Korotkova; Bernadette Baker; Susan Greenwood; Mark Wareing; Venkata R Kotamraju; Tambet Teesalu; Francesco Cellesi; Nicola Tirelli; Erkki Ruoslahti; John D Aplin; Lynda K Harris Journal: Theranostics Date: 2017-08-29 Impact factor: 11.556
Authors: Jayne C Charnock; Mark R Dilworth; John D Aplin; Colin P Sibley; Melissa Westwood; Ian P Crocker Journal: Am J Physiol Endocrinol Metab Date: 2015-11-03 Impact factor: 4.310