Objective:
To investigate the pathological changes of
placenta in
pregnant women with
aortic dissection/
aneurysm and their relationship with clinical features.
Methods:
The placental samples of 14
pregnant women with
aortic dissection/
aneurysm diagnosed from January 2012 to October 2021 and 10 normal placental samples of
pregnant women from January 2021 to December 2021 at
Beijing Anzhen
Hospital Affiliated to
Capital Medical
University,
Beijing,
China were selected. Routine H&E
staining and
immunohistochemistry were used to analyze the histological features under
light microscope. The clinical data were also analyzed.
Results:
The age of 14 pregnant
patients with
aortic dissection/
aneurysm for placental examination ranged from 22 to 38 years (median, 28 years). The
gestational ages ranged from 22 to 39 weeks (median, 34 weeks). The
pregnancy of
second trimester was noted in 2 cases, and the
third trimester in 12 cases. All cases were singleton
pregnancy. Seven cases were Stanford type A
aortic dissection, 6 cases were Stanford type B
aortic dissection, and one case was
aortic root aneurysm. Four of the
pregnant women underwent
aortic dissection surgery after
caesarean section, three underwent
caesarean section after
aortic dissection surgery, and seven underwent both
caesarean section and
aortic dissection procedures. Among the
newborns, 2 cases were full-
term birth, and 12 cases were
premature birth. Twelve cases had alive
newborns, and 2 cases
stillbirths. Fetal/placental weight ratio (FPR)<10th percentile was in 5 cases and FPR>90th percentile in one case. Compared with the normal group, accelerated villus maturation and distal villus dysplasia were more frequently found in
pregnancy with
aortic dissection group (P<0.05). There was no significant difference in villi
infarction and
decidua vascular lesions between the two groups (P>0.05), nor was there correlation between the type of
aortic dissection and distal villus dysplasia and accelerated villus maturation of
placentas (P>0.05). The number of villous interstitial
blood vessels in the
placentas of
pregnancy with
aortic dissection group was significantly fewer than that in the normal
control group (P<0.01).
Conclusions:
There are considerable pathological changes in the
placentas of
pregnant women with
aortic dissection/
aneurysm. The main histological features are accelerated villus maturation and distal villus dysplasia, which are manifestations of villous
ischemia and
hypoxia, and also a part of the placental pathological manifestations of maternal vascular dysperfusion.
